Abstract
Early prenatal screening at 26 + 6 weeks detected Citrobacter koseri vaginal colonization in an asymptomatic high-risk gravida. Culture-guided IV ceftazidime (susceptible per CLSI testing) eradicated the pathogen without maternal/fetal compromise. Multidisciplinary management prevented vertical transmission, neonatal CNS complications, and yielded a healthy term delivery (Apgar 9/10). Emphasizes susceptibility-directed antimicrobial stewardship for optimal outcomes in rare pregnancy infections.