An Outbreak Due to Serratia marcescens in a Neonatal Intensive Care Unit Typed by 2-Day Pulsed Field Gel Electrophoresis Protocol

Novales, María Guadalupe Miranda; Leaños-Miranda, Blanca; Díaz-Ramos, Rita Delia; González-Tejeda, Lourdes; Peregrino-Bejarano, Leoncio; Villegas-Silva, Raúl; Solórzano-Santos, Fortino

doi:10.1016/s0188-4409(03)00026-2

Cited by 12 publications

(12 citation statements)

References 15 publications

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“…From these pediatric nosocomial infection studies, many environmental sources or point sources have been found as reservoirs for S. marcescens, including hands of health care workers and exposure to health care workers (14,156,198,249,267,362,393,396,423), contaminated breast milk, formula, and breast pumps (133,156,204,274,393), contaminated parenteral nutrition (18), an infected neonate as the index patient or colonization of hospitalized infants (28,63,100,148,238,269,270,275,338,362,400), equipment such as incubators (28,198), laryngoscopes (95,204), suction tubes, soap dispensers (52), and waste jars (393), air conditioning ducts (387), contaminated hand brushes (7), contaminated disinfectants and soap (14,52,76,258,313,396), cotton wool pads (137), multidose nebulizer dropper bottles (215), and multidose medications (133).…”

Section: S Marcescensmentioning

confidence: 99%

“…As in outbreaks that have occurred in adults, genotyping methods have been used in many pediatric outbreaks to type the involved S. marcescens strains, including sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis of disrupted S. marcescens cells (116), plasmid profiling (18,41,157,258), PFGE (52,190,228,239,269,270,309,313,338,341,366,396), ribotyping (150), rep-PCR (239, 393), RAPD-PCR (18), and PCR fingerprinting (366). Voelz and others performed a systematic analysis of several pediatric S. marcescens outbreak studies from 1984 to 2010 that utilized typing procedures to determine clonality.…”

Section: S Marcescensmentioning

confidence: 99%

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Serratia Infections: from Military Experiments to Current Practice

2011

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SUMMARY Serratia species, in particular Serratia marcescens , are significant human pathogens. S. marcescens has a long and interesting taxonomic, medical experimentation, military experimentation, and human clinical infection history. The organisms in this genus, particularly S. marcescens , were long thought to be nonpathogenic. Because S. marcescens was thought to be a nonpathogen and is usually red pigmented, the U.S. military conducted experiments that attempted to ascertain the spread of this organism released over large areas. In the process, members of both the public and the military were exposed to S. marcescens , and this was uncovered by the press in the 1970s, leading to U.S. congressional hearings. S. marcescens was found to be a certain human pathogen by the mid-1960s. S. marcescens and S. liquefaciens have been isolated as causative agents of numerous outbreaks and opportunistic infections, and the association of these organisms with point sources such as medical devices and various solutions given to hospitalized patients is striking. Serratia species appear to be common environmental organisms, and this helps to explain the large number of nosocomial infections due to these bacteria. Since many nosocomial infections are caused by multiply antibiotic-resistant strains of S. marcescens , this increases the danger to hospitalized patients, and hospital personnel should be vigilant in preventing nosocomial outbreaks due to this organism. S. marcescens , and probably other species in the genus, carries several antibiotic resistance determinants and is also capable of acquiring resistance genes. S. marcescens and S. liquefaciens are usually identified well in the clinical laboratory, but the other species are rare enough that laboratory technologists may not recognize them. 16S rRNA gene sequencing may enable better identification of some of the less common Serratia species.

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Section: S Marcescensmentioning

confidence: 99%

Section: S Marcescensmentioning

confidence: 99%

Serratia Infections: from Military Experiments to Current Practice

2011

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“…Recently, nosocomial outbreaks preferably in neonatal units have increased [56,57]. The hemolytic activity was biochemically characterised and described as hemolysin ShlA in the section before.…”

Section: Pathogenicity Of the Serratia Type Pore Forming Toxin Familymentioning

confidence: 99%

The Family of Serratia Type Pore Forming Toxins

Hertle

2005

CPPS

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The Serratia marcescens hemolysin represents the prototype of a growing family of pore forming toxins. The available bacterial genome sequences reveal Serratia hemolysin homologues in additional species. However, only S. marcescens hemolysin has been studied in great molecular detail. This family of toxins has nothing in common with the pore forming toxins of E. coli type (RTX toxins), the Staphylococcus aureus alpha-toxin or the thiol activated toxin of group A beta-hemolytic streptococci (Streptolysin O). Studies on erythrocytes, eukaryotic cells and artificial black lipid membranes, have shown that the mechanism of pore formation of ShlA is different form other pore forming toxins. The S. marcescens hemolysin proteins ShlB and ShlA, exhibit protein sequence homologues in Proteus mirabilis, Haemophilus ducreyi, Yersinia pestis, Yersinia enterocolitica, Edwardsiella tarda, Photorhabdus luminescens and Xylella fastidiosa . The family of Serratia type pore forming toxins show a unique secretory mechanism which has been described as a two partner secretion system (TPSS) or type V-secretion system. Not only Serratia type pore forming toxins are secreted via TPSS but also adhesins from Bordetella pertussis, Erwinia chrysanthemi and Haemophilus influenzae. The uniqueness of the Serratia family is underlined by the fact that activation of ShlA by ShlB strictly requires phosphatidylethanolamine as a cofactor. And, quite unusual, ShlA undergoes a conformational change during activation.

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“…4,6 In recent years, both S. marcescens and K. pneumoniae have frequently been reported as the cause of outbreaks involving newborn infants in neonatal intensive care units (NICUs). [7][8][9][10][11][12][13] Risk factors for acquisition of nosocomial infections in NICUs are low gestational age, low birth weight, presence of underlying diseases, lengthy hospitalization, and need for intensive care (e.g. parenteral nutrition, oxygen therapy, mechanical ventilation, catheterization).…”

Section: Introductionmentioning

confidence: 99%

“…contaminated medical devices, 18 contaminated milk, 15 intravenous and topical solutions, [19][20][21] liquid soap, 22,23 air conditioning 24 ), although epidemiological investigation often fails to reveal a common source for the outbreak. 13,25,26 However, colonized and infected infants are the most frequent reservoir of micro-organisms and are potential sources of horizontal transmission through handling by healthcare personnel. [27][28][29][30] The study of epidemiological markers of isolated strains is an important tool in the search for the source of contamination and to attempt to prevent patient-to-patient dissemination of infection.…”

Section: Introductionmentioning

confidence: 99%