Antimicrobial Treatment of Serratia marcescens Invasive Infections: Systematic Review

Abstract

Background: Serratia marcescens (SM) is a Gram-negative pathogen discovered by Italian pharmacist, Bizio, in 1819. According to the literature, S. marcescens is resistant to a wide range of antibiotics, including penicillin, cephalosporin, tetracycline, macrolide, nitrofurantoin, and colistin. We conducted a systematic review of published reports, determined what invasive infections could cause SM, and established the most appropriate antibiotic therapy. Methods: We registered this systematic review on the PROSPERO registry of systematic reviews–meta-analyses before we started our research (registration number CRD42022323159). The online searches of published studies were implemented via MEDLINE, the Cochrane Central Register of Controlled Trials, EBSCO, Scopus, Google Scholar, SCIndex, and the registry of clinical studies of human participants (ClinicalTrials.gov). Results: Our study included 32 published articles (9 case series and 23 case reports). There were 57 individual cases, respectively. The oldest patient was 97 years and the youngest patient was a newborn. S. marcescens was, in most cases, isolated from blood followed by urine and cerebrospinal fluid. In most cases, sensitivity was tested to cotrimoxazole (from 27 isolates, 10 showed resistance) followed by gentamicin (from 26 isolates, 3 showed resistance) as well as amikacin (from 21 isolates, none showed resistance). Patients died from an infection in 21 cases (31%). Conclusions: Treatment of SM infections should include carbapenems or aminoglycosides in combination with third-generation (and eventually fourth-generation) cephalosporin. Cotrimoxazole should be considered in cases of uncomplicated urinary infections.

Cutaneous Serratia marcescens infection in two dogs

“…In this report, S. marcescens identified in both cases showed susceptibility with carbapenem (imipenem), third‐generation cephalosporins (cefotaxime and cefovecin), aminoglycosides (tobramycin and amikacin) and TS. On the other hand, S. marcescens , which is reportedly resistant to amoxicillin/clavulanic acid, ampicillin and cephalothin in humans (Seo et al., 2016; Zaric et al., 2023), was also resistant to them in these two canine cases.…”

“…In humans, S. marcescens usually causes opportunistic and nosocomial infections, particularly in immunocompromised patients (Zaric et al., 2023). However, a previous report suggests that cutaneous S. marcescens infection should be considered even in healthy patients.…”

“…Serratia marcescens , a Gram‐negative bacillus of the Enterobacteriaceae family, is a saprophytic water organism widely distributed in the environment (Zaric et al., 2023). In humans, it causes opportunistic and nosocomial infections in critically ill or immunocompromised patients (Zaric et al., 2023).…”

“…Serratia marcescens , a Gram‐negative bacillus of the Enterobacteriaceae family, is a saprophytic water organism widely distributed in the environment (Zaric et al., 2023). In humans, it causes opportunistic and nosocomial infections in critically ill or immunocompromised patients (Zaric et al., 2023). Cutaneous infections due to S. marcescens are rarely reported in humans and are characterised by cellulitis, hidradenitis and necrotising fasciitis (Bachmeyer et al., 2004; Combemale et al., 2000; Pithadia et al., 2019).…”

Antimicrobial treatment in invasive infections caused by Gordonia bronchialis: systematic review

“…The following bases of bias were evaluated: (1) reporting bias and (2) attrition bias. Reporting bias is related to the adequacy of the displayed data in terms of detail, and attrition bias is important for whether we finally tracked down what happened to the patient ( 9 ).…”