Clustering of <i>Serratia marcescens</i> Infections in a Neonatal Intensive Care Unit

Sarvikivi, Emmi; Lyytikäinen, Outi; Salmenlinna, Saara; Vuopio‐Varkila, Jaana; Luukkainen, Päivi; Tarkka, Eveliina; Saxén, Harri

doi:10.1086/502467

Cited by 38 publications

(29 citation statements)

References 30 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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“…Some months after the outbreak, two new NI (18 and 19 samples, Figure 1) were observed, but they were controlled. Future outbreak control measures should concentrate on the intensity of colonization, not only of the neonates, but also of the mothers and HWCs 1,14,15 . The antibiotic use and prophylaxis in mothers should be evaluated on a case-by-case basis, thus limiting the potential for broad-spectrum antibiotics to select multiresistant Gram-negative bacteria.…”

Section: Resultsmentioning

confidence: 99%

Outbreak of neonatal infection by an endemic clone of Serratia marcescens

Lima

Carvalho

Carneiro

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: The outbreak occurred between February and June 2006 and included identification of the cases, analysis of medical records, cultures from environmental sources, resistance analyses and genotyping profile of Serratia marcescens. Methods: The cultures were composed of 13 blood isolates, 17 rectal and hand swabs and air sampling. Results: The data obtained by pulsed-field gel electrophoresis exhibited three strains that contaminated 24 patients. Systemic infection was the most common in neonates with lower weight, long periods of hospitalization, premature delivery and the use of mechanical ventilation. Conclusions: This investigation revealed the multifactorial nature of the outbreak. An endemic clone of S. marcescens was detected.

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“…In addition to transmission via the hands of staff, 24,[26][27][28][29] pathogens may also spread from inanimate point sources. An increased role for environmental sources has indeed been documented for S marcescens and P aeruginosa, as compared with other pathogens.…”

Section: Discussionmentioning

confidence: 99%