Extended Epidemic of Nosocomial Urinary Tract Infections Caused by
            <i>Serratia marcescens</i>

Su, Lin‐Hui; Ou, Jonathan T.; Leu, Hsieh-Shong; Chiang, Ping-Cherng; Chiu, Yueh-Pi; Chia, Ju‐Hsin; Kuo, An-Jing; Chiu, Cheng-Hsun; Chu, Chishih; Wu, Tsu‐Lan; Sun, Chien‐Feng; Riley, Thomas V.; Chang, Barbara J.

doi:10.1128/jcm.41.10.4726-4732.2003

Cited by 73 publications

(64 citation statements)

References 30 publications

(35 reference statements)

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“…In the 1960s and 1970s, serological typing was the primary method used to determine strain relatedness, in addition to phenotypic characteristics and antibiogram similarity. PFGE has been used in many investigations and is a very reliable typing method for Serratia outbreaks (26,77,83,113,181,183,201,211,246,289,304,349,369,374,382,391,395). Enzyme electrophoresis was used to study isolates in at least one study (155).…”

Section: S Marcescensmentioning

confidence: 99%

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%

Serratia Infections: from Military Experiments to Current Practice

2011

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“…The Serratia species of most concern, S. marcescens, is a human pathogen responsible for a large percentage of nosocomial infections involving the urinary tract, respiratory tract, wound infections, and bacteremia (1, 5, 7). Today, S. marcescens has attracted great attention due to its increasing number of cases, its virulence (7,15), and its emerging resistance to antibiotics (13). However, in the genome database, only seven S. marcescens strains had been sequenced for the whole genome until now.…”

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confidence: 99%

Draft Genome Sequence of Serratia marcescens Strain LCT-SM213

et al. 2012

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“…The majority of those studies evaluated outbreaks that lasted for up to several months in one or two centers (5,21,26,31,33). In a recent report by Su et al (39), PFGE and PCR-based methods were used to study an outbreak of urinary tract infection that lasted several years and that was caused by two predominant S. marcescens strains. Together, all these studies have demonstrated that the complex epidemiology of S. marcescens strongly contributes to the present view of S. marcescens as a dangerous nosocomial pathogen.…”

Section: Discussionmentioning

confidence: 99%

“…Many investigators have addressed the epidemiology of S. marcescens infections; but although some cases of multicenter epidemics have been described (11,31,37), most of the reports concerned situations in a single hospital or a single ward (17,26,33,36,39,41). Different phenomena were documented in those works, including clonal outbreaks, the persistence of strains over prolonged periods, and recurrent outbreaks (11,26,31,32,33,41).…”

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Molecular Epidemiology of Serratia marcescens in Two Hospitals in Danzig, Poland, over a 5-Year Period

et al. 2004

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The history of the Serratia marcescens population in two hospitals in Danzig, Poland, over a 5-year period was analyzed in a study that combined MIC evaluation, typing by randomly amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis, and analysis of extended-spectrum ␤-lactamases (ESBLs). We analyzed 354 isolates collected from 341 patients in two teaching hospitals in Danzig, Poland, from 1996 to 2000. The antimicrobial susceptibility profiles varied greatly, and for resistance to newer ␤-lactams, probable AmpC cephalosporinase derepression and ESBL production occurred in about 23 and 19% of the isolates, respectively. RAPD typing, by which 69 types were discerned altogether, revealed a high degree of clonal diversity among the populations. However, the four most prevalent types were highly predominant, grouping approximately 71% of the isolates studied. These clones were observed in the two hospitals and were strong contributors to both outbreaks and the background of endemicity of the S. marcescens infections. Some of the strains that were not so widely spread (12 RAPD types; ϳ14% of the isolates) were responsible for several smaller outbreaks, and the remaining isolates represented unique RAPD types (53 types; ϳ15% of the isolates) and were probably sporadic introductions from other environments. ESBLs were identified in several different clones, and some of these had most likely already been introduced into the hospitals as ESBL producers, whereas the others acquired the ESBL-encoding genes from other enterobacterial strains in these environments. The CTX-M-3 enzyme, which is widely observed in Poland, was the most common ESBL type among the S. marcescens isolates, followed by TEM-47 and SHV-5. The complex epidemiology of ESBLs, especially in 1999 and 2000, must have arisen from the introduction of ESBL producers from other centers, their clonal dissemination, and the constant penetration of the S. marcescens populations with plasmids with ESBL genes. Multiple S. marcescens isolates were obtained from 11 patients, who probably represented both patients with recolonizations and reinfections and patients with recurrences of infections with the evolution of the strain's susceptibility.Serratia marcescens has been reported to be a significant agent of hospital infections since the 1950s. Because it is an opportunistic pathogen, it mainly affects patients in neonatal and surgical units and patients in intensive care units (ICUs). It is also responsible for various types of infections, including pneumonia, sepsis, meningitis, and fasciitis (1, 45). Treatment of these infections is often very difficult, which to a big extent is due to the widespread natural and acquired resistance of the organism to antimicrobials. S. marcescens strains with combined resistance to expanded-spectrum ␤-lactams, aminoglycosides, fluoroquinolones, and/or co-trimoxazole have been identified in numerous hospitals worldwide (1,20,23,35). As in other enterobacteria, resistance to newer ␤-lactams is usually ␤-lact...

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Extended Epidemic of Nosocomial Urinary Tract Infections Caused by Serratia marcescens

Abstract: In recent years a significant increase in the incidence of Serratia marcescens infections was noted at the Chang Gung Memorial Hospital, Taoyuan

Cited by 73 publications

References 30 publications

Serratia Infections: from Military Experiments to Current Practice

Serratia Infections: from Military Experiments to Current Practice

Draft Genome Sequence of Serratia marcescens Strain LCT-SM213

Molecular Epidemiology of Serratia marcescens in Two Hospitals in Danzig, Poland, over a 5-Year Period

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