Fatal Serratia marcescens meningitis and myocarditis in a patient with an indwelling urinary catheter.

Johnson, Jotham; Croall, J.; Power, J. S. F.; Armstrong, G. R.

doi:10.1136/jcp.51.10.789

Cited by 19 publications

(8 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,4,7,[12][13][14][15]25 Our experience with the case presented in this report further substantiates this view. Despite documented sensitivity to both imipenem and gentamicin, S. marcescens persisted in our patient's CSF.…”

Section: Discussionsupporting

confidence: 93%

Spontaneous bacterial peritonitis causing Serratia marcescens and Proteus mirabilis ventriculoperitoneal shunt infection

Tumialán

Lin

2006

JNS

View full text Add to dashboard Cite

The authors report their experience treating a polymicrobial ventriculoperitoneal (VP) shunt infection in a developmentally delayed 21-year-old woman. Cerebrospinal fluid (CSF) cultures grew Serratia marcescens and Proteus mirabilis. On admission and throughout her hospitalization, results of physical examination of her abdomen were normal, and radiographic studies showed no evidence of bowel perforation or pseudocyst formation. Contrast-enhanced computed tomography of the abdomen revealed a small fluid collection. After a course of intravenous gentamicin and imipenem with cilastatin in conjunction with intrathecal gentamicin, the infection was resolved and the VP shunt was reimplanted. Although VP shunt infections are not uncommon, S. marcescens as a causative agent is exceedingly rare and potentially devastating. Only two previous cases of S. marcescens shunt infection have been reported in the literature. Authors reporting on S. marcescens infections in the central nervous system (CNS) have observed significant morbidity and death. Although more common, the presence of P. mirabilis in the CSF is still rare and highly suggestive of bowel perforation, which was absent in this patient. Spontaneous bacterial peritonitis was the likely source from which these bacteria gained entrance into the VP shunt system, eventually causing ventriculitis in this patient. The authors conclude that in light of the high morbidity associated with S. marcescens infection of the CNS, intrathecal administration of gentamicin should be strongly considered as part of first-line therapy for S. marcescens infections in VP shunts.

show abstract

Section: Discussionsupporting

confidence: 93%

Spontaneous bacterial peritonitis causing Serratia marcescens and Proteus mirabilis ventriculoperitoneal shunt infection

Tumialán

Lin

2006

JNS

View full text Add to dashboard Cite

show abstract

“…For panel B, each circle indicates one animal, bar indicates median value. Individual groups were compared using Dunn's multiple-comparison posttest: ***, P Ͻ 0.001; **, P Ͻ 0.01; *, P Ͻ 0.05. derly people, or those with chronic granulomatous disease, are at serious risk for complications such as meningitis, myocarditis, osteomyelitis, pneumonia, and death from S. marcescens lung infections (16,(43)(44)(45). In support of a protective role for neutrophils, we observed high numbers of infiltrating neutrophils early after infection, and neutropenic mice were highly susceptible to otherwise nonfatal infection.…”

Section: Discussionmentioning

confidence: 66%

Requirement for Serratia marcescens Cytolysin in a Murine Model of Hemorrhagic Pneumonia

Mares¹,

Medina²,

Cantwell³

et al. 2015

Infect Immun

View full text Add to dashboard Cite

Serratia marcescens, a member of the carbapenem-resistant Enterobacteriaceae, is an important emerging pathogen that causes a wide variety of nosocomial infections, spreads rapidly within hospitals, and has a systemic mortality rate of <41%. Despite multiple clinical descriptions of S. marcescens nosocomial pneumonia, little is known regarding the mechanisms of bacterial pathogenesis and the host immune response. To address this gap, we developed an oropharyngeal aspiration model of lethal and sublethal S. marcescens pneumonia in BALB/c mice and extensively characterized the latter. Lethal challenge (>4.0 ؋ 10 6 CFU) was characterized by fulminate hemorrhagic pneumonia with rapid loss of lung function and death. Mice challenged with a sublethal dose (<2.0 ؋ 10 6 CFU) rapidly lost weight, had diminished lung compliance, experienced lung hemorrhage, and responded to the infection with extensive neutrophil infiltration and histopathological changes in tissue architecture. Neutrophil extracellular trap formation and the expression of inflammatory cytokines occurred early after infection. Mice depleted of neutrophils were exquisitely susceptible to an otherwise nonlethal inoculum, thereby demonstrating the requirement for neutrophils in host protection. Mutation of the genes encoding the cytolysin ShlA and its transporter ShlB resulted in attenuated S. marcescens strains that failed to cause profound weight loss, extended illness, hemorrhage, and prolonged lung pathology in mice. This study describes a model of S. marcescens pneumonia that mimics known clinical features of human illness, identifies neutrophils and the toxin ShlA as a key factors important for defense and infection, respectively, and provides a solid foundation for future studies of novel therapeutics for this important opportunistic pathogen. Serratia marcescens is a facultative anaerobic, rod-shaped, Gram-negative bacterium that is ubiquitous in water, in soil, and on plant surfaces. S. marcescens is also an antibiotic-resistant opportunistic pathogen and is among the top 10 causative agents of bloodstream bacterial infections in North America, with a mortality rate of 41% (1-3). In newborns and immunocompromised and intensive care patients, S. marcescens can cause severe infections such as pneumonia (4), bloodstream infections (5), and urinary tract infections, surgical site infections, and ocular infections (6). S. marcescens infections are most often associated with the hospital environment (5), but community-acquired infections are now increasingly diagnosed (7).S. marcescens has acquired notoriety in the last 20 years because of its resistance to multiple antibiotics (7,8). An 8-year surveillance study in Taiwan identified multiple S. marcescens strains that were resistant to the antibiotics ciprofloxacin and levofloxacin (9). Multiple studies have revealed an alarming increase in S. marcescens resistance to carbapenem and other ␤-lactam antibiotics (8, 10, 11). As such, S. marcescens is considered a member of the carbapenem-resistant Enterobac...

show abstract

“…8 However, it is a rare pathogen of central nervous system (CNS) infections. There were only case reports in patients with a history of head trauma, neurosurgical procedures, mastoiditis or chronic sinusitis.…”

Section: Introductionmentioning

confidence: 99%

Serratia marcescens meningitis: Epidemiology, prognostic factors and treatment outcomes

Hsu

Yang

et al. 2013

Journal of Microbiology, Immunology and Infection

View full text Add to dashboard Cite

show abstract

Fatal Serratia marcescens meningitis and myocarditis in a patient with an indwelling urinary catheter.

Cited by 19 publications

References 4 publications

Spontaneous bacterial peritonitis causing Serratia marcescens and Proteus mirabilis ventriculoperitoneal shunt infection

Spontaneous bacterial peritonitis causing Serratia marcescens and Proteus mirabilis ventriculoperitoneal shunt infection

Requirement for Serratia marcescens Cytolysin in a Murine Model of Hemorrhagic Pneumonia

Serratia marcescens meningitis: Epidemiology, prognostic factors and treatment outcomes

Contact Info

Product

Resources

About