<i>Serratia liquefaciens</i>Bloodstream Infections from Contamination of Epoetin Alfa at a Hemodialysis Center

Grohskopf, Lisa A.; Roth, Virginia; Feikin, Daniel R.; Arduino, Matthew J.; Carson, Loretta A.; Tokars, Jerome I.; Holt, Stacey C.; Jensen, Bette; Hoffman, Richard E.; Jarvis, William R.

doi:10.1056/nejm200105173442001

Cited by 130 publications

(67 citation statements)

References 7 publications

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“…All of the S. liquefaciens isolates were identical by PFGE, and the outbreak stopped when pooling of epoetin alfa was discontinued and the soap and lotion were replaced. All of the patients recovered with antimicrobial therapy (171).…”

Section: S Liquefaciensmentioning

confidence: 94%

“…Like S. marcescens, S. liquefaciens is an environmental organism that has been associated with infections from contaminated medical devices, products, and equipment, including a vitamin C infusion (123), pressure-monitoring equipment (175), neonatal enteral feeding tubes (193), Alsever's solution (252), and endoscopes (261). There have also been several described instances of contaminated blood products with associated transfusion reactions in humans (44,117,171,200,326,412).…”

Section: S Liquefaciensmentioning

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 Liquefaciensmentioning

confidence: 94%

Section: S Liquefaciensmentioning

confidence: 99%

Serratia Infections: from Military Experiments to Current Practice

2011

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“…Although the overall risk for extrinsic contamination of multidose vials is likely minimal [168], the consequences of contamination might result in lifethreatening infection [169,170]. Single-use vials are frequently preservative-free and might pose a risk for contamination if they are punctured several times.…”

Section: Multidose Parenteral Medication Vialsmentioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

635

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…During an outbreak investigation of S. liquefaciens, BSI, and pyrogenic reactions in a haemodialysis centre, pathogens were isolated from extrinsically contaminated vials of medication resulting from multiple dose usage, antibacterial soap, and hand lotion. 161 Duckro and colleagues 126 showed that VRE could be transferred from a contaminated environment or patients' intact skin to clean sites via the hands of HCWs in 10.6% of contacts.…”

Section: Cross-transmission Of Organisms By Contaminated Handsmentioning

confidence: 99%