NosocomialSerratia marcescensInfections Associated With Extrinsic Contamination of a Liquid Nonmedicated Soap

Abstract

Extrinsic contamination of a non-medicated liquid soap by S marcescens resulted in handborne transmission of S marcescens NIs by HCWs in our setting. This finding led to the application of strict guidelines for nonmedicated soap use and to the reinforcement of alcoholic hand disinfection.

Hand Hygiene

“…Contaminated HCWs' hands have been associated with endemic HCAIs. 159, 160 Sartor and colleagues 160 provided evidence that endemic S. marcescens was transmitted from contaminated soap to patients via the hands of HCWs. 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.…”

“…Occasionally, plain soaps have become contaminated, which may lead to the colonization of HCWs hands with Gram-negative bacilli. 160 Nevertheless, there is some evidence that the actual hazard of transmitting microorganisms through handwashing with previously used soap bars is negligible. 265,266 …”

“…160,[640][641][642][643][644] Multiple-use bar soap should be avoided because it is difficult to store bar soap dry at a sink, with a subsequent increase in the risk of contamination. [640][641][642] Although liquid soaps are generally preferred over bar soaps for handwash, the risk for either intrinsic 643 or extrinsic 160,644 microbial contamination still exists.…”

Extrinsic Contamination of Liquid Soap with Various Gram-Negative Bacteria in a Hospital in Turkey

“…3,4,6 S. marcescens was associated with hospital infections and infection outbreaks following contamination of soap, particularly in critical patient groups, such as newborns and transplantation recipients. 4,7,8 In this study, we aimed to evaluate the microbial contamination of "in use" soaps and the clonal relatedness of the soap-contaminating microorganisms in our hospital, a 450-bed university hospital in Turkey. This research was performed with the approval of the university's Training and Research Hospital Ethics Committee.…”

“…No contamination was found in the original container or the plastic cans used to distribute the soap, demonstrating extrinsic contamination of the soaps during use. The organisms isolated from the soaps were P. aeruginosa (16 isolates), Enterobacter aerogenes (9), E. coli (8), K. pneumoniae (6), Enterobacter cloacae (3), S. marcescens (2), and Klebsiella oxytoca (1).…”