Serratia marcescens outbreak due to contaminated 2% aqueous chlorhexidine

Frutos, Mónica de; López-Urrutia, Luis; Domínguez‐Gil, Marta; Arias, Marta; Muñoz‐Bellido, Juan Luis; Eirós, José María; Ramos, Carlos Martínez

doi:10.1016/j.eimce.2017.11.006

Cited by 8 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this work, 80% of the cases corresponded to males and 20% to females, which is similar to what has been reported in another outbreak [2], but at the same time, diferent from what has been reported by other researchers [15,24], probably because when the outbreak occurs, it can afect both males and females equally. On the other hand, most of the cases corresponded to neonates born at term with a birth weight of more than 2,500 grams, which contrasts with what has been reported by other authors who identify low birth weight and prematurity as risk factors for morbidity and mortality due to this type of pathogen [19].…”

Section: Discussionsupporting

confidence: 76%

Outbreak of Serratia marcescens in the Neonatal Intensive Care Unit of a Tertiary Care Hospital in Mexico

Guel-Gomez,

Angulo-Zamudio,

Leon-Sicairos

et al. 2023

Advances in Medicine

View full text Add to dashboard Cite

Introduction. We describe an outbreak of Serratia marcescens (S. marcescens) infection in the neonatal intensive care unit at Women’s Hospital in Sinaloa, Mexico. Methods. In April 2021, an outbreak of S. marcescens infection was identified. A case was identified as any patient who tested positive for S. marcescens and showed signs of an infectious process. Results. S. marcescens was isolated from the blood cultures of 15 neonates with clinical signs of neonatal sepsis. Statistical analysis showed that all neonates had an invasive medical device. The problem was controlled after hospital hygiene and sanitation measures were strengthened. Conclusion. The study provides evidence of an outbreak of nosocomial bacteremia due to the cross-transmission of S. marcescens. The findings highlight the need for hospitals to implement strict hygiene measures, especially regarding hand washing, to prevent future outbreaks.

show abstract

Section: Discussionsupporting

confidence: 76%

Outbreak of Serratia marcescens in the Neonatal Intensive Care Unit of a Tertiary Care Hospital in Mexico

Guel-Gomez,

Angulo-Zamudio,

Leon-Sicairos

et al. 2023

Advances in Medicine

View full text Add to dashboard Cite

show abstract

“…The Serratia species is known to survive and grow in moist environments. Several Serratia outbreaks have been associated with contaminated liquids including saline bottles, 19 chlorhexidine, 20 – 22 and IV pain control fluids 23 . However, the sink environment as a potential source has been suggested only rarely.…”

Section: Discussionmentioning

confidence: 99%

Sink traps as the source of transmission of OXA-48–producing Serratia marcescens in an intensive care unit

Regev‐Yochay

Smollan

Tal

et al. 2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

BackgroundCarbapenemase-producing Enterobacteriaceae (CPE) outbreaks are mostly attributed to patient-to-patient transmission via healthcare workers.ObjectiveWe describe successful containment of a prolonged OXA-48–producing S. marcescens outbreak after recognizing the sink traps as the source of transmission.MethodsThe Sheba Medical Center intensive care unit (ICU), contains 16 single-bed, semi-closed rooms. Active CPE surveillance includes twice-weekly rectal screening of all patients. A case was defined as a patient detected with OXA-48 CPE >72 hours after admission. A root-cause analysis was used to investigate the outbreak. All samples were inoculated on chrom-agar CRE, and carbapenemase genes were detected using commercial molecular Xpert-Carba-R. Environmental and patient S. marcescens isolates were characterized using PFGE.ResultsFrom January 2016 to May 2017, 32 OXA-48 CPE cases were detected, and 81% of these were S. marcescens. A single clone was the cause of all but the first 2 cases. The common factor in all cases was the use of relatively large amounts of tap water. The outbreak clone was detected in 2 sink outlets and 16 sink traps. In addition to routine strict infection control measures, measures taken to contain the outbreak included (1) various sink decontamination efforts, which eliminated the bacteria from the sink drains only temporarily and (2) educational intervention that engaged the ICU team and lead to high adherence to ‘sink-contamination prevention guidelines.’ No additional cases were detected for 12 months.ConclusionsDespite persistence of the outbreak clones in the environmental reservoir for 1 year, the outbreak was rapidly and successfully contained. Addressing sink traps as hidden reservoirs played a major role in the intervention.

show abstract

“…Serratia türleri hastane ortamında kolayca kolonize olup, yoğun bakım ve yenidoğan üniteleri gibi immunsuprese ve kritik durumdaki hastaların izlendiği bölümlerde, morbiditesi ve mortalitesi yüksek salgınlara neden olabilmektedir (5). Serratia türleri ile gelişen nozokomiyal salgınlarda bir diğer önemli kazanım yolu antisepsi için kullanılan solüsyonla-rın ve parenteral yolla kullanılan medikal ilaçların kontamine olmasıdır (9)(10)(11)(12). S. marcescens ile gelişen ilk nozokomiyal salgın 1951 yılından tanımlanmış, sonraki yıllarda giderek artan sayıda bildirimler olmuştur (2).…”

Section: Irdelemeunclassified

“…İspanya' da 2014 yılında açık kalp cerrahisi uygulanan hastalarda, %2'lik sıvı klorheksidin solüsyonlarının, üretim aşamasında S. marcescens ile kontamine olmasına bağlı sternal yara infeksiyonu ve katater ilişkili kan dolaşımı infeksiyonu salgınları bildirilmiştir (9)(10)(11). Amerika Birleşik Devletleri'nde ikibinli yıllarda çok sayıda eyalette, intravenöz magnezyum sülfat ve heparin solüsyonlarının üretim aşamasında S. marcescens ile kontaminasyonunun neden olduğu kan dolaşımı infeksiyonu salgınları saptanmıştır (12,17).…”

Section: Irdelemeunclassified