Serratia marcescens outbreak in a neonatal intensive care unit related to the exit port of an oscillator

MacDonald, Tracy M.; Langley, Joanne M.; Mailman, Tim; Allain, Kimberley; Nelson, George E.; Hatton, Lydia; Sanford, Timothy; George, Ken; Hancock, David; Stinson, Dora A.; Mulvey, Michael R.

doi:10.1097/pcc.0b013e31820ac42a

Cited by 19 publications

(16 citation statements)

References 7 publications

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“…Outbreaks in NICUs caused by Serratia spp. have been reported in the literature (13). In our study, non-fermentative bacteria were found to be the third leading causative agent after Enterobacteriaceae.…”

Section: Discussionsupporting

confidence: 51%

A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation

Ergül¹,

Isik²,

Altıntop³

et al. 2017

Turk Pediatri Ars

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Aim: In this study, it was aimed to retrospectively assess the frequency and antibiotic resistance of microorganisms isolated from blood cultures of patients in a pediatric intensive care unit. Material and Methods: The study was conducted on blood culture tests obtained from patients in a pediatric intensive care unit and sent to a microbiology laboratory between 2013 and 2016. The species and antibiotic susceptibilities were assessed in microorganisms isolated from the blood cultures. Results: Overall, 4239 blood cultures were obtained. Growth was detected in 324 blood cultures (7.6%). Of the microorganisms isolated, 195 (60.2%) were Gram-positive bacteria, and 107 (33.0%) were Gram-negative bacteria; 22 (6.8%) were fungi. The most commonly isolated microorganisms were Coagulase-negative staphylococci (45.1%), followed by Klebsiella pneumonia (14.5%), and Enterococcus faecalis (6.5%). Among the fungi, the most common was Candida albicans (59.1%), followed by Candida parapsilosis. The resistance rate against methicillin was 89.9% in coagulase-negative staphylococci, and 66% in S. aureus strains. The resistance rate against vancomycin was 3.6% in Enterococci spp. There was no resistance against linezolid in Gram-positive microorganisms. The rate of extended-spectrum beta lactamase positivity was found as 34% in Klebsiella spp. and 100% in Escherichia coli. The resistance rate against carbapenem was 44.9% in Gram-negative bacteriae. The resistance rate against carbapenem was 100% in Acinetobacter baumanii. In Candida albicans, resistance to amphotericine B was 61.5%, and resistance to voriconazole was 7.7%. Conclusions: To plan effective empiric antibiotic therapy against nosocomial infections in intensive care units, all units should have information about the characteristics of their own flora.

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Section: Discussionsupporting

confidence: 51%

A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation

Ergül¹,

Isik²,

Altıntop³

et al. 2017

Turk Pediatri Ars

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“…However, in other studies S. marcescens could not be detected among pathogens isolated from cases of neonatal sepsis [25, 31, 39]. In the last decade, several outbreaks in NICU were documented [56–58], causing potentially fatal sepsis, meningitis, or pneumonitis in very premature or low birth weight neonates with high mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

El‐Din

El‐Sokkary

Bassiouny

et al. 2015

BioMed Research International

157

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Prospective analytic study was conducted in NICUs of three Egyptian Neonatal Network (EGNN) participants in Mansoura Hospitals in Egypt over a period of 18 months from March 2011 to August 2012. By using EGNN 28-day discharge form, all demographic, clinical, and laboratory data were recorded and studied. During the study period, 357 neonates were diagnosed as suspected sepsis with an incidence of 45.9% (357/778) among the admitted neonates at the three neonatal intensive care units. 344 neonates (sex ratio = 1.3:1) were enrolled in the study in which 152 (44.2%) were classified as early onset sepsis EOS (≤72 hr) and 192 (55.8%) as late onset sepsis LOS (>72 hr). Among the LOS cases, 33.9% (65/192) were caused by nosocomial infections. In 40.7% (140/344), sepsis was confirmed by positive blood culture. The total mortality rate for the proven neonatal sepsis was 51% (25/49) and 42.9% (39/91) for EOS and LOS, respectively. Coagulase negative staphylococci were predominant isolates in both EOS and LOS, followed by Klebsiella pneumoniae. Most of the bacterial isolates had low sensitivity to the commonly used empiric antibiotics. However, 70.1% (89/127) exhibited multidrug resistance. Best sensitivities among Gram-positive isolates were found against imipenem, ciprofloxacin, vancomycin, and amikacin.

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“…Die Verwendung einer anderen Mineralwassermarke beendete den Ausbruch. Bei der Ausbruchsuntersuchung von Yapicioglu et al [34] Interessant an der Untersuchung von MacDonald et al [26] ist nicht nur die besondere Quelle des Serratia-Isolates (HFO-Beatmungsgerät, Auslassventil), sondern auch das systematische proaktive Vorgehen des Ausbruchsmanagementteams, das die infektionsepidemiologische Relevanz von S. marcescens für NICU-Patienten frühzeitig erkannt hat [42]. Die Autoren verweisen darauf, dass Hygienerisiken beim Einsatz der HFOBeatmung durchaus beschrieben sind [43], jedoch nicht in ausreichendem Ausmaß zur Implementierung zusätzlicher Schutzmaßnahmen geführt haben.…”

Section: Ausbruchsuntersuchung Und Maßnahmen Zur Ausbruchskontrolleunclassified

Literatur-Update zu Ausbrüchen auf neonatologischen Intensivpflegestationen – Serratia marcescens, Klebsiella pneumoniae, Acinetobacter baumannii und Pseudomonas aeruginosa

Kraus-Haas

Mielke

Simon

2015

Bundesgesundheitsbl.

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Häufungen von Infektionen mit einem (vermeintlich) einheitlichen Erreger in neonatologischen Intensivpflegestationen (NICUs) sind unerwünschte Ereignisse, durch die die Sicherheit der Patienten und ein günstiger Ausgang der Intensivtherapie gefährdet wird [1]. Mitunter sterben die Kinder an unmittelbaren Komplikationen bzw. langfristigen Folgen dieser "Late-onset"-Infektionen oder ihre psychomotorischen und mentalen Entwicklungsoptionen werden durch diese Ereignisse nachhaltig beeinträchtigt [2]. Ausbrüche bedingen zudem erhebliche Mehrbelastungen des Behandlungsteams (zu dem wir auch das Hygienefachpersonal zählen) [3] und können zur vorüber-gehenden oder dauerhaften Schließung einer Abteilung führen [4][5][6][7][8]. Aufgrund der besonderen Infektionsgefährdung der Patienten, der strukturell-organisatorischen Besonderheiten der Intensivtherapie in NICUs, des initial sehr uncharakteristischen klinischen Bildes und aufgrund des speziellen Erregerspektrums (z. B. Serratia marcescens) müssen Ausbrüche auf NICUs separat von anderen Ausbrüchen betrachtet werden [1].Die

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Serratia marcescens outbreak in a neonatal intensive care unit related to the exit port of an oscillator

Abstract: Implementation and adherence to infection control measures is essential to prevent transmission of opportunistic pathogens among ventilated infants. Oscillators can generate droplets that travel farther than 1 m from the source.

Cited by 19 publications

References 7 publications

A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation

A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation

Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

Literatur-Update zu Ausbrüchen auf neonatologischen Intensivpflegestationen – Serratia marcescens, Klebsiella pneumoniae, Acinetobacter baumannii und Pseudomonas aeruginosa

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