Consecutive Serratia marcescens multiclone outbreaks in a neonatal intensive care unit

Background This report describes 3 consecutive outbreaks caused by genetically unrelated Serratia marcescens clones that occurred in a neonatal intensive care unit (NICU) over a 35-month period. Methods Carriage testing in neonates and health care workers and environmental investigation were perform...

Full description

Saved in:
Bibliographic Details
Published in:American journal of infection control 2012-09, Vol.40 (7), p.637-642
Main Authors: Maltezou, Helena C., MD, PhD, Tryfinopoulou, Kyriaki, MD, Katerelos, Panos, MSc, Ftika, Lemonia, MD, Pappa, Olga, MD, Tseroni, Maria, RN, Kostis, Evangelos, MD, PhD, Kostalos, Christos, MD, PhD, Prifti, Helen, MD, Tzanetou, Konstantina, MD, PhD, Vatopoulos, Alkiviadis, MD, PhD
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Bacteremia
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Carriage
Carrier State - epidemiology
Carrier State - microbiology
Case-Control Studies
Cross Infection - epidemiology
Cross Infection - microbiology
Disease control
Disease Outbreaks
Drug Contamination
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Environmental Microbiology
Epidemics
Epidemiology. Vaccinations
Female
General aspects
Gram-negative bacteria
Human bacterial diseases
Humans
Infant
Infant, Newborn
Infection
Infection Control
Infectious Disease
Infectious diseases
Intensive care medicine
Intensive Care Units, Neonatal
Male
Medical sciences
Molecular Epidemiology
Molecular Typing
Neonatal care
Nosocomial infections
Parenteral nutrition
Parenteral Nutrition Solutions
Risk Factors
Serratia Infections - epidemiology
Serratia Infections - microbiology
Serratia marcescens - classification
Serratia marcescens - genetics
Serratia marcescens - isolation & purification
Total parenteral nutrition
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background This report describes 3 consecutive outbreaks caused by genetically unrelated Serratia marcescens clones that occurred in a neonatal intensive care unit (NICU) over a 35-month period. Methods Carriage testing in neonates and health care workers and environmental investigation were performed. An unmatched case-control study was conducted to identify risk factors for S marcescens isolation. Results During the 35-month period, there were 57 neonates with S marcescens isolation in the NICU, including 37 carriers and 20 infected neonates. The prevalence rate of S marcescens isolation was 12.3% in outbreak 1, 47.4% in outbreak 2, and 42% in outbreak 3. Nine of the 20 infected neonates died (45% case fatality rate). A total of 10 pulsed field gel electrophoresis types were introduced in the NICU in various times; 4 of these types accounted for the 9 fatal cases. During outbreak 3, a type VIII S marcescens strain, the prevalent clinical clone during this period, was detected in the milk kitchen sink drain. Multiple logistic regression revealed that the only statistically significant factor for S marcencens isolation was the administration of total parenteral nutrition. Conclusions Total parenteral nutrition solution might constitute a possible route for the introduction of microorganisms in the NICU. Gaps in infection control should be identified and strict measures implemented to ensure patient safety.
ISSN:0196-6553
1527-3296
DOI:10.1016/j.ajic.2011.08.019