Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-9lvz7 Total loading time: 0.161 Render date: 2021-09-27T22:26:15.604Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Rapid Eradication of a Cluster of Serratia marcescens in a Neonatal Intensive Care Unit: Use of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis

Published online by Cambridge University Press:  02 January 2015

Kwan Kew Lai*
Affiliation:
UMass Memorial Medical Center, Worcester, Massachusetts University of Massachusetts Medical School, Worcester, Massachusetts
Stephen P. Baker
Affiliation:
UMass Memorial Medical Center, Worcester, Massachusetts University of Massachusetts Medical School, Worcester, Massachusetts
Sally A. Fontecchio
Affiliation:
UMass Memorial Medical Center, Worcester, Massachusetts
*
UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655

Abstract

Objective:

To investigate a cluster of patients infected and colonized with Serratia marcescens in a neonatal intensive care unit (NICU).

Methods:

In June 2001, two neonates in the NICU had clinical infections with S. marcescens and one died. Infection control surveillance data for the NICU revealed that S. marcescens was rarely isolated from clinical specimens. Surveillance and environmental cultures were performed and isolates were typed using pulsed-field gel electrophoresis. Staff and neonates were cohorted and a waterless, alcohol-based handwashing agent was introduced. A case-control study was performed.

Results:

From June 2 through August 20, 2001, 11 neonates with S. marcescens infection and colonization were identified. The incidence of S. marcescens infections increased from 0.19 per 1,000 patient-days in 2000 to 0.52 per 1,000 patient-days in 2001 (P < .0001). In the first 3 weeks of the investigation, there were 2 sets of patients and sinks with indistinguishable strains; however, in subsequent weeks, all isolates were of unique strains, signifying no further transmission of the two initial predominant strains. Neonates with S. marcescens were more likely to have a lower gestational age and birth weight. There was no association between cases and healthcare workers (HCWs).

Conclusions:

A cluster of S. marcescens was quickly terminated after the introduction of preventive measures including cohorting of infected and colonized neonates and HCWs, contact precautions, surveillance cultures, and a waterless, alcohol-based hand antiseptic. Chromosomal typing determined that strains with an indistinguishable pattern were no longer present in the unit after control measures were implemented.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Sartor, C, Jacomo, V, Duvivier, C, Tissot-Dupont, H, Sambuc, R, Drancourt, M. Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap. Infect Control Hosp Epidemiol 2000;21:196199.CrossRefGoogle ScholarPubMed
2.Yu, VL. Serratia marcescens: historical perspective and clinical review. N Engl J Med 1979;300:887893.CrossRefGoogle ScholarPubMed
3.Manning, ML, Archibald, LK, Bell, LM, Banerjee, SN, Jarvis, WR. Serratia marcescens transmission in a pediatric intensive care unit: a multifactorial occurrence. Am J Infect Control 2001;29:115119.CrossRefGoogle Scholar
4.Jones, BL, Gorman, LJ, Simpson, J, et al.An outbreak of Serratia marcescens in two neonatal intensive care units. J Hosp Infect 2000; 46:314319.CrossRefGoogle ScholarPubMed
5.Berthelot, P, Grattard, F, Amerger, C, et al.Investigation of a nosocomial outbreak due to Serratia marcescens in a maternity hospital. Infect Control Hosp Epidemiol 1999;20:233236.CrossRefGoogle Scholar
6.van Ogtrop, ML, van Zoeren-Grobben, D, Verbakel-Salomons, EM, van Boven, CP. Serratia marcescens infections in neonatal departments: description of an outbreak and review of the literature. J Hosp Infect 1997;36:95103.CrossRefGoogle ScholarPubMed
7.Stamm, WE, Kolff, CA, Dones, EM, et al.A nursery outbreak caused by Serratia marcescens: scalp-vein needles as a portal of entry. J Pediatr 1976;89:9699.CrossRefGoogle ScholarPubMed
8.Sanders, CV Jr, Luby, JP, Johanson, WG Jr, Barnett, JA, Sanford, JP. Serratia marcescens infections from inhalation therapy medications: nosocomial outbreak. Ann Intern Med 1970;73:1521.CrossRefGoogle ScholarPubMed
9.Archibald, LK, Cori, A, Shah, B, et al. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol 1997;18:704709.CrossRefGoogle ScholarPubMed
10.Sautter, RL, Mattman, LH, Legaspi, RC. Serratia marcescens meningitis associated with a contaminated benzalkonium chloride solution. Infect Control 1984;5:223225.CrossRefGoogle Scholar
11.Tenover, FC, Arbeit, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.Google ScholarPubMed
12.Snedecor, GW, Cochran, WG. Statistical Methods. Ames, IA: Iowa State University Press; 1989.Google ScholarPubMed
13.Siegel, S. Nonparametric Statistics for the Behavioral Sciences. New York: McGraw-Hill; 1956.Google Scholar
14.Miranda, G, Kelly, C, Solorzano, F, Leanos, B, Coria, R, Patterson, JE. Use of pulsed-field gel electrophoresis typing to study an outbreak of infection due to Serratia marcescens in a neonatal intensive care unit. J Clin Microbiol 1996;34:31383141.Google Scholar
15.Braver, DJ, Hauser, GJ, Berns, L, Siegman-Igra, Y, Muhlbauer, B. Control of a Serratia marcescens outbreak in a maternity hospital. J Hosp Infect 1987;10:129137.CrossRefGoogle Scholar
16.Moolenaar, RL, Crutcher, JM, San Joaquin, VH, et al.A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol 2000;21:8085.CrossRefGoogle Scholar
17.Schroeder, P, Kieffer, P, Kilian, C, et al.Outbreak of Serratia marcescens in a neonatal intensive care unit. Presented at the 28th Annual Meeting of the Association for Professionals in Infection Control and Epidemiology; June 10-14, 2001; Seattle, WA. Abstract 245.Google Scholar
18.McNeil, SA, Foster, CL, Hedderwick, SA, Kauffman, CA. Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clin Infect Dis 2001;32:367372.CrossRefGoogle ScholarPubMed
17
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Rapid Eradication of a Cluster of Serratia marcescens in a Neonatal Intensive Care Unit: Use of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Rapid Eradication of a Cluster of Serratia marcescens in a Neonatal Intensive Care Unit: Use of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Rapid Eradication of a Cluster of Serratia marcescens in a Neonatal Intensive Care Unit: Use of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *