TY - JOUR
TI - Consecutive Serratia marcescens multiclone outbreaks in a neonatal
intensive care unit
AU - Maltezou, Helena C.
AU - Tryfinopoulou, Kyriaki
AU - Katerelos, Panos and
AU - Ftika, Lemonia
AU - Pappa, Olga
AU - Tseroni, Maria
AU - Kostis, Evangelos
AU - and Kostalos, Christos
AU - Prifti, Helen
AU - Tzanetou, Konstantina and
AU - Vatopoulos, Alkiviadis
JO - American Journal of Infection Control
PY - 2012
VL - 40
TODO - 7
SP - 637-642
PB - MOSBY-ELSEVIER
SN - 0196-6553, 1527-3296
TODO - 10.1016/j.ajic.2011.08.019
TODO - Bacteremia; Carriage; Infection; Total parenteral nutrition; Infection
control
TODO - 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. Copyright (C) 2012 by the
Association for Professionals in Infection Control and Epidemiology,
Inc. Published by Elsevier Inc. All rights reserved.
ER -