Successful control of Serratia marcescens outbreak in a neonatal unit of a tertiary-care hospital in Spain
Enferm Infecc Microbiol Clin (Engl Ed). 2021 Jun 16:S0213-005X(21)00186-5.
doi: 10.1016/j.eimc.2021.05.003.
Online ahead of print.
[Article in
English,
Spanish]
Authors
María Isabel Millán-Lou
1
, Concepción López
2
, Jessica Bueno
3
, Vanesa Pérez-Laguna
4
, Carlos Lapresta
5
, María Elena Fuertes
6
, Segundo Rite
6
, Mónica Santiago
2
, María Romo
2
, Sofia Samper
7
, Alberto Cebollada
8
, Jesús Oteo-Iglesias
9
, Antonio Rezusta
10
Affiliations
- 1 Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain. Electronic address: [email protected].
- 2 Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain.
- 3 Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- 4 Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain. Electronic address: [email protected].
- 5 Servicio de Medicina Preventiva, Hospital Universitario Miguel-Servet, Zaragoza, Spain.
- 6 Unidad de neonatología, Hospital Universitario Miguel-Servet, Zaragoza, Spain.
- 7 Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
- 8 CIBERES, ISCIII, Madrid, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; Unidad de Biocomputación, Instituto Aragonés de Ciencias de la Salud (IACS/IIS Aragón), Zaragoza, Spain.
- 9 Laboratorio de Referencia e Investigación en Resistencia a Antibióticos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.
- 10 Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain.
Abstract
Objective:
Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit.
Methods:
In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens.
Results:
During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens.
Conclusion:
A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.
Keywords:
Brote; Campo pulsado; Chlorhexidine; Clorhexidina; Neonatal unit; Outbreak; PFGE; S. marcescens; Unidad neonatal.
Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.