Dataset Information

Outbreak of Serratia marcescens in the Neonatal Intensive Care Unit of a Tertiary Care Hospital in Mexico.

ABSTRACT:

Introduction

We describe an outbreak of Serratia marcescens (S. marcescens) infection in the neonatal intensive care unit at Women's Hospital in Sinaloa, Mexico.

Methods

In April 2021, an outbreak of S. marcescens infection was identified. A case was identified as any patient who tested positive for S. marcescens and showed signs of an infectious process.

Results

S. marcescens was isolated from the blood cultures of 15 neonates with clinical signs of neonatal sepsis. Statistical analysis showed that all neonates had an invasive medical device. The problem was controlled after hospital hygiene and sanitation measures were strengthened.

Conclusion

The study provides evidence of an outbreak of nosocomial bacteremia due to the cross-transmission of S. marcescens. The findings highlight the need for hospitals to implement strict hygiene measures, especially regarding hand washing, to prevent future outbreaks.

SUBMITTER: Guel-Gomez M

PROVIDER: S-EPMC10539092 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Outbreak of <i>Serratia marcescens</i> in the Neonatal Intensive Care Unit of a Tertiary Care Hospital in Mexico.

Guel-Gomez Martha M Angulo-Zamudio Uriel A UA Leon-Sicairos Nidia N Flores-Villaseñor Hector H Mendívil-Zavala Edna E Plata-Guzmán Amparo A Martinez-Garcia Jesus J JJ Angulo-Rocha Jorge J Ochoa-Espinoza Rosangela R Crespo-Palazuelos Paola P Bracamontes-Murillo Jesús J León-Ramírez Angel A Rodriguez-Ceceña Juan C JC Canizalez-Roman Adrian A

Advances in medicine 20230921

<h4>Introduction</h4>We describe an outbreak of <i>Serratia marcescens</i> (<i>S. marcescens</i>) infection in the neonatal intensive care unit at Women's Hospital in Sinaloa, Mexico.<h4>Methods</h4>In April 2021, an outbreak of <i>S. marcescens</i> infection was identified. A case was identified as any patient who tested positive for <i>S. marcescens</i> and showed signs of an infectious process.<h4>Results</h4><i>S. marcescens</i> was isolated from the blood cultures of 15 neonates with clinic ...[more]

PMID: 37780054

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Project description:Compelling evidence suggests a contribution of the sink environment to the transmission of opportunistic pathogens from the hospital environment to patients in neonatal intensive care units (NICU). In this study, the distribution of the opportunistic pathogen Serratia marcescens in the sink environment and newborns in a NICU was investigated. More than 500 sink drain and faucet samples were collected over the course of five sampling campaigns undertaken over 3 years. Distribution and diversity of S. marcescens were examined with a modified MacConkey medium and a high-throughput short-sequence typing (HiSST) method. Sink drains were an important reservoir of S. marcescens, with an average of 44% positive samples, whereas no faucet sample was positive. The genotypic diversity of S. marcescens was moderate, with an average of two genotypes per drain, while the spatial distribution of S. marcescens was heterogeneous. The genotypic profiles of 52 clinical isolates were highly heterogeneous, with 27 unique genotypes, of which 71% of isolates were found in more than one patient. S. marcescens acquisition during the first outbreaks was mainly caused by horizontal transmissions. HiSST analyses revealed 10 potential cases of patient-to-patient transmission of S. marcescens, five cases of patient-to-sink transmission, and one bidirectional transfer between sink and patient. Environmental and clinical isolates were found in sink drains up to 1 year after the first detection, supporting persisting drain colonization. This extensive survey suggests multiple reservoirs of S. marcescens within the NICU, including patients and sink drains, but other external sources should also be considered. IMPORTANCE The bacterium Serratia marcescens is an important opportunistic human pathogen that thrives in many environments, can become multidrug resistant, and is often involved in nosocomial outbreaks in neonatal intensive care units (NICU). We evaluated the role of sinks during five suspected S. marcescens outbreaks in a NICU. An innovative approach combining molecular and culture methods was used to maximize the detection and typing of S. marcescens in the sink environment. Our results indicate multiple reservoirs of S. marcescens within the NICU, including patients, sink drains, and external sources. These results highlight the importance of sinks as a major reservoir of S. marcescens and potential sources of future outbreaks.

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