Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-12-01T01:36:07.586Z Has data issue: false hasContentIssue false

Morganella morganii: Epidemiology of Bacteremic Disease

Published online by Cambridge University Press:  02 January 2015

Carolyn McDermott
Affiliation:
Division of Infectious Diseases, Veterans Administration Medical Center, Buffalo, New York, and the Department of Medicine, Division of Infectious Diseases, State University of New York at Buffalo, School of Medicine, Buffalo, New York
Joseph M. Mylotte*
Affiliation:
Division of Infectious Diseases, Veterans Administration Medical Center, Buffalo, New York, and the Department of Medicine, Division of Infectious Diseases, State University of New York at Buffalo, School of Medicine, Buffalo, New York
*
Infectious Diseases (111F), VA Medical Center, 3495 Bailey Avenue, Buffalo, NY 14215

Abstract

A retrospective review of microbiology records revealed 19 documented episodes of M. morganii bacteremia in 18 patients at a Veterans Administration hospital during a 5.5 year period. Thirteen of 19 bacteremias were related to nosocomial infections; 11 of the 13 nosocomial bacteremias occurred in surgical patients. Nine of the 13 patients with nosocomial bacteremia had received recent therapy with a beta-lactam antibiotic. The most common source of bacteremia was a postoperative wound infection (seven episodes). Only one episode was related to a urinary tract infection.

Retrospective analysis showed that clusters of cases of M. morganii bacteremia had occurred almost yearly. This finding prompted a six-month period of prospective monitoring of all cultures for M. morganii to identify human reservoirs in our institution. Sixty percent of all cultures growing M. morganii came from urine cultures, 18% came from wound cultures, and the remaining 22% came from a variety of body fluids or tube drainage. Thirty-one percent of patients harboring M. morganii were on the Surgical Service.

M. morganii bacteremia most commonly occurs in postoperative patients who receive beta-lactam antibiotics. From the data in this study, M. morganii is an infrequent cause of bacteremia, and its presence in blood cultures may be an indicator of an environment conducive for an outbreak of nosocomial infection.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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.Brenner, DJ, Farmer, JJ, Fickman, FW, et al: Taxonomic and nomenclature changes in enterobacteriaceae. Department of Health, Education, and Welfare publication No. (CDC) 79-8356. Centers for Disease Control, Atlanta, Georgia, October 1979.Google Scholar
2.Dupont, HL, Spink, WW: Infections du e to gram-negative organisms: An analysis of 860 patients with bacteremia at the University of Minnesota Medical Center 1958-1966. Medicine 1969;48:307332.CrossRefGoogle Scholar
3.McGowan, JE, Parrott, PL, Duty, VP: Nosocomial bacteremia: Potential for prevention of procedure-related cases. JAMA 1977;237:27272729.CrossRefGoogle ScholarPubMed
4.Spengler, RF, Greenbugh, WB, Stolley, PO: A descriptive study of nosocomial bacteremia at the Johns Hopkins Hospital 1968-1974. Johns Hopkins Med J 1978;142:7784.Google Scholar
5.Kreger, BE, Craven, DE, Carling, PC, et al: Gram-negative bacteremia. III. Reassessment of etiology, epidemiology, and ecology in 612 patients. Am J Med 1980;68:332.CrossRefGoogle ScholarPubMed
6.Adler, JL, Burke, JP, Martin, DF, et al: Proteus infections in a general hospital II. Some clinical and epidemiological characteristics. Ann Intern Med 1971;75:531536.CrossRefGoogle Scholar
7.Marier, RA, Valenti, AJ, Mardi, JA: Gram-negative endocarditis following cystoscopy. J Urol 1978;119:134137.CrossRefGoogle ScholarPubMed
8.Tucci, V, Isenberg, HD: Hospital cluster epidemic with Morganella morganii. J Clin Microbiol 1981;14:563566.CrossRefGoogle ScholarPubMed
9.National Committee for Clinical Laboratory Standards. Approved Standard: M2-A2S. Performance standards for antimicrobial disc susceptibility tests, in National Committee for Clinical Laboratory Standards, ed 4. Villanova, Pennsylvania, 1981.Google Scholar
10.Maki, DG, Hennekens, CG, Phillips, CW, et al: Nosocomial urinary tract infection with Serratia marcescens: An epidemiologic study. J Infect Dis 1973;128:579587.CrossRefGoogle ScholarPubMed
11.Craig, WA, Uman, SJ, Shaw, WR, et al: Hospital use of antimicrobial agents. Survey of 19 hospitals and results of antimicrobial control program. Ann Intern Med 1978;89(part 2):793795.CrossRefGoogle Scholar
12.Hermans, PE, Washington, JA: Polymicrobial bacteremia. Ann Intern Med 1970;73:387392.CrossRefGoogle ScholarPubMed
13.Roselle, GA, Watanakunakorn, C: Polymicrobial bacteremia. JAMA 1979;242:24112413.CrossRefGoogle ScholarPubMed
14.Holzman, RS, Florman, AL, Toharsky, B: The clinical usefulness of an ongoing bacteremia surveillance program. Am J Med Sci 1977;274:1319.CrossRefGoogle ScholarPubMed