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Epidemic of Serratia marcescens Bacteremia and Meningitis in a Neonatal Unit in Mexico City

Published online by Cambridge University Press:  21 June 2016

Mussaret Zaidi ,
José Sifuentes ,
Miriam Bobadilla ,
David Moncada  and
Samuel Ponce de León
Mussaret Zaidi
Affiliation:
Department of Pediatrics, Hospital General “Dr. Manuel Cea Gonzalez, ”, Mexico City, Mexico
José Sifuentes
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, S.Z, Mexico City, Mexico
Miriam Bobadilla
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, S.Z, Mexico City, Mexico
David Moncada
Affiliation:
Clinical Laboratory, Hospital General “Dr. Manuel Cea Gonzalez, ”, Mexico City, Mexico
Samuel Ponce de León*
Affiliation:
Department of Infectious Diseases, Instituto Nacional de la Nutrición, S.Z, Mexico City, Mexico
*
Unidad de Epidemiología Hospitalaria, Instituto Nacional de la Nutrición, S.Z., Vasco de Quimga #15, Deleg. Tlalpan 14000, México D.F
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Abstract

A case-control study was conducted on an epidemic of bacteremia and meningitis caused by Serratia marcescens in the neonatal intensive care unit and special care nursery of a general hospital in Mexico City, Mexico. A 19.9% incidence of bacteremia and meningitis was recorded in contrast to 1.4% and 3.7% during pre-epidemic and postepidemic periods; a 69% mortality rate was observed. Peripheral IV catheters and the use of mixed IV fluids prepared in the wards were the major risk factors (P < 0.001). Rectal and nasopharyngeal cultures were positive in 68% of asymptomatic neonates and hand cultures were positive in 16.7% of personnel. Strains were resistant to all aminoglycosides and broad-spectrum penicillins, and belonged to the A5/8 bio-group. Containment of this outbreak was difficult because of failure to identify colonized infants early in the epidemic and because of persistent carriage of S marcescens by personnel. Comparisons between this hospital and tertiary care centers in Mexico suggest that in developing countries nosocomial infections could be of greater magnitude in secondary than in tertiary level centers.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 1 , January 1989 , pp. 14 - 20
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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References

1.Acar, JF: Serratia marcescens infections. Infect Control. 1986;7:273–278.CrossRefGoogle ScholarPubMed
2.Yu, VL: Serratia marcescens: Historical perspective and clinical review. N Engl J Med. 1979;300:887–893.Google Scholar
3.Daschner, FD: The epidemiology of Serratia marcescens in Von Graenitz, A, Rubin, Si (eds): The Genus Sevratio. Boca Raton, CRC Press. 1980, pp 188–196.Google Scholar
4.Christensen, GD. Korones, SB, Reed, L, et al: Epidemic Serratia marcescens in a neonatal intensive care unit: Importance of the gastrointestinal tract as a reservoir. Infect Control. 1982;3:127–131CrossRefGoogle Scholar
5.Montanaro, D, Grasso, GM. Anmino, I, et al: Epidemiological and bacteriological investigation of Serratia marcescens epidemic in a nursery and in a neonatal intensive care unit. J Hyg (Camb). 1984;93:67–78.CrossRefGoogle Scholar
6.Smith, PJ, Brookfield, DSK. Shaw, DA, et al: An outbreak of Serratia marcescens. infection in a neonatal unit. Lancet. 1984;1:151–153.Google Scholar
7.Nelson, JD: The neonate, in Donowitz, LG (ed): Hospital Acquired Infection in the Pediatric Patient. Baltimore, Williams and Wilkins, 1988, pp 273–291.Google Scholar
8.Baker, CJ: Nosocomial septicemia and meningitis in neonates. Am J Med. 1981;70:1198–701.Google Scholar
9.Donowitz, LG: Infection in the newborn, in Wenzel, RP (ed): Prevention and Control of Nosocomial Infections. Baltimore, Williams and Wilkins, 1987, pp 181–193.Google Scholar
10.Zaidi-Jacobson, NA, Ponce de León-Rosales, S, Flores-Calderón, J, et al: Infecciones nosocomiales en una unidad de pediatria. Bol Med Host Infant Mex. 1988;45:115–421.Google Scholar
11.Kelly, MT, Bremer, DJ, Farmer, JJ III: Enterobactcriaceae, in Lenuette, EH, Balows, A, Flimsier, WI Jr, et al (eds): Manual oof Clinical Microbiology ed 4. Washington, DC, American Society for Microbiology. 1985, pp 263–277.Google Scholar
12.Jones, RN, Barry, AL, Garan, TLet al: Susceptibility tests: Microdilution and macrodilution broth procedures. in Lennette, EH, Balows, A, Hausler, WJ Jr., et al (eds): Manual of Clinical Microbiology, ed 4. Washington, DC, American Society for Microbiology, 1985, pp 972–977.Google Scholar
13.Siluentes-Osornio, J, Ruiz-Palacios, GM, and Gröschel, DHE, Analysis of epidemiological markers of nosocomial Serratia marcescens isolates with special reference to the Grimont biotyping system. J Clin Microbiol. 1986;23:230–234.CrossRefGoogle Scholar
14.Feinstein, A: Clinical Biostatistics, CV Mosby Company, St. Louis, 1977, pp 207-208 and 293–294.Google Scholar
15.Braver, DJ, Hauser, L, Berns, V. et al: Control of a Sertatia marcescens outbreak in a maternity hospital. J Hosp Infect 1987;10:129–137.Google Scholar
16.Von Graevenitz, A: Infection and colonization with Senotia in Von Graevenitz, A, Rubin, SI (eds): The Genus Serratia Boca Raton, CRC Press. 1980, pp 167–186.Google Scholar
17.Schaberg, DR, Weinstein, RA, Stamm, WE: Epidemics of nosocomial urinary tract infection caused by multiply resistant gram-negative bacilli: Epidemiology and control, J Infect Dis. 1976;133:363–366.CrossRefGoogle ScholarPubMed
18.Maki, DG: Nosocomial bacteremia: An epidemiologic overview. Am J Med. 1981;70:719–732.CrossRefGoogle ScholarPubMed
19.Stamm, WE, Korff, CA, Muñoz-Dones, E, et al: A nursery Outbreak caused by Serratia marcescens—scalp-vein needles as a portal of entry. J Pediatr. 1976;89:96–99.Google Scholar
20.Hemming, VG, Overall, JC Jr, Britt, MR: Nosocomial infections in a newborn intensive care unit. N Engl J Med. 1976;294:1310–1316.CrossRefGoogle Scholar
21.Ruiz-Palacios, G, Ponce de León, S, Sifuentes, J. et al: Control of resistance of gram-negative bacilli to aminoglycosides: Three-year prospective study with the exclusive use of amikacin. Rev Invest Clin. 1986;38:1–6.Google Scholar
22.Farmer, JJ III, Davis, BR, Hickman, FW: Detection of Serratia outbreaks in hospitals. Lancet. 1976;ii:55–159.Google Scholar
23.Bourrillon, A. Brackman, D. Boussougant, Y. et al: Cefotaxime effects on the intestinal flora of the newborn. Dev Pharmacol Ther 1984;7(suppl 1):144–149.Google Scholar
24.Ambrosio, RE, Van Wyk, AJ, de Klerk, HC: Antibiotic resistant Seratia marcescens infection in a hospital. S Afr Med J. 1979;55:584–587.Google Scholar
25.Grimont, PAD. Grimont, F. Le Minor, S. et al: Compatible results obtained from biotyping and serotyping in Serratia marcescens, J Clin Microbiol. 1979;10:425–432.CrossRefGoogle ScholarPubMed
26.Volkow, P, Sifuentes, J, Ponce de Leóti, S, et al: Outbreak of Serratia marcescens primary bitcheretinas related to the earthquakes in Mexico City (abstract). 87th Annual Meeting of the American Society fOr Microbiology, Atlanta. Georgia, Match 1-6. 1987.Google Scholar
27.Goldmann, D: Bacterial colonization and infection in the neonate. Am J Med. 1981;70:417–422.CrossRefGoogle Scholar
28.Haley, RW: Incidence and nature of endemic and epidemic nosocomial infections, in Bennett, JV, Brachman, PS (eds): Hospital Infections, ed 2. Boston, Little, Brown and Company, 1986, pp:359–371.Google Scholar
29.Wenzel, RP, Thompson, RL, Landry, SM, et al: Hospital-acquired infections in intensive care unit patients: An overview with emphasis on epidemics. Infect Control. 1983;4:371–375.CrossRefGoogle ScholarPubMed