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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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