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Nosocomial Outbreak of Serratia Marcescens in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Ojan Assadian ,
Angelika Berger ,
Christoph Aspöck ,
Stefan Mustafa ,
Christina Kohlhauser  and
Alexander M. Hirschl
Ojan Assadian*
Affiliation:
Clinical Institute for Hygiene and Medical Microbiology, University of Vienna Medical School, Division of Hospital Hygiene, Vienna, Austria
Angelika Berger
Affiliation:
Department of Neonatology, Inborn Errors of Metabolism and Pediatric Intensive Care, University Children's Hospital, Vienna, Austria
Christoph Aspöck
Affiliation:
Clinical Institute for Hygiene and Medical Microbiology, University of Vienna Medical School, Division of Hospital Hygiene, Vienna, Austria
Stefan Mustafa
Affiliation:
Clinical Institute for Hygiene and Medical Microbiology, University of Vienna Medical School, Division of Hospital Hygiene, Vienna, Austria
Christina Kohlhauser
Affiliation:
Department of Neonatology, Inborn Errors of Metabolism and Pediatric Intensive Care, University Children's Hospital, Vienna, Austria
Alexander M. Hirschl
Affiliation:
Clinical Institute for Hygiene and Medical Microbiology, University of Vienna Medical School, Division of Clinical Microbiology, Vienna, Austria
*
Clinical Institute for Hygiene and Medical Microbiology, University of Vienna Medical School, Division of Hospital Hygiene, Vienna General Hospital, Waehringer Guertel 18-20, A -1090 Vienna, Austria
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Abstract

Objectives:

To investigate and describe an outbreak of Serratia marcescens in a neonatal intensive care unit (NICU) and to report the interventions leading to cessation of the outbreak.

Setting:

A 2,168-bed, tertiary-care, university teaching hospital in Vienna, Austria, with an 8-bed NICU.

Design:

We conducted a case–control study to identify risk factors for colonization and infection with S. marcescens. A case-patient was defined as any neonate in the NICU with a positive culture for S. marcescens between October 1, 2000, and February 28, 2001. Polymerase chain reaction was applied to type isolates.

Methods:

During unannounced observations, the NICU was examined and existing policies were reviewed. Staff were reinstructed in hand antisepsis and gloving policies. Admissions were halted on December 27. During previously planned technical maintenance of the ward, the NICU was closed for 10 days and thorough aldehyde-based disinfection of the NICU was performed.

Results:

Ten neonates met the case definition: 6 with infections (among them 3 with cerebral abscesses) and 4 with asymptomatic colonization. Previous antibiotic treatment of the mothers with cefuroxime was the single significant risk factor for colonization or infection (P = .028; odds ratio, 17; 95% confidence interval, 1.3 to 489.5).

Conclusions:

S. marcescens can cause rapidly spreading outbreaks associated with fatal infections in NICUs. With aggressive infection control measures, such outbreaks can be stopped at an early stage. Affected neonates themselves may well be the source of cross-infection to other patients on the ward. Antibiotic treatment of mothers should be reevaluated to avoid unnecessary exposure to antibiotics with the potential of overgrowth of resistant organisms.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 8 , August 2002 , pp. 457 - 461
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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