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Serratia marcescens pseudobacteraemia in neonates associated with a contaminated blood glucose/lactate analyzer
T J Neal1, J E Corkill, K J Bennett
1Department of Medical Microbiology, Royal Liverpool University Hospital.
Abstract:
Three episodes of Serratia marcescens pseudobacteraemia occurred on a neonatal intensive care unit. Following the first two cases, one full term and one pre-term infant, the source was identified as a glucose/lactate analyzer. Blood culture and environmental isolates of the organisms involved were indistinguishable when subjected to pulsed-field gel electrophoresis of Spe 1 digests and PCR ribotyping. Failure to recognize pseudobacteraemia in neonates results in inappropriate therapy for the individual and increased antibiotic pressures on the unit. Attention to the possibility of cross infection when using automated analyzers is required to minimize the risks of true or pseudoinfection to patients.
Insights
Serratia marcescens pseudobacteraemia in neonates was linked to a glucose/lactate analyzer. Prompt recognition and analyzer maintenance are crucial to prevent infant infections and antibiotic resistance.
Area of Science:
- Neonatal Intensive Care Unit Medicine
- Infectious Diseases
- Clinical Microbiology
Background:
- Pseudobacteraemia, a false positive blood culture result, poses diagnostic challenges in neonatal intensive care units.
- Serratia marcescens is an opportunistic pathogen that can cause serious infections in vulnerable infant populations.
Observation:
- Three distinct episodes of Serratia marcescens pseudobacteraemia were identified in neonates within a single intensive care unit.
- Investigation traced the source of infection to a shared glucose/lactate analyzer used for patient monitoring.
Findings:
- Molecular typing techniques, including pulsed-field gel electrophoresis and PCR ribotyping, confirmed the indistinguishable genetic identity between clinical isolates and environmental samples from the analyzer.
- This molecular evidence strongly implicated the automated analyzer as the source of cross-contamination.
Implications:
- Failure to accurately diagnose pseudobacteraemia can lead to unnecessary antibiotic treatment, contributing to antimicrobial resistance.
- Implementing stringent protocols for the cleaning and maintenance of automated medical equipment is essential to prevent healthcare-associated infections in neonates.