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Colonization and infection by Serratia species in a paediatric surgical intensive care unit
M J Albers1, J W Mouton, D Tibboel
1Department of Pediatric Surgery, Sophia Children's Hospital/University Hospital Rotterdam, Rotterdam, The Netherlands. albers@chis.azr.nl
Insights
Serratia species infections are a concern in pediatric intensive care units (PICUs). This study highlights respiratory infections as most common and identifies both respiratory and digestive tracts as reservoirs in critically ill children.
Area of Science:
- Pediatric Intensive Care
- Infectious Diseases
- Microbiology
Background:
- Serratia species are recognized pathogens in adult and neonatal intensive care settings.
- Limited data exists on Serratia species colonization and infection patterns in pediatric intensive care patients.
Purpose of the Study:
- To characterize Serratia species infections in critically ill neonates, infants, and children.
- To compare outcomes of patients colonized with Serratia species versus other microorganisms.
- To evaluate the respiratory and digestive tracts as potential reservoirs for Serratia species.
Main Methods:
- Retrospective analysis of microbiological samples and patient records from a pediatric surgical intensive care unit (1986-1993).
- Identification and quantification of Serratia species isolates.
- Clinical data review for infection types, colonization, and patient outcomes.
Main Results:
- Serratia species were isolated 1356 times from 97 patients; 85 infections were diagnosed in 40 patients.
- Respiratory tract infections were most frequent (65 cases), followed by septicemia (13 cases).
- Serratia species colonization correlated with younger age at admission, prolonged ICU stay, and increased mortality.
Conclusions:
- The respiratory tract is a significant site for Serratia species colonization and infection in pediatric intensive care patients.
- Contrary to some hypotheses, the digestive tract may not be a more important reservoir than the respiratory tract in neonates.
- Serratia species pose a considerable threat in pediatric intensive care, necessitating further research into prevention and management strategies.
Abstract:
Serratia species are known for the infections they cause in adult and neonatal intensive care patients. Little is known about colonization and infection in paediatric intensive care patients. This study aims to describe the type of infections in critically ill newborns, infants and children, caused by Serratia spp., to compare patients colonized by Serratia spp. to patients colonized with other micro-organisms, and to assess the importance of the respiratory and digestive tracts as reservoirs. To this end, all microbiological samples taken from patients in our paediatric surgical intensive care unit between January 1986 and November 1993 were retrieved from the hospital database and patient records reviewed. Serratia spp. were isolated 1356 times from 97 patients. Eighty-five infections were diagnosed in 40 patients. Infections of the respiratory tract occurred most frequently (n= 65), followed by septicaemia (13), urinary tract infections (3), omphalitis (2), meningitis (1) and conjunctivitis (1). Colonization by Serratia spp. was associated with yearly age at admission, long ICU stay and high mortality. Both the respiratory and digestive tracts were frequently colonized. Our findings do not support the contention that the digestive tract is more important as reservoir than the respiratory tract in neonates.