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Outbreak of Serratia marcescens infection in a neonatal intensive care unit

G A Prasad1, P G Jones, J Michaels

  • 1Department of Internal Medicine, University of Wisconsin Medical School, Sinai Samaritan Medical Center, Milwaukee, USA.

Insights

A Serratia marcescens outbreak infected eight neonates in a NICU, resulting in one death. Prompt isolation and cohorting of infected infants contained the serious bacterial infection.

Area of Science:

  • Infectious Diseases
  • Neonatal Care
  • Microbiology

Background:

  • Neonatal intensive care units (NICUs) are vulnerable settings for hospital-acquired infections.
  • Serratia marcescens is an opportunistic pathogen that can cause severe infections in vulnerable populations.
  • Outbreaks of multidrug-resistant organisms in NICUs pose significant challenges to patient safety.

Purpose of the Study:

  • To describe an outbreak of Serratia marcescens infection in a community hospital NICU.
  • To identify the source and transmission dynamics of the outbreak.
  • To evaluate the effectiveness of control measures.

Main Methods:

  • Retrospective case review of neonates admitted to the NICU during the outbreak period.
  • Microbiological analysis of clinical isolates using pulsed-field gel electrophoresis (PFGE).
  • Environmental and staff screening to identify potential sources.

Main Results:

  • Eight neonates were affected (five infected, three colonized) by an identical strain of Serratia marcescens.
  • One neonate died during the outbreak.
  • Despite thorough investigation, no environmental source of the infection was identified.

Conclusions:

  • Serratia marcescens outbreaks in NICUs require prompt and effective infection control interventions.
  • Cohorting and isolation are crucial for managing such outbreaks.
  • The lack of an identified environmental source highlights the challenges in preventing and controlling Gram-negative bacilli outbreaks in NICUs.

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