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Serratia marcescens in the neonatal intensive care unit: re-emphasis of the potentially devastating sequelae
Angelika Berger1, Klaudia Rohrmeister, Nadja Haiden
1Division of Neonatology, Department of Pediatrics, University of Vienna, Vienna, Austria. angelika.berger@akh-wien.ac.at
Background:
It is known that infections with Serratia marcescens can take a progressive course in preterm infants and that meningoencephalitis with this pathogen exhibits an extremely bad neurologic prognosis.
Methods And Results:
We report on five cases of septicemia with Serratia marcescens in preterm infants during a nosocomial outbreak. Three patients developed meningoencephalitis with brain abscesses. Mild clinical and laboratory findings of infection contrasted with destructive findings on MRI scan. All five patients survived, those with isolated bacteremia without neurologic sequelae.
Conclusion:
When Serratia marcescens is isolated from any source in a neonatal intensive care unit, preventive measures including strict hygiene and cohorting of infants must be implemented immediately since this pathogen seems to exhibit specific affinity for the central nervous system and Serratia marcescens meningoencephalitis takes a progressive and destructive course despite antibiotic therapy.
Insights
Serratia marcescens outbreaks in preterm infants can cause severe meningoencephalitis. Prompt hygiene measures are crucial to prevent this dangerous central nervous system infection in neonatal intensive care units.
Area of Science:
- Neonatal infectious diseases
- Bacterial pathogenesis
- Neurology
Background:
- Serratia marcescens infections pose a significant risk to preterm infants.
- Meningoencephalitis caused by S. marcescens is associated with poor neurological outcomes.
Observation:
- A nosocomial outbreak of Serratia marcescens septicemia occurred in five preterm infants.
- Three infants developed meningoencephalitis with brain abscesses.
- Mild clinical signs contrasted with severe MRI findings.
Findings:
- All five infants survived the infection.
- Patients with isolated bacteremia showed no neurological sequelae.
- Meningoencephalitis cases, despite treatment, exhibited destructive neurological progression.
Implications:
- Immediate implementation of strict hygiene and cohorting is vital upon S. marcescens isolation in NICUs.
- Serratia marcescens demonstrates a predilection for the central nervous system.
- Early and aggressive preventive strategies are essential due to the destructive potential of S. marcescens meningoencephalitis.