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Serratia marcescens outbreak in a neonatal intensive care unit related to the exit port of an oscillator

Tracy M Macdonald1, Joanne M Langley, Tim Mailman

  • 1Department of Infection Prevention and Control Services, IWK Health Center, Halifax, Canada.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 2, 2011
PubMed
Abstract

Insights

A neonatal intensive care unit outbreak of Serratia marcescens was investigated. Infection control measures and containment of oscillator circuitry condensate are crucial to prevent transmission of this opportunistic pathogen.

Area of Science:

  • Infectious Disease Epidemiology
  • Neonatal Care
  • Microbiology

Background:

  • Neonatal intensive care units (NICUs) are vulnerable to healthcare-associated infections.
  • Serratia marcescens is an opportunistic pathogen that can cause outbreaks in vulnerable populations.
  • Ventilated premature infants are at high risk for respiratory infections.

Purpose of the Study:

  • To identify the source and interrupt transmission of Serratia marcescens colonization in a NICU.
  • To evaluate the role of medical equipment in pathogen dissemination.

Main Methods:

  • A multidisciplinary outbreak investigation was conducted in a Level III NICU.
  • Pulsed-field gel electrophoresis (PFGE) analyzed Serratia marcescens isolates for relatedness.
  • Droplet generation from a high-frequency oscillator was simulated using fluorescent dye.

Main Results:

  • Affected infants were cohoused, suggesting localized transmission.
  • PFGE revealed indistinguishable or closely related Serratia marcescens isolates.
  • Uncontained oscillator circuitry expelled droplets up to 107.8 cm, demonstrating potential for wide dissemination.

Conclusions:

  • Strict adherence to infection control protocols is vital for preventing pathogen transmission in NICUs.
  • Medical equipment, such as oscillators, can aerosolize and transmit pathogens over significant distances.
  • Containment systems for medical device condensate are necessary to mitigate infection risk.

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