Outbreak of Serratia marcescens postoperative infection traced to barbers and razors

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• A cluster of fourteen postoperative infections caused by Serratia marcescens occurred in a large hospital between December 2012 and June 2013.
• The infections affected patients on neurosurgical and spinal surgery wards, prompting an investigation into the outbreak's source.

Purpose of the Study:

• To identify the source and transmission routes of the Serratia marcescens outbreak.
• To determine risk factors associated with the infections.
• To implement effective infection control strategies to halt the outbreak.

Main Methods:

• Collected cultures from healthcare workers and environmental sources, including barbers and their razors.
• Characterized Serratia marcescens isolates using antibiotic susceptibility testing and pulsed-field gel electrophoresis (PFGE).
• Conducted a retrospective case-control study to identify independent risk factors for infection.

Main Results:

• Serratia marcescens was isolated from patients and from the hands and razors of two barbers.
• Pre-operative shaving by these barbers was identified as the sole independent risk factor (OR 78.0, P < 0.0001).
• The outbreak ceased after the barbers were removed and infection control protocols were reinforced.

Conclusions:

• Pre-operative wet shaving poses a significant risk for postoperative infections, particularly with Serratia marcescens.
• Highlights the critical role of environmental and personnel hygiene in preventing healthcare-associated infections.
• Emphasizes the importance of thorough source identification and targeted interventions in managing infectious outbreaks.