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Published on: February 9, 2011
Community-acquired cutaneous ulcer in a child caused by Serratia marcescens
Vineeta Sharma1, Archana Angrup1, Santwana Verma1
1Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Introduction:
Serratia marcescens is a Gram-negative, aerobic, motile bacillus belonging to the family Enterobacteriaceae. S. marcescens has been implicated in different types of infections including urinary tract infection, septicaemia, meningitis and wound infections. Very few cases of skin infections caused by this organism have been reported in the medical literature. S. marcescens is an important nosocomial pathogen but has rarely been implicated as a cause of community-acquired soft-tissue infections.
Case Presentation:
We present a rare case of a community-acquired spontaneous cutaneous ulcer in an immunocompetent child from a sub-Himalayan region. Infections caused by S. marcescens may be difficult to treat because of its ability to produce a β-lactamase, which confers resistance to broad-spectrum, β-lactam antibiotics.
Conclusion:
In our patient, the treatment was modified to ceftazidime and amikacin after sensitivity testing and the patient's condition improved. This necessitated isolation by culture and antimicrobial susceptibility testing to ensure appropriate therapy.
Insights
Serratia marcescens, a rare cause of community-acquired skin infections, can be challenging to treat due to antibiotic resistance. Prompt diagnosis and susceptibility testing are crucial for effective management of these infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Dermatology
Background:
- Serratia marcescens is a Gram-negative bacterium commonly associated with hospital-acquired infections.
- While implicated in various infections, S. marcescens is rarely reported as a cause of community-acquired skin or soft-tissue infections.
- The organism's ability to produce beta-lactamase poses challenges for antibiotic treatment.
Purpose of the Study:
- To report a rare case of community-acquired spontaneous cutaneous ulcer caused by Serratia marcescens in an immunocompetent child.
- To highlight the diagnostic and therapeutic considerations for S. marcescens soft-tissue infections.
- To emphasize the importance of antimicrobial susceptibility testing for guiding treatment.
Main Methods:
- Case presentation of a community-acquired cutaneous ulcer in a child.
- Isolation of Serratia marcescens by culture.
- Antimicrobial susceptibility testing to determine effective antibiotics.
Main Results:
- Successful treatment of the cutaneous ulcer with ceftazidime and amikacin based on susceptibility results.
- Demonstration of Serratia marcescens as the causative agent of the spontaneous ulcer.
- Improvement in the patient's condition following targeted antibiotic therapy.
Conclusions:
- Serratia marcescens can cause rare community-acquired soft-tissue infections, even in immunocompetent individuals.
- Antimicrobial susceptibility testing is essential for effective treatment of Serratia marcescens infections.
- Combination therapy with ceftazidime and amikacin can be effective for treating S. marcescens infections.
