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Epidemic outbreak of Serratia marcescens infection in a cardiac surgery unit
Abstract:
Between 2 February and 16 April 1985, an outbreak of Serratia marcescens infection involving 10 male patients occurred in a cardiac surgery unit. All the patients had surgical wound infection, five also had osteomyelitis (four sternal, one costal), and another had peritonitis secondary to peritoneal dialysis. Three patients had concomitant bacteremia. All Serratia strains isolated produced a cherry-red pigment, and all had the same biochemical and antibiotic susceptibility pattern. An intensive search for the origin of the outbreak was initially unsuccessful, and it proved impossible to isolate S. marcescens from cultures of numerous samples taken from hospital personnel and from the environment. The fact that all patients were male and had been shaved for surgery by the same team of barbers led us to investigate the shaving procedures. We finally isolated a strain of pigmented S. marcescens, corresponding to that involved in the outbreak, from samples taken from the hands and equipment of the barbers. After suitable action had been taken, the epidemic terminated.
Insights
A 1985 cardiac surgery outbreak of Serratia marcescens infections in 10 male patients was traced to contaminated shaving procedures. Interventions targeting barbers successfully terminated the epidemic.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- An outbreak of Serratia marcescens infection occurred in a cardiac surgery unit between February and April 1985.
- Ten male patients were affected, primarily with surgical wound infections, osteomyelitis, and peritonitis.
Purpose of the Study:
- To identify the source of the Serratia marcescens outbreak in the cardiac surgery unit.
- To determine the transmission route of the infection among male patients.
Main Methods:
- Epidemiological investigation focusing on patient demographics and procedures.
- Microbiological analysis of patient isolates and environmental/personnel samples.
- Investigated shaving procedures due to all patients being male and shaved by the same team.
Main Results:
- All Serratia strains were pigmented, biochemically identical, and shared antibiotic susceptibility patterns.
- Initial environmental and personnel cultures were negative.
- Serratia marcescens was isolated from barbers' hands and equipment, linking them to the outbreak.
Conclusions:
- Contaminated shaving procedures by barbers served as the source of the Serratia marcescens outbreak.
- Prompt intervention targeting the identified source led to the termination of the epidemic.
- Highlights the importance of meticulous hygiene in preventing healthcare-associated infections.