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The emergence of Serratia marcescens as a pathogen in a newborn unit
Abstract:
During a 12 month period, the Waikato Hospital Newborn Intensive Care Unit experienced an epidemic of Serratia marcescens infection. Seventeen serious infections occurred, resulting in three deaths. A further 15 cases of minor infection were also noted. Although no point source of introduction was found, gut colonization proved to be the most important reservoir for nosocomial spread of the organism. At the peak of the outbreak, a 95% incidence of rectal colonization with S. marcescens was observed. Eradication was achieved within a 4 month period using cohort isolation of affected infants.
Insights
A Serratia marcescens outbreak in a NICU caused serious infections and deaths. Gut colonization was the main spread source, but cohort isolation successfully eradicated the bacteria.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Neonatal Care
Background:
- The Waikato Hospital Newborn Intensive Care Unit (NICU) faced a significant Serratia marcescens outbreak over 12 months.
- This epidemic led to severe health consequences for vulnerable infants.
Purpose of the Study:
- To investigate the epidemiology of Serratia marcescens infections in a NICU.
- To identify the primary reservoir and transmission routes of the organism.
- To evaluate the effectiveness of control measures for bacterial eradication.
Main Methods:
- Retrospective analysis of infection data over a 12-month period.
- Investigation into potential sources of Serratia marcescens introduction.
- Assessment of gut colonization as a reservoir for nosocomial spread.
- Implementation and evaluation of cohort isolation for affected infants.
Main Results:
- Seventeen serious Serratia marcescens infections and 15 minor infections were recorded.
- Three infant deaths were attributed to the serious infections.
- Rectal colonization with Serratia marcescens reached a 95% incidence at the outbreak's peak.
- No single point source for the initial introduction of the organism was identified.
- Gut colonization was identified as the most significant reservoir for nosocomial transmission.
Conclusions:
- Gut colonization is a critical factor in the nosocomial spread of Serratia marcescens within NICU settings.
- Cohort isolation proved an effective strategy for controlling and eradicating Serratia marcescens during an epidemic.