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Morbidity and mortality of Serratia marcescens bacteraemia during the substance use epidemic
Ryan Bloom1, Kinna Thakarar2, Kristina E Rokas3
1Tufts University School of Medicine, Boston, MA, USA.
Background:
Serratia marcescens (S. marcescens) is an Enterobacterales species present throughout the environment and causes a range of infections. Historically, S. marcescens has been associated with persons who inject drugs (PWID), but literature is scarce. This study aimed to compare treatment characteristics and clinical outcomes between PWID and non-PWID with Serratia marcescens bacteraemia.
Methods:
This was a retrospective cohort study of patients hospitalised with S. marcescens bacteraemia from 1 January 2013 to 31 December 2019 at a tertiary medical centre. Patients were included if they were aged ≥ 18 years and had at least one positive blood culture for S. marcescens.
Results:
Of the 67 patients who met inclusion criteria, 14 were identified as PWID (21%) and 53 were non-PWID (79%). Persons who inject drugs were younger (median age: PWID 32 years, non-PWID 67 years) and less likely to have renal disease (PWID 7%, non-PWID 34%). Persons who inject drugs had a higher incidence of infective endocarditis (IE) (PWID 48%, non-PWID 0%) and were more likely to receive combination antimicrobial therapy (PWID 29%, non-PWID 2%). All-cause mortality at 12 months was comparable between groups (PWID 21%, non-PWID 21%).
Conclusion:
This study demonstrates that long-term outcomes of PWID are comparable with non-PWID, despite PWID being a younger cohort with fewer comorbidities. Clinicians should have high suspicion of IE in PWID with S. marcescens bacteraemia.
Insights
Outcomes for persons who inject drugs (PWID) with Serratia marcescens bacteraemia are similar to non-PWID. Despite being younger with fewer comorbidities, PWID have higher rates of infective endocarditis.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Serratia marcescens is an environmental bacterium causing diverse infections.
- Historically linked to persons who inject drugs (PWID), literature on this association is limited.
- This study compares S. marcescens bacteraemia in PWID versus non-PWID.
Purpose of the Study:
- To compare treatment characteristics and clinical outcomes of S. marcescens bacteraemia between PWID and non-PWID.
- To identify differences in comorbidities, infection types, and treatment strategies.
- To assess long-term mortality in these patient groups.
Main Methods:
- Retrospective cohort study from 2013-2019 at a tertiary medical center.
- Inclusion criteria: age ≥ 18 years with positive blood culture for S. marcescens.
- Comparison of demographic, clinical, and outcome data between PWID and non-PWID.
Main Results:
- 14 PWID (21%) and 53 non-PWID (79%) identified.
- PWID were younger (median 32 vs. 67 years) with less renal disease (7% vs. 34%).
- PWID had higher infective endocarditis (IE) rates (48% vs. 0%) and received more combination antimicrobial therapy (29% vs. 2%).
- 12-month all-cause mortality was comparable (21% in both groups).
Conclusions:
- Long-term outcomes for PWID with S. marcescens bacteraemia are comparable to non-PWID.
- PWID represent a younger cohort with fewer comorbidities but higher IE incidence.
- Clinicians should maintain high suspicion for IE in PWID presenting with S. marcescens bacteraemia.
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