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Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat
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Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat

Published on: October 29, 2014

Endemic Serratia marcescens infection in a neonatal intensive care nursery associated with gastrointestinal

M T Newport, J F John, Y M Michel

    Pediatric Infectious Disease
    |March 1, 1985
    PubMed

    Insights

    Serratia marcescens (SM) caused a prolonged NICU outbreak, leading to gastrointestinal colonization and respiratory infections, particularly in very low birth weight infants. Frequent respirator tubing changes reduced SM-associated pneumonia.

    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Neonatal Care

    Background:

    • Serratia marcescens (SM) outbreaks pose significant risks in Neonatal Intensive Care Units (NICUs).
    • High-level gastrointestinal colonization by SM was observed during a prolonged NICU outbreak.
    • Early outbreak strains harbored a plasmid conferring resistance to gentamicin, tobramycin, and beta-lactam agents.

    Purpose of the Study:

    • To investigate the characteristics and clinical impact of a Serratia marcescens outbreak in a NICU.
    • To identify risk factors and associated morbidities in neonates colonized or infected with SM.
    • To evaluate the effectiveness of interventions in controlling the SM outbreak.

    Main Methods:

    • Observational study during a prolonged NICU outbreak.
    • Analysis of SM strains, including plasmid carriage and antibiotic resistance profiles.
    • Correlation of SM colonization with neonatal birth weight and clinical outcomes.
    • Assessment of intervention impact on SM transmission and associated infections.

    Main Results:

    • SM colonization was linked to very low birth weight (<1500 g).
    • In very low birth weight neonates, SM was associated with pneumonia, patent ductus arteriosus, congestive heart failure, and septicemia.
    • In neonates >1500 g, SM was associated with bronchopulmonary dysplasia, respirator use, patent ductus arteriosus, and congestive heart failure.
    • Frequent changing of respirator tubing reduced respiratory tract colonization and pneumonia.
    • Contaminated sinks remained a source of multiresistant SM.

    Conclusions:

    • Serratia marcescens outbreaks in NICUs can lead to severe gastrointestinal and respiratory complications, especially in vulnerable neonates.
    • Antibiotic resistance patterns, including plasmid-mediated resistance, are critical factors in outbreak dynamics.
    • Environmental contamination, such as sinks and respirator equipment, contributes to sustained transmission.
    • Interventions targeting environmental hygiene and equipment management are crucial for outbreak control.

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