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An outbreak of Serratia marcescens infections in a neonatal unit
Abstract:
Over a 15-month period 732 babies were admitted to a neonatal unit, and Serratia marcescens was isolated from 153 (21%). In one-fifth (34) a clinical infection (9 major and 25 minor) developed. Major infection was associated with high mortality and morbidity and 2 cases presented after the neonatal period. No environmental reservoir was found. Colonised symptom-free neonates were considered to be the source, with transmission by staff-baby contact despite adequate hand-washing. Overcrowding was believed to be responsible for the difficulties experienced in eradicating this transmission.
Insights
Serratia marcescens caused infections in 21% of neonatal unit admissions. Asymptomatic neonates likely spread the bacteria through staff contact, exacerbated by overcrowding.
Area of Science:
- Neonatal infections
- Infectious disease epidemiology
- Clinical microbiology
Background:
- Serratia marcescens is an opportunistic pathogen that can cause severe infections in vulnerable populations.
- Neonatal units are high-risk environments for healthcare-associated infections due to the susceptibility of newborns.
Observation:
- Over a 15-month period, Serratia marcescens was isolated from 21% of 732 neonates admitted to a neonatal unit.
- Clinical infection developed in 34 neonates (one-fifth), with 9 major and 25 minor cases.
- Major infections were linked to significant mortality and morbidity, with two cases occurring post-neonatal discharge.
Findings:
- No environmental source for Serratia marcescens was identified.
- Colonized, asymptomatic neonates were identified as the likely source of transmission.
- Transmission occurred via staff-to-baby contact, even with proper hand hygiene protocols.
Implications:
- Overcrowding in neonatal units may hinder the effective control of bacterial transmission.
- Strategies to prevent Serratia marcescens colonization and infection in neonates require further investigation.
- Understanding transmission dynamics is crucial for implementing targeted infection control measures in neonatal intensive care units.