Serratia: a problem in a neonatal nursery

Area of Science:

• Neonatal infections
• Microbiology
• Infectious diseases

Background:

• An increasing incidence of Serratia species isolates was observed in a Special Care Nursery.
• A 7-year review (1976-1982) was conducted to analyze the experience with Serratia isolates in newborn infants.

Purpose of the Study:

• To investigate the incidence and characteristics of Serratia species infections in a Special Care Nursery.
• To assess the antibiotic susceptibility patterns of Serratia isolates over time.
• To evaluate the clinical outcomes of Serratia infections in neonates.

Main Methods:

• Retrospective review of medical records for neonates with Serratia isolates.
• Identification of Serratia species (Serratia marcescens and Serratia liquefaciens).
• Antimicrobial susceptibility testing of isolates.

Main Results:

• Fifty newborn infants had Serratia isolates, with a significant increase noted in 1982.
• Serratia marcescens was the predominant species.
• Initial sensitivity to gentamicin, kanamycin, chloramphenicol, and co-trimoxazole decreased over time, with increasing resistance.
• Ampicillin resistance also rose.
• Recent isolates showed sensitivity to cefotaxime sodium.
• 58% of infants were colonized, 32% had minor infections, and 10% developed life-threatening illnesses (meningitis, sepsis).
• One infant died; both meningitis cases resulted in porencephaly.

Conclusions:

• Serratia species pose a significant threat to neonates, with increasing antibiotic resistance being a major concern.
• Effective antibiotic strategies are crucial for managing these infections.
• The emergence of resistant strains necessitates vigilant monitoring and infection control measures in neonatal units.