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Newborn conjunctivitis associated with triclosan 0.5% antiseptic intrinsically contaminated with Serratia marcescens
Abstract:
In February 1994, three cases of conjunctivitis with Serratia marcescens occurred in infants in the newborn nursery. An epidemiological investigation was conducted including environmental sampling. S marcescens was isolated from the bottle of triclosan 0.5% antiseptic soap that was in use in the nursery and from an unopened bottle on the pharmacy shelf. The manufacturer confirmed that this contaminant was dislodged from the air purification system during a filter change while the packaging was being completed in an adjoining room. The product was withdrawn from use in the nursery and replaced by individual bar soap. No further cases of infection with S marcescens have been identified following the withdrawal of the triclosan 0.5% soap.
Insights
A Serratia marcescens outbreak in a newborn nursery caused infant conjunctivitis. The contamination originated from triclosan antiseptic soap, leading to its withdrawal and a halt in infections.
Area of Science:
- Infectious Disease Epidemiology
- Healthcare-Associated Infections
- Microbiology
Background:
- Conjunctivitis cases caused by Serratia marcescens were identified in infants within a newborn nursery.
- An epidemiological investigation was initiated to determine the source and spread of the bacterial contamination.
Purpose of the Study:
- To identify the source of Serratia marcescens contamination in a neonatal intensive care unit.
- To implement control measures to prevent further infant infections.
Main Methods:
- Epidemiological investigation including patient and environmental sampling.
- Microbiological analysis of clinical and environmental samples.
- Traceback of implicated product to manufacturing processes.
Main Results:
- Serratia marcescens was isolated from triclosan 0.5% antiseptic soap bottles in use and from unopened stock.
- The manufacturer identified contamination originating from the air purification system during product packaging.
- No further cases of Serratia marcescens infection were observed after product withdrawal.
Conclusions:
- Triclosan 0.5% antiseptic soap was the source of Serratia marcescens outbreak in the newborn nursery.
- Environmental contamination during manufacturing can lead to healthcare-associated infections.
- Product withdrawal and replacement with alternative hygiene measures effectively controlled the outbreak.