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An outbreak of Serratia marcescens traced to a contaminated bronchoscope
C M Vandenbroucke-Grauls1, A C Baars, M R Visser
1Department of Clinical Microbiology, University Hospital, Utrecht, The Netherlands.
Abstract:
An outbreak of colonization and infection with Serratia marcescens in a surgical Intensive Care Unit is described. A case-control study pointed to a bronchoscope as the source of the epidemic strain, and cultures of washing effluent of the incriminated bronchoscope yielded S. marcescens. Discontinuation of the use of the instrument and the implementation of recommendations for future use of bronchoscopes ended the outbreak.
Insights
A surgical Intensive Care Unit outbreak of Serratia marcescens infection was traced to a contaminated bronchoscope. Implementing new cleaning protocols for the bronchoscope successfully ended the S. marcescens outbreak.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Critical Care Medicine
Background:
- Surgical Intensive Care Units (SICUs) are vulnerable to healthcare-associated infections.
- Serratia marcescens is an opportunistic pathogen that can cause serious infections in immunocompromised patients.
- Outbreaks of multidrug-resistant organisms in critical care settings pose significant challenges.
Purpose of the Study:
- To describe an outbreak of Serratia marcescens colonization and infection in a SICU.
- To identify the source of the epidemic strain of S. marcescens.
- To implement control measures to contain and prevent further spread.
Main Methods:
- A case-control study was conducted to investigate potential sources of infection.
- Environmental cultures, including bronchoscope washing effluent, were performed.
- Epidemiological data was analyzed to identify transmission patterns.
Main Results:
- A case-control study identified a bronchoscope as the likely source of the S. marcescens outbreak.
- Cultures of the washing effluent from the implicated bronchoscope confirmed the presence of S. marcescens.
- Discontinuation of the bronchoscope's use and adherence to revised protocols halted the outbreak.
Conclusions:
- Contaminated bronchoscopes can serve as a reservoir for S. marcescens transmission in SICUs.
- Strict adherence to reprocessing guidelines for bronchoscopes is crucial for preventing outbreaks.
- Effective infection control measures, including source identification and protocol revision, can successfully manage S. marcescens outbreaks.