Antibiotic-Sensitive Serratia Marcescens Infections Complicating Cardiopulmonary Operations: Contaminated Disinfectant as a Reservoir

Ehrenkranz, N. Joel; Bolyard, Elizabeth; Wiener, Maria; Cleary, Timothy J.

doi:10.1016/s0140-6736(80)92349-1

Cited by 78 publications

(30 citation statements)

References 15 publications

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“…Since the late 1960s, a tremendous number of nosocomial outbreaks attributed to S. marcescens have been described for adult patients; Farmer and others noted that by 1977, more than 100 outbreaks due to S. marcescens had been described (129). Outbreaks have occurred in medical wards and medical ICUs (112,147,280,320,329,335,383,408), a hepatologic intensive care unit (306), various surgery units and wards, including cardiac, urology, and neurosurgery wards (17,19,43,102,103,106,113,121,124,186,202,213,237,289,293,299,304,319,327,349,360,389,390,397,409,418), dialysis units (223), obstetric wards (365), bone marrow transplant and oncology units (221), a pulmonary ward (391), a gastrointestinal disease ward (382), neurology wards (242,349), and an outpatient pain clinic (83). In some nosocomial outbreaks, S. marcescens was isolated from patients from wards and units throughout hospitals (53,…”

Section: S Marcescensmentioning

confidence: 99%

Serratia Infections: from Military Experiments to Current Practice

2011

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SUMMARY Serratia species, in particular Serratia marcescens , are significant human pathogens. S. marcescens has a long and interesting taxonomic, medical experimentation, military experimentation, and human clinical infection history. The organisms in this genus, particularly S. marcescens , were long thought to be nonpathogenic. Because S. marcescens was thought to be a nonpathogen and is usually red pigmented, the U.S. military conducted experiments that attempted to ascertain the spread of this organism released over large areas. In the process, members of both the public and the military were exposed to S. marcescens , and this was uncovered by the press in the 1970s, leading to U.S. congressional hearings. S. marcescens was found to be a certain human pathogen by the mid-1960s. S. marcescens and S. liquefaciens have been isolated as causative agents of numerous outbreaks and opportunistic infections, and the association of these organisms with point sources such as medical devices and various solutions given to hospitalized patients is striking. Serratia species appear to be common environmental organisms, and this helps to explain the large number of nosocomial infections due to these bacteria. Since many nosocomial infections are caused by multiply antibiotic-resistant strains of S. marcescens , this increases the danger to hospitalized patients, and hospital personnel should be vigilant in preventing nosocomial outbreaks due to this organism. S. marcescens , and probably other species in the genus, carries several antibiotic resistance determinants and is also capable of acquiring resistance genes. S. marcescens and S. liquefaciens are usually identified well in the clinical laboratory, but the other species are rare enough that laboratory technologists may not recognize them. 16S rRNA gene sequencing may enable better identification of some of the less common Serratia species.

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Section: S Marcescensmentioning

confidence: 99%

Serratia Infections: from Military Experiments to Current Practice

2011

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“…Most but not all outbreaks were linked to the storage of benzalkonium chloride with cotton or gauze or the improper dilution of the benzalkonium chloride solution. The use of benzalkonium chloride to disinfect endoscopes has also led to urinary tract and pulmonary infections (20), and the use of contaminated spray bottles for environmental disinfection led to S. marcescens infections complicating cardiopulmonary surgery (22). The failure of benzalkonium chloride as a preservative in multidose albuterol bottles led to respiratory tract colonization and infection (31).…”

Section: Antisepticsmentioning

confidence: 99%

Outbreaks Associated with Contaminated Antiseptics and Disinfectants

Weber

Rutala

Sickbert-Bennett

2007

Antimicrob Agents Chemother

187

139

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“…Even though clinical personnel are quite stringent in preparing proper disinfectant concentrations, the recommended interaction time between instruments and disinfectants is frequently ignored and forgotten (3). In addition, the use of certain chemical agents may be questionable considering the many reports implicating disinfectant solutions as sources of nosocomial infections (4,7,10,(13)(14)(15). However, because of their efficacy against gram-positive bacteria and fungi, these agents may still be used in some busy clinics, especially those involved in dermatologic treatments (16).…”

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confidence: 99%