Brote de infección nosocomial por Serratia marcescens asociado a contaminación intrínseca de clorhexidina acuosa

Hervé, Beatrice; Chomali, May; Gutiérrez, Cecilia; Luna, Mariana; Rivas, Jeannette; Blamey, Rodrigo; Espinoza, Ricardo; Izquierdo, Giannina; Cabezas, Catalina; Álvarez, Claudio; Fuente, Sergio de la

doi:10.4067/s0716-10182015000600004

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Serratia species harbor several virulence factors including hemolysins (ShlAB), Quorum-Sensing proteins (LuxI-R), biofilm development proteins (BsmB) (only seen in S. marcescens ), phospholipases (PhlA), peptidases (Clp), metalloproteases, chitinases (ChiABC), siderophores and hemophores (HasA), the lipopolysaccharide LPS, and motility and adherence factors such as flagella and fimbriae ( Mahlen, 2011 ). S. marcescens is among the 10 most recovered pathogens in hospitals worldwide ( Mahlen, 2011 ; Bertrand and Dowzicky, 2012 ) and has been cultured from a variety of sources including disinfectants, pressure transducers, bronchoscopes, multi-dose medication vials, contaminated antiseptic solutions, fentanyl-containing fluids, contaminated MgSO 4 and contaminated saline syringes among others ( Sunenshine et al, 2007 ; Liu et al, 2011 ; Chiang et al, 2013 ; Merkier et al, 2013 ; Šiširak and Hukić, 2013 ; Liou et al, 2014 ; Hervé et al, 2015 ; Dawczynski et al, 2016 ; Morillo et al, 2016 ; Vetter et al, 2016 ). Historically, outbreaks of S. marcescens have been reported since 1950 and have been considered nosocomial in origin ( Mahlen, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

The Genomic Basis of Intrinsic and Acquired Antibiotic Resistance in the Genus Serratia

et al. 2018

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Serratia marcescens, a member of the Enterobacteriaceae family, was long thought to be a non-pathogenic bacterium prevalent in environmental habitats. Together with other members of this genus, it has emerged in recent years as an opportunistic nosocomial pathogen causing various types of infections. One important feature of pathogens belonging to this genus is their intrinsic and acquired resistance to a variety of antibiotic families, including β-lactam, aminoglycosides, quinolones and polypeptide antibiotics. The aim of this study was to elucidate which genes participate in the intrinsic and acquired antibiotic resistance of this genus in order to determine the Serratia genus resistome. We performed phylogenomic and comparative genomic analyses using 32 Serratia spp. genomes deposited in the NCBI GenBank from strains isolated from different ecological niches and different lifestyles. S. marcescens strain SmUNAM836, which was previously isolated from a Mexican adult with obstructive pulmonary disease, was included in this study. The results show that most of the antibiotic resistance genes (ARGs) were found on the chromosome, and to a lesser degree, on plasmids and transposons acquired through horizontal gene transfer. Four strains contained the gyrA point mutation in codon Ser83 that confers quinolone resistance. Pathogenic and environmental isolates presented a high number of ARGs, especially genes associated with efflux systems. Pathogenic strains, specifically nosocomial strains, presented more acquired resistance genes than environmental isolates. We may conclude that the environment provides a natural reservoir for antibiotic resistance, which has been underestimated in the medical field.

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Section: Introductionmentioning

confidence: 99%

The Genomic Basis of Intrinsic and Acquired Antibiotic Resistance in the Genus Serratia

et al. 2018

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“…marcescens . Further investigation revealed contamination of a batch of the antiseptic solution during the production process [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Infection of Multiple Tunneled Dialysis Catheters Resulting From the Contamination of the Chlorhexidine Solution by Serratia marcescens

Gomes Cochicho,

Silva,

Viegas

2023

Cureus

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Tunnelled dialysis catheters continue to be a choice in several patients as hemodialysis access. According to Kidney Disease Outcomes Quality Initiative guidelines, its handling implies disinfection, that can be performed using chlorhexidine solutions. Theoretically, these solutions have bactericidal capacity at concentrations greater than 0.12%. We present a curious situation of failure of the antiseptic process due to contamination of the chlorhexidine solution 4% of aqueous base. In this hemodialysis clinic, three cases of infections by the bacteria Serratia marcescens were identified over 2 weeks - in two of the cases, identified in blood culture, and in the other case in the exudate from the exit site of the catheter. Considering the abnormal number of infections by this agent and the fact that these patients were on different shifts, were treated in different rooms, and handled by different nurses, the antiseptic solutions used in the different hemodialysis rooms were analyzed, as well as a closed package from the same batch. After microbiological tests were performed on the antiseptic solution, we identified the growth of Serratia marcescens . This result identified the culprit as being the contamination of the 4% chlorhexidine solution. The competent authorities were notified, and the disinfection method was changed to use a chlorhexidine alcohol-based solution.

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“…Además, se recomendó que se fabricaran en presentación de uso único, para evitar su contaminación una vez abiertos en los centros de salud 97 . En Chile, a raíz de brote de S. marcescens ocurrido por contaminación intrínseca de clorhexidina 2% en base acuosa durante el año 2014, la autoridad nacional (ISP) emitió una instrucción en enero de 2015 indicando que los antisépticos deben contar con controles microbiológi-cos, tanto de las materias primas como de los productos terminados 98,99 , a fin de entregar mayor seguridad a los usuarios clínicos.…”

Section: Aspectos Regulatorios Del Uso De Antisépticos Y Desinfectantesunclassified

Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología

Diomedi

Chacón

Delpiano

et al. 2017

Rev. chil. infectol.

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Brote de infección nosocomial por Serratia marcescens asociado a contaminación intrínseca de clorhexidina acuosa

Cited by 6 publications

References 14 publications

The Genomic Basis of Intrinsic and Acquired Antibiotic Resistance in the Genus Serratia

The Genomic Basis of Intrinsic and Acquired Antibiotic Resistance in the Genus Serratia

Infection of Multiple Tunneled Dialysis Catheters Resulting From the Contamination of the Chlorhexidine Solution by Serratia marcescens

Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología

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