<i>Serratia marcescens</i> antibiotic resistance mechanisms of an opportunistic pathogen: a literature review

Tavares-Carreón, Faviola; Anda-Mora, Karla De; Rojas‐Barrera, Idalia C.; Andrade, Ángel

doi:10.7717/peerj.14399

Cited by 49 publications

(32 citation statements)

References 115 publications

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“…Sometimes, a congenital central nervous system malformation (e.g., myelomeningocele) can predispose one to infection [17]. Few cases of brain abscesses after an initial diagnosis of S. marcescens septicemia and meningitis have been published in the literature [4,18,21,24].…”

Section: Discussionmentioning

confidence: 99%

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Neonatal Brain Abscess with Serratia marcescens after Intrauterine Infection: A Case Report

et al. 2023

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Brain abscesses are a possible complication of bacterial sepsis or central nervous system infection but are uncommon in the neonatal period. Gram-negative organisms often cause them, but Serratia marcescens is an unusual cause of sepsis and meningitis in this age group. This pathogen is opportunistic and frequently responsible for nosocomial infections. Despite the existing antibiotics and modern radiological tools, mortality and morbidity remain significant in this group of patients. We report an unusual unilocular brain abscess in a preterm neonate caused by Serratia marcescens. The infection had an intrauterine onset. The pregnancy was achieved through assisted human reproduction techniques. It was a high-risk pregnancy, with pregnancy-induced hypertension, imminent abortion, and required prolonged hospitalization of the pregnant woman with multiple vaginal examinations. The infant was treated with multiple antibiotic cures and percutaneous drainage of the brain abscess associated with local antibiotic treatment. Despite treatment, evolution was unfavorable, complicated by fungal sepsis (Candida parapsilosis) and multiple organ dysfunction syndrome.

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Section: Discussionmentioning

confidence: 99%

“…S. marcescens is the main pathogen responsible for central nervous system infections, respiratory tract infections, bacteremia, endocarditis, peritonitis, arthritis, osteomyelitis, keratitis, urinary tract infections, and skin infections [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Neonatal Brain Abscess with Serratia marcescens after Intrauterine Infection: A Case Report

et al. 2023

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“…Antibiotic therapy is the main method of treating infections caused by S. marcescens . 4 However, the therapeutic effectiveness has been attenuated by emerging resistant strains. 5 Meanwhile, the common multidrug-resistant nature of S. marcescens complicates the treatment of its infections.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Characterization of Serratia marcescens Isolated from Clinical Bovine Mastitis Cases in Ningxia Hui Autonomous Region of China

Zhong¹,

Shen²,

Liu³

et al. 2023

IDR

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Purpose This study aimed to investigate the prevalence and genetic characterization of Serratia marcescens isolates from clinical bovine mastitis in Ningxia Hui Autonomous Region of China. Methods S. marcescens was identified by the polymerase-chain reaction of 16S rRNA gene and sequencing. Antimicrobial susceptibility was tested by the disk diffusion method. Genes of resistance and virulence were determined by the PCR. Results Overall, S. marcescens were confirmed from 32 of 2897 (1.1%) mastitis milk samples. These isolates showed high resistance to cefazolin (30/32, 93.8%) and chloramphenicol (28/32, 87.5%). A 12.5% (4/32) of the isolates displayed multidrug resistance (MDR). The most prevalent resistant genes found in S. marcescens were TEM (32/32, 100%) and CTX-M (24/32, 75.0%; CTX-M-15 , 14/32, 43.8%; CTX-M-14 , 8/32, 25.0%; CTX-M-65 , 2/32, 6.3%) for extended-spectrum beta-lactamase, cmlA (28/32, 87.5%) and floR (16/32, 50.0%) for chloramphenicol resistance, SIM-1 (2/32, 6.3%) for carbapenemases, and sdeB (28/32, 87.5%), sdeY (26/32, 81.3%), sdeR (26/32, 81.3%) and sdeD (20/32, 62.5%) for efflux pumps. Moreover, all isolates carried virulence genes flhD, entB , and kpn , and most of them contained mrkD (30/32, 93.8%), ycfM (26/32, 81.3%), bsmB (26/32, 81.3%), pigP (26/32, 81.3%), kfu (24/32, 75.0%) and shlB (24/32, 75.0%). Conclusion To our knowledge, this is the first report of genetic determinants for antimicrobial resistance and virulence in S. marcescens isolated from bovine mastitis cases in China. These findings are useful for developing strategies for prevention and treatment of bovine mastitis caused by S. marcescens in China.

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“…Resistance to broader spectrum beta-lactams is by way of chromosomal AmpC β-lactamase enzyme, plasmid-encoded β-lactamases, plasmid-mediated extended spectrum β-lactamases and plasmid-mediated carbapenemases. 6 Resistance to other classes of antibiotics such as aminoglycosides and fluoroquinolones is attributed to a combination of mutations as well as chromosomally and plasmid mediated mechanisms. 6 Reports of primary cutaneous infection as a result of S. marcescens are rare and typically occur in the context of immunosuppression.…”

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confidence: 99%

“…6 Resistance to other classes of antibiotics such as aminoglycosides and fluoroquinolones is attributed to a combination of mutations as well as chromosomally and plasmid mediated mechanisms. 6 Reports of primary cutaneous infection as a result of S. marcescens are rare and typically occur in the context of immunosuppression. 1,7,8 Skin infection can present either acutely with life-threatening cellulitis, abscesses, ulcers and necrotising fasciitis, or more indolently as a chronic infection in the form of nodules or granulomatous lesions.…”

mentioning

confidence: 99%

Serratia marcescens causing recurrent superficial skin infections in an immunosuppressed patient

Drummond,

Maliampurakal,

Jamdar

et al. 2023

Skin Health and Disease

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Serratia marcescens is a gram‐negative bacterium found commonly in water and soil. Initially thought to be non‐pathogenic, it is now recognised as an important cause of nosocomial and opportunistic infections. Skin infections are rare, but cases of S. marcescens causing ulcers, abscesses and necrotizing fasciitis have been reported. We report an unusual cutaneous presentation of S. marcescens in an immunosuppressed patient. A 77‐year‐old man under review for non‐melanoma skin cancer in the context of a previous cardiac transplant, presented with an asymptomatic scalp eruption. Immunosuppressive medications included ciclosporin 90 mg twice daily (2.5 mg/kg/day) and mycophenolate mofetil 1 g twice daily. Physical examination revealed well‐defined annular and polycyclic patches with brownish crusting across his scalp. Bacterial culture demonstrated a heavy growth of Staphylococcus aureus sensitive to flucloxacillin. The patient was treated with 7 days of flucloxacillin 500 mg four times daily. Despite this, the eruption extended. Skin biopsy demonstrated epidermal spongiosis, florid dermal inflammatory cell infiltrate and abundant bacteria and neutrophils in the parakeratotic crust. Fungal stains were negative as was direct immunofluorescence. Repeat culture demonstrated heavy growth of S. marcescens sensitive to ciprofloxacin. The patient was treated with 10 days of oral ciprofloxacin 500 mg twice daily along with 1% hydrogen peroxide cream topically with significant clinical improvement. Microbiological review indicated that a gram‐negative organism was present in the initial scalp swab. In addition, S. marcescens had been detected previously on a skin swab from a recent transient eruption on the torso. Further, a heavy growth of a coliform bacillus was demonstrated in a similar eruption on the chest in 2013. It was concluded that the patient was likely colonised with S. marcescens which appeared to have caused recurrent superficial skin infections over several years. We report this case to highlight an unusual clinical presentation of cutaneous S. marcescens infection. This should be considered in the differential diagnosis of skin eruptions in immunocompromised patients. Clinical information detailing a patient’s immunosuppressed state must be supplied on microbiology requests to allow accurate interpretation of results, and consideration of organisms which may otherwise be overlooked or considered contaminants.

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Serratia marcescens antibiotic resistance mechanisms of an opportunistic pathogen: a literature review

Cited by 49 publications

References 115 publications

Neonatal Brain Abscess with Serratia marcescens after Intrauterine Infection: A Case Report

Neonatal Brain Abscess with Serratia marcescens after Intrauterine Infection: A Case Report

Prevalence and Characterization of Serratia marcescens Isolated from Clinical Bovine Mastitis Cases in Ningxia Hui Autonomous Region of China

Serratia marcescens causing recurrent superficial skin infections in an immunosuppressed patient

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