<i>Serratia marcescens</i>Infections

Acar, J. F.

doi:10.1017/s0195941700064201

Cited by 63 publications

(36 citation statements)

References 53 publications

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“…Pneumonia, bloodstream infections, meningitis, and ocular and urinary tract infections can result from an S. marcescens infection (2)(3)(4)(5)(6). S. marcescens is also well known as a nosocomial pathogen and has been responsible for outbreaks, particularly in critically ill neonates and patients in intensive care units (2,(7)(8)(9). Multidrugresistant S. marcescens strains are reported to cause more-invasive infections and tend to spread rapidly in nosocomial environments (10)(11)(12)(13).…”

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Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

et al. 2013

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dSerratia marcescens causes health care-associated infections with important morbidity and mortality. Particularly, outbreaks produced by multidrug-resistant isolates of this species, which is already naturally resistant to several antibiotics, including colistin, are usually described with high rates of fatal outcomes throughout the world. Thus, it is important to survey factors associated with increasing frequency and/or emergence of multidrug-resistant S. marcescens nosocomial infections. We report the investigation and control of an outbreak with 40% mortality due to multidrug-resistant S. marcescens infections that happened from November 2007 to April 2008 after treatment with colistin for Acinetobacter baumannii meningitis was started at hospital H1 in 2005. Since that year, the epidemiological pattern of frequently recovered species has changed, with an increase of S. marcescens and Proteus mirabilis infections in 2006 in concordance with a significant decrease of the numbers of P. aeruginosa and A. baumannii isolates. A single pulsed-field gel electrophoresis (PFGE) cluster of S. marcescens isolates was identified during the outbreak. When this cluster was compared with S. marcescens strains (n ‫؍‬ 21) from 10 other hospitals (1997 to 2010), it was also identified in both sporadic and outbreak isolates circulating in 4 hospitals in Argentina. In132::ISCR1::bla CTX-M-2 was associated with the multidrug-resistant cluster with epidemic behavior when isolated from outbreaks. Standard infection control interventions interrupted transmission of this cluster even when treatment with colistin continued in several wards of hospital H1 until now. Optimizing use of colistin should be achieved simultaneously with improved infection control to prevent the emergence of species naturally resistant to colistin, such as S. marcescens and P. mirabilis.

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Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

et al. 2013

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“…In the case of other species of the family Enterobacteriaceae, infections caused by S. marcescens represent the tip of the iceberg, whereas colonization reflects the submerged part. Hand carriage plays an important role in the patient-to-patient transmission of the organism; however, several outbreaks were attributed to the contamination of medical devices and solutions as well (1,5,11,45).The aim of this study was to characterize in detail the population of S. marcescens isolates in two hospitals in Danzig, Poland, over a 5-year period. The clonal structure, antimicrobial susceptibility, and ESBL epidemiology of the isolates in the population were analyzed in the context of clinical data.…”

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“…Treatment of these infections is often very difficult, which to a big extent is due to the widespread natural and acquired resistance of the organism to antimicrobials. S. marcescens strains with combined resistance to expanded-spectrum ␤-lactams, aminoglycosides, fluoroquinolones, and/or co-trimoxazole have been identified in numerous hospitals worldwide (1,20,23,35). As in other enterobacteria, resistance to newer ␤-lactams is usually ␤-lactamase mediated (20,30).…”

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“…Because it is an opportunistic pathogen, it mainly affects patients in neonatal and surgical units and patients in intensive care units (ICUs). It is also responsible for various types of infections, including pneumonia, sepsis, meningitis, and fasciitis (1,45). Treatment of these infections is often very difficult, which to a big extent is due to the widespread natural and acquired resistance of the organism to antimicrobials.…”

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Molecular Epidemiology of Serratia marcescens in Two Hospitals in Danzig, Poland, over a 5-Year Period

et al. 2004

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The history of the Serratia marcescens population in two hospitals in Danzig, Poland, over a 5-year period was analyzed in a study that combined MIC evaluation, typing by randomly amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis, and analysis of extended-spectrum ␤-lactamases (ESBLs). We analyzed 354 isolates collected from 341 patients in two teaching hospitals in Danzig, Poland, from 1996 to 2000. The antimicrobial susceptibility profiles varied greatly, and for resistance to newer ␤-lactams, probable AmpC cephalosporinase derepression and ESBL production occurred in about 23 and 19% of the isolates, respectively. RAPD typing, by which 69 types were discerned altogether, revealed a high degree of clonal diversity among the populations. However, the four most prevalent types were highly predominant, grouping approximately 71% of the isolates studied. These clones were observed in the two hospitals and were strong contributors to both outbreaks and the background of endemicity of the S. marcescens infections. Some of the strains that were not so widely spread (12 RAPD types; ϳ14% of the isolates) were responsible for several smaller outbreaks, and the remaining isolates represented unique RAPD types (53 types; ϳ15% of the isolates) and were probably sporadic introductions from other environments. ESBLs were identified in several different clones, and some of these had most likely already been introduced into the hospitals as ESBL producers, whereas the others acquired the ESBL-encoding genes from other enterobacterial strains in these environments. The CTX-M-3 enzyme, which is widely observed in Poland, was the most common ESBL type among the S. marcescens isolates, followed by TEM-47 and SHV-5. The complex epidemiology of ESBLs, especially in 1999 and 2000, must have arisen from the introduction of ESBL producers from other centers, their clonal dissemination, and the constant penetration of the S. marcescens populations with plasmids with ESBL genes. Multiple S. marcescens isolates were obtained from 11 patients, who probably represented both patients with recolonizations and reinfections and patients with recurrences of infections with the evolution of the strain's susceptibility.Serratia marcescens has been reported to be a significant agent of hospital infections since the 1950s. Because it is an opportunistic pathogen, it mainly affects patients in neonatal and surgical units and patients in intensive care units (ICUs). It is also responsible for various types of infections, including pneumonia, sepsis, meningitis, and fasciitis (1, 45). Treatment of these infections is often very difficult, which to a big extent is due to the widespread natural and acquired resistance of the organism to antimicrobials. S. marcescens strains with combined resistance to expanded-spectrum ␤-lactams, aminoglycosides, fluoroquinolones, and/or co-trimoxazole have been identified in numerous hospitals worldwide (1,20,23,35). As in other enterobacteria, resistance to newer ␤-lactams is usually ␤-lact...

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“…Consecutive cultures obtained from the wound yielded growth of Serratia marcescens and Pseudomonas aeruginosa. S. marcescens is an opportunistic gram-negative bacterium that is associated with sporadic urinary tract infections and pneumonia in patients in intensive care units, although outbreaks can occur (1).…”

Section: Case Reportmentioning

confidence: 99%

Infection with an Extended-Spectrum β-Lactamase-Producing Strain of Serratia marcescens following Tongue Reconstruction

Dhawan¹,

Bonnet

Shukla

et al. 2003

J Clin Microbiol

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We report a case of postsurgical wound infection of polymicrobial etiology caused by Serratia marcescens and Pseudomonas aeruginosa following the use of a radial forearm free flap for oncological tongue reconstruction. S. marcescens was a producer of SHV-12 extended-spectrum ␤-lactamase (ESBL). This is the first report from India of this ESBL. S. marcescens and P. aeruginosa were resistant to the empirical perioperative antibiotics administered. Delay in the recognition of the type of infection and in the institution of appropriate therapy resulted in total loss of the free flap. CASE REPORTA 39-year-old man was admitted to the surgical oncology ward of the All India Institute of Medical Sciences (New Delhi, India) with a history of a nonhealing ulcer of 1-year duration on the left side of the tongue. An initial examination revealed a 0.5-by 1-cm indurate area on the left ventrolateral surface of the tongue. A biopsy was performed which showed a welldifferentiated squamous cell carcinoma of the left lateral border of the tongue. The tumor was classified as stages T1, N1, and M0.The patient underwent operative treatment consisting of left hemiglossectomy and unilateral supraomohyoid neck dissection. This was followed by reconstruction of the tongue with a radial forearm free flap. An initial regimen of metronidazole, amoxicillin, and clavulanic acid was started postoperatively.Ten days later, there were signs of collection of pus at the postoperative wound site. The pus was drained and sent for bacterial culture. Consecutive cultures obtained from the wound yielded growth of Serratia marcescens and Pseudomonas aeruginosa. S. marcescens is an opportunistic gram-negative bacterium that is associated with sporadic urinary tract infections and pneumonia in patients in intensive care units, although outbreaks can occur (1).Antibiotic susceptibility profiles were done by using a standard disk diffusion method recommended by the NCCLS (7). P. aeruginosa was susceptible to ciprofloxacin, ceftazidime, cefpirome, piperacillin-tazobactam, and cefoperazone-sulbactam. It was resistant to amoxicillin-clavulanic acid, piperacillin, cefotaxime, and amikacin. S. marcescens exhibited resistance to piperacillin, cefotaxime, ceftazidime, ceftriaxone, cefoperazone, cefpirome, amikacin, netilmicin, ciprofloxacin, and amoxicillin-clavulanic acid. It was sensitive to piperacillin-tazobactam and cefoperazone-sulbactam. The strain tested positive, by the method described by the NCCLS (7), for the production of extended-spectrum ␤-lactamase (ESBL).Isoelectric focusing and gene sequencing characterized the ESBL. Isoelectric focusing was performed with polyacrylamide gels containing Ampholine with a pH range of 3.5 to 10 as previously described (2). ␤-lactamases of known isoelectric points (pIs), TEM-1 (pI 5.4), TEM-2 (pI 5.6), TEM-24 (pI 6.5), SHV-5 (pI 8.2), and CTX-M-1 (pI 8.4), were used as standards. Isoelectric focusing showed that the ESBL focused at a pI of 8.4, suggesting that the ESBL of the S. marcescens strain was an SHV-type ␤-l...

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Serratia marcescensInfections

Cited by 63 publications

References 53 publications

Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

Molecular Epidemiology of Serratia marcescens in Two Hospitals in Danzig, Poland, over a 5-Year Period

Infection with an Extended-Spectrum β-Lactamase-Producing Strain of Serratia marcescens following Tongue Reconstruction

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