Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013–2014

Dawczynski, K; Proquitté, Hans; Roedel, Jürgen; Edel, Birgit; Pfeifer, Yvonne; Hoyer, Heike; Dobermann, Helke; Hagel, Stefan; Pletz, Mathias W.

doi:10.1007/s15010-016-0922-y

Cited by 27 publications

(15 citation statements)

References 25 publications

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“…Both PFGE and core hqSNV identified multiple clones during this NICU S. marcescens outbreak investigation, a phenomenon reported previously (2,5,8). Strains isolated from patients belonged to 5 different PFGE banding patterns and hqSNV clusters, but only 1 of those was identified in more than 1 patient (PFGE pattern A).…”

Section: Discussionsupporting

confidence: 62%

“…Strains isolated from patients belonged to 5 different PFGE banding patterns and hqSNV clusters, but only 1 of those was identified in more than 1 patient (PFGE pattern A). Similarly, implementation of S. marcescens screening procedures in the NICU of a German hospital led to the identification of isolates corresponding to 8 different PFGE patterns over a 3-month period, with 6 of the patterns occurring in the same unit and 1 dominant strain leading to multiple cases (8). These results indicate that multiple sources could be involved in S. marcescens contamination of hospitalized neonates and that screening procedures implemented during outbreak investigations might have detected S. marcescens strains that would have gone undetected under normal conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations showed that generally more than one clone can be identified during S. marcescens outbreak investigations (2,5,8,9). Typing of bacterial isolates can be particularly challenging and relies on the use of molecular biology tools such as pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and ribotyping.…”

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confidence: 99%

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Serratia marcescens Outbreak in a Neonatal Intensive Care Unit: New Insights from Next-Generation Sequencing Applications

Martineau

Lalancette

et al. 2018

J Clin Microbiol

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is an environmental bacterium that is commonly associated with outbreaks in neonatal intensive care units (NICUs). Investigations of outbreaks require efficient recovery and typing of clinical and environmental isolates. In this study, we investigated how the use of next-generation sequencing applications, such as bacterial whole-genome sequencing (WGS) and bacterial community profiling, could improve outbreak investigations. Phylogenomic links and potential antibiotic resistance genes and plasmids in isolates were investigated using WGS, while bacterial communities and relative abundances of in environmental samples were assessed using sequencing of bacterial phylogenetic marker genes (16S rRNA and genes). Typing results obtained using WGS for the 10 isolates recovered during a NICU outbreak investigation were highly consistent with those obtained using pulsed-field gel electrophoresis (PFGE), the current standard typing method for this bacterium. WGS also allowed the identification of genes associated with antibiotic resistance in all isolates, while no plasmids were detected. Sequencing of the 16S rRNA and genes both showed greater relative abundances of at environmental sampling sites that were in close contact with infected babies. Much lower relative abundances of were observed following disinfection of a room, indicating that the protocol used was efficient. Variations in the bacterial community composition and structure following room disinfection and among sampling sites were also identified through 16S rRNA gene sequencing. Together, results from this study highlight the potential for next-generation sequencing tools to improve and to facilitate outbreak investigations.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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Serratia marcescens Outbreak in a Neonatal Intensive Care Unit: New Insights from Next-Generation Sequencing Applications

Martineau

Lalancette

et al. 2018

J Clin Microbiol

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“…In conclusion, all laboratory-run typing methods, wgMLST included, are valuable in the context of hospital-wide screening for pathogens but also for analyses of random clinical isolates (27,28). wgMLST for S. marcescens has here been demonstrated to be a promising epidemiological typing support tool.…”

Section: Resultsmentioning

confidence: 91%

Epidemiological Typing of Serratia marcescens Isolates by Whole-Genome Multilocus Sequence Typing

et al. 2019

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Serratia marcescens is an opportunistic bacterial pathogen. It is notorious for its increasing antimicrobial resistance and its potential to cause outbreaks of colonization and infections, predominantly in neonatal intensive care units (NICUs). There, its spread requires rapid infection control response. To understand its spread, detailed molecular typing is key. We present a whole-genome multilocus sequence typing (wgMLST) method for S. marcescens. Using a set of 299 publicly available whole-genome sequences (WGS), we developed an initial wgMLST system consisting of 9,377 gene loci. This included 1,455 loci occurring in all reference genomes and 7,922 accessory loci. This closed system was validated using three geographically diverse collections of S. marcescens consisting of 111 clinical isolates implicated in nosocomial dissemination events in three hospitals. The validation procedure showed a full match between epidemiological data and the wgMLST analyses. We set the cutoff value for epidemiological (non)relatedness at 20 different alleles, though for the majority of outbreak-clustered isolates, this difference was limited to 4 alleles. This shows that the wgMLST system for S. marcescens provides prospects for successful future monitoring for the epidemiological containment of this opportunistic pathogen.

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“…As a matter of concern, reduced CHX susceptibility was associated with resistance to colistin, likely caused by increased efflux of both substances via the same route. Furthermore, we have reported a polyclonal outbreak with Serratia marcescens on a neonatology ICU [8]. These isolates exhibited resistance to 0.5% Mikrobac forte ® consisting of benzyl-C12-18-alkyl dimethyl ammonium chloride 199 mg/g and N-(3-aminopropyl)-N-dodecylpropane-1,3-diamine 50 mg/g, which was used for disinfection of surfaces before the outbreak.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Newly Developed Vacuum Dried Microtiter Plate for Rapid Biocide Susceptibility Testing of Clinical Enterococcus faecium Isolates

et al. 2020

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We investigated the suitability of a newly developed biocide susceptibility test system based on microtiter plates containing vacuum dried biocides as a fast and reliable screening method. The evaluated substances included the cationic biocides benzalkonium chloride (BAC), chlorhexidine dihydrochloride (CHX), cetylpyridinium chloride, didecyldimethylammonium chloride, and octenidine dihydrochloride. Testing a selection of Escherichia coli and enterococci, the biocide microtiter plates provided results comparable to those obtained from broth microdilution according to ISO 20776-1. Broad MIC ranges allowed for testing gram-positive and gram-negative species with the same plate design. In the second part of our study, we applied the established method to analyze the susceptibility of 90 clinical Enterococcus faecium isolates from a German university hospital, as previous studies have indicated a link between reduced susceptibility to substances such as CHX and BAC and vancomycin resistance. We therefore determined MIC and minimum bactericidal concentrations (MBC) for 48 non-clonal vancomycin susceptible and 42 non-clonal vancomycin resistant isolates, but MIC95 and MBC95 were quite similar in both groups. Our easy to handle and ready to use test system enables the routine surveillance of bacterial tolerance towards disinfectants in hospitals. As a result, hygiene measures can be adapted and nosocomial infections controlled despite increasing prevalence of antibiotic-resistant bacteria.

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Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013–2014

Abstract: The revised KRINKO recommendation may help identify unnoticed outbreaks. Colonised non-VLBW patients may be an underestimated source of S. marcescens.

Cited by 27 publications

References 25 publications

Serratia marcescens Outbreak in a Neonatal Intensive Care Unit: New Insights from Next-Generation Sequencing Applications

Serratia marcescens Outbreak in a Neonatal Intensive Care Unit: New Insights from Next-Generation Sequencing Applications

Epidemiological Typing of Serratia marcescens Isolates by Whole-Genome Multilocus Sequence Typing

Evaluation of a Newly Developed Vacuum Dried Microtiter Plate for Rapid Biocide Susceptibility Testing of Clinical Enterococcus faecium Isolates

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