Long-term Evolution of Multiple Outbreaks of Serratia marcescens Bacteremia in a Neonatal Intensive Care Unit

Villa, Jennifer; Alba, C. de; Barrado, Laura; Sanz, Francisca; Castillo, Espinoza; Viedma, Esther; Otero, Joaquín R.; Cháves, Fernando

doi:10.1097/inf.0b013e318267f441

Cited by 15 publications

(6 citation statements)

References 8 publications

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“…encountered several species. S. marcescens isolates are mostly associated with neonatal outbreaks in ICUs worldwide (54,55). Dissemination of NDM-1-producing S. marcescens in ICUs has not, to our knowledge, been reported before.…”

Section: Discussionmentioning

confidence: 88%

Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa

Pedersen

Sekyere

Govinden

et al. 2018

Antimicrob Agents Chemother

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Whole-genome sequence analyses revealed the presence of ( = 31), ( = 8), ( = 1), or ( = 1) in extensively drug-resistant and pandrug-resistant organisms isolated from in-patients in 10 private hospitals (2012 to 2013) in Durban, South Africa. Two novel NDM-1-encoding plasmids from were circularized by PacBio sequencing. In p19-10_01 [IncFIB(K); 223.434 bp], was part of a Tn-like structure (16.276 bp) delineated by IS The multireplicon plasmid p18-43_01 [IncR_1/IncFIB(pB171)/IncFII(Yp); 212.326 bp] shared an 80-kb region with p19-10_01, not including the -containing region. The two plasmids were used as references for tracing NDM-1-encoding plasmids in the other genome assemblies. The p19-10_01 sequence was detected in ( = 7) only, whereas p18-43_01 was tracked to ( = 4), ( = 1), ( = 11), spp. ( = 7), and ( = 1), revealing horizontal spread of this -bearing plasmid structure. Global phylogeny showed clustering of the (18/20) isolates together with closely related carbapenemase-negative ST101 isolates from other geographical origins. The South African isolates were divided into three phylogenetic subbranches, where each group had distinct resistance and replicon profiles, carrying either p19-10_01, p18-10_01, or pCHE-A1 (8,201 bp). The latter plasmid carried and within an integron mobilization unit. Our findings imply independent plasmid acquisition followed by local dissemination. Additionally, we detected carried by pPKPN4 in (ST14) and contained by a pNDM-MGR194-like genetic structure in (ST167), adding even more complexity to the multilayer molecular mechanisms behind nosocomial spread of carbapenem-resistant in Durban, South Africa.

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Section: Discussionmentioning

confidence: 88%

Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa

Pedersen

Sekyere

Govinden

et al. 2018

Antimicrob Agents Chemother

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“…In the two cases that we have presented there were no breast pumps associated with infections, even though several cases have been described previously in the literature. 2 8 9 Even though our first case could have been infected on her 4th day of hospitalization, the second case could have been community acquired as described by Laupland et al 4 …”

Section: Discussionmentioning

confidence: 77%

Pink Breast Milk: Serratia marcescens Colonization

Valle¹,

Salinas²

2014

AJP Rep

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Background Breast milk can turn pink with Serratia marcescens colonization, this bacterium has been associated with several diseases and even death. It is seen most commonly in the intensive care settings. Discoloration of the breast milk can lead to premature termination of nursing. We describe two cases of pink-colored breast milk in which S. marsescens was isolated from both the expressed breast milk. Antimicrobial treatment was administered to the mothers. Return to breastfeeding was successful in both the cases. Conclusions Pink breast milk is caused by S. marsescens colonization. In such cases,early recognition and treatment before the development of infection is recommended to return to breastfeeding.

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“…This fact can be explained on the basis of the ubiquity and resistance of this species; it can survive on inanimate surfaces (including medical devices and breast pumps) and even in antiseptic solutions for long periods of time [19–24]. In addition, they colonize the respiratory and/or gastrointestinal tract of symptomatic and asymptomatic hosts [12, 17, 25]. The current study was directed to elucidate the colonization rate in preterm neonates, one of the populations more affected by S. marcescens infections.…”

Section: Discussionmentioning

confidence: 99%

Serratia marcescens colonization in preterm neonates during their neonatal intensive care unit stay

Moles

Gómez

Moroder

et al. 2019

Antimicrob Resist Infect Control

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Background Nosocomial sepsis is the main problem that preterms have to face during their stay at neonatal intensive care units (NICU). Serratia marcescens is an emerging cause of preterm sepsis but its epidemiology is still largely unknown. Consequently, the aims of this study were to know the rate of preterms colonized by S. marcescens during their stay at the NICU and the characteristics and evolution of the S. marcescens population, including the susceptibility to clinically relevant antibiotics. Methods Twenty-six preterm infants born with a gestational age ≤ 32 weeks and/or weigh ≤1500 g were included in the study. Samples of meconium and feces ( n = 92) were collected during their first month of life of the infants, together with feeding samples after their pass through enteral feeding tubes ( n = 37). Samples were inoculated on MacConkey agar plates. The isolates identified as S. marcescens were genotyped using RAPD and PFGE; and antibiotics susceptibility was performed in a Vitek 2 system. Results A total of 179 S. marcescens isolates were obtained from the samples. PFGE profiling and cluster analysis allowed the classification of the isolates into 7 different S. marcescens clones. PFGE patterns 1 and 3 were the dominant strains in the fecal samples colonizing 31 and 35% of the infants, respectively. Those isolates causing bacteremia in two infants clustered in PFGE pattern 3. Conclusion S. marcescens is a bacterial species closely associated to the NICU environment. It can be frequently isolated from preterm’s feces although only some genetic lineages seem to be associated to sepsis. Enteral feeding tubes act as important reservoirs to keep the S. marcescens population in the NICU. Trial registration The local ethic committee approved this trial with the reference 09/157.

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Long-term Evolution of Multiple Outbreaks of Serratia marcescens Bacteremia in a Neonatal Intensive Care Unit

Cited by 15 publications

References 8 publications

Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa

Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa

Pink Breast Milk: Serratia marcescens Colonization

Serratia marcescens colonization in preterm neonates during their neonatal intensive care unit stay

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