Serratia Marcescens Meningitis Following Spinal Anaesthesia and Arthroscopy

SBA 2020: Regional anesthesia safety recommendations update

“… 76 The main agent described in this case is Serratia marcecens , an opportunistic gram-negative bacterium that colonizes the human gastrointestinal tract. 77 , 78 Disconnection of the epidural catheter and infusion system exposes the catheter internal lumen to the environment, which can lead to subsequent epidural infusion of contaminated solution. A study with catheter contaminated by Staphylococcus epidermidis concluded that cutting the proximal end of the catheter exposed to the environment, with disinfection of the contaminated site and subsequent infusion of the local anesthetic, can prevent contamination of the infusate.…”

“…The incidence of catheter-related epidural abscess is low, and cases of meningitis and osteomyelitis are rarer. 76 , 78 Delaying diagnosis and treatment of major CNS infections, even for a few hours, significantly worsens neurological outcome. Bacterial meningitis is a medical emergency.…”