Serratia marcescens outbreak in a neonatal intensive care unit: crucial role of implementing hand hygiene among external consultants

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• 作者：Carlotta Montagnani (1) (2)
  Priscilla Cocchi (1)
  Laura Lega (2)
  Silvia Campana (2)
  Klaus Peter Biermann (2)
  Cesare Braggion (2)
  Patrizia Pecile (3)
  Elena Chiappini (1) (2)
  Maurizio de Martino (1) (2)
  Luisa Galli (1) (2)
  
  1. Department of Health Sciences ; University of Florence ; Viale Pieraccini 23 ; 50139 ; Florence ; Italy
  2. Anna Meyer Children鈥檚 University Hospital ; Viale Pieraccini 23 ; 50139 ; Florence ; Italy
  3. Microbiology and Virology Unit ; Careggi University Hospital ; Florence ; Italy
  
• 关键词：Serratia marcescens ; Outbreak ; Neonatal intensive care unit ; Molecular epidemiology ; Ocular colonization ; Rectal colonization ; Hand hygiene
• 刊名：BMC Infectious Diseases
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：338 KB
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• 刊物主题：Infectious Diseases; Parasitology; Medical Microbiology; Tropical Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2334

文摘

Background Serratia marcescens represents an important pathogen involved in hospital acquired infections. Outbreaks are frequently reported and are difficult to eradicate. The aim of this study is to describe an outbreak of Serratia marcescens occurred from May to November 2012 in a neonatal intensive care unit, to discuss the control measures adopted, addressing the role of molecular biology in routine investigations during the outbreak. Methods After an outbreak of Serratia marcescens involving 14 neonates, all admitted patients were screened for rectal and ocular carriage every two weeks. Extensive environmental sampling procedure and hand sampling of the staff were performed. Antimicrobial susceptibility pattern and molecular analysis of isolates were carried out. Effective hand hygiene measures involving all the external consultants has been implemented. Colonized and infected babies were cohorted. Dedicated staff was established to care for the colonized or infected babies. Results During the surveillance, 65 newborns were sampled obtaining 297 ocular and rectal swabs in five times. Thirty-four Serratia marcescens isolates were collected: 11 out of 34 strains were isolated from eyes, being the remaining 23 isolated from rectal swabs. Two patients presented symptomatic conjunctivitis. Environmental and hand sampling resulted negative. During the fifth sampling procedure no colonized or infected patients have been identified. Two different clones have been identified. Conclusions Ocular and rectal colonization played an important role in spread of infections. Implementation of infection control measures, involving also external specialists, allowed to control a serious Serratia marcescens outbreak in a neonatal intensive care unit.