Miranda-Novales Guadalupe, Leaños-Miranda Blanca, Díaz-Ramos Rita, González-Tejeda Lourdes, Peregrino-Bejarano Leoncio, Villegas-Silva Raúl, Solórzano-Santos Fortino
Departamento de Infectología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Arch Med Res. 2003 May-Jun;34(3):237-41. doi: 10.1016/S0188-4409(03)00026-2.
Serratia marcescens is a well-recognized nosocomial pathogen. The objective of the study was to describe typing results using a rapid pulsed field gel electrophoresis (PFGE) protocol and infection control measures during an outbreak of Serratia marcescens in a 24-bed, referral, neonatal intensive care unit (NICU) of a tertiary-care pediatric hospital.
Two patients with S. marcescens sepsis were identified in the NICU. Health care personnel of the unit were requested to reinforce infection control measures. Active surveillance was established to detect infected and/or colonized patients and environmental and staff reservoirs. Infected and colonized patients were cohorted on one side of the unit; admissions to NICU were limited. Isolates were typed with a short 2-day pulsed-field gel electrophoresis (PFGE) protocol.
Thirty three patients were exposed during a period of 20 days. Ten S. marcescens isolates were obtained from six patients, in two from blood culture and in three from stool culture; a single clone was identified in four. S. marcescens was not isolated from environmental or staff cultures.
PFGE results were obtained in 2 days, infection control measures were reinforced, outbreak was promptly interrupted, and the NICU remained opened.
粘质沙雷氏菌是一种公认的医院病原体。本研究的目的是描述在一家三级儿科医院拥有24张床位的转诊新生儿重症监护病房(NICU)发生粘质沙雷氏菌暴发期间,使用快速脉冲场凝胶电泳(PFGE)方案的分型结果及感染控制措施。
在NICU中识别出两名患有粘质沙雷氏菌败血症的患者。要求该科室的医护人员加强感染控制措施。建立主动监测以检测感染和/或定植的患者以及环境和工作人员中的病原体储存库。将感染和定植的患者集中安置在科室的一侧;限制新生儿重症监护病房的入院人数。采用为期2天的短脉冲场凝胶电泳(PFGE)方案对分离株进行分型。
在20天内有33名患者暴露。从6名患者中获得了10株粘质沙雷氏菌分离株,其中2株来自血培养,3株来自粪便培养;在4株中鉴定出单一克隆。未从环境或工作人员培养物中分离出粘质沙雷氏菌。
在2天内获得了PFGE结果,加强了感染控制措施,暴发迅速得到控制,新生儿重症监护病房仍然开放。