Arslan Ugur, Erayman Ibrahim, Kirdar Sevin, Yuksekkaya Serife, Cimen Omer, Tuncer Inci, Bozdogan Bülent
Department of Clinical Microbiology, Selcuk University Meram Medical Faculty, Konya, Turkey.
Pediatr Int. 2010 Apr;52(2):208-12. doi: 10.1111/j.1442-200X.2009.02934.x. Epub 2009 Aug 2.
Contaminated parenteral nutrition (PN) is an important source of infection in neonates. Many organisms have been reported to cause contamination resulting in outbreaks in intensive care units. The aim of the present study was to investigate an outbreak caused by Serratia marcescens in a neonatal intensive care unit (NICU).
This was a descriptive study of an outbreak of sepsis in an NICU of a university teaching hospital. The outbreak was detected in seven patients from 10 to 12 December 2005 following the administration of PN. Extensive environmental samplings for culture were performed. The clonal relationship among isolates was tested using pulsed-field gel electrophoresis, random amplification of polymorphic DNA-polymerase chain reaction and plasmid DNA typing.
Serratia marcescens was found in blood cultures from infected newborns and from in-use PN solutions. Gestational age of the seven babies ranged from 28 to 34 weeks (median, 32 weeks), birthweight ranged from 1000 g to 2190 g (median, 1469 g), and postnatal age ranged from 8 to 22 days. The mortality rate was 14.3%. All these strains of S. marcescens had the same antibiotic susceptibility pattern and the same genomic DNA profile. Plasmid typing, as well as RAPD-PCR showed that all isolates had the same profile.
The source of the nosocomial sepsis in seven neonates was the PN solution. Contamination may occur during storage or repeated handling during PN preparation.
污染的肠外营养（PN）是新生儿感染的重要来源。据报道，许多微生物可导致污染，进而在重症监护病房引发感染暴发。本研究的目的是调查新生儿重症监护病房（NICU）中由粘质沙雷菌引起的一次感染暴发。
这是一项对某大学教学医院NICU中一次败血症暴发的描述性研究。2005年12月10日至12日，在7名接受PN治疗的患者中检测到此次暴发。对环境进行了广泛的培养采样。使用脉冲场凝胶电泳、随机扩增多态性DNA - 聚合酶链反应和质粒DNA分型检测分离株之间的克隆关系。
在感染新生儿的血培养物和正在使用的PN溶液中均发现了粘质沙雷菌。7名婴儿的胎龄为28至34周（中位数为32周），出生体重为1000克至2190克（中位数为1469克），出生后年龄为8至22天。死亡率为14.3%。所有这些粘质沙雷菌菌株具有相同的抗生素敏感性模式和相同的基因组DNA图谱。质粒分型以及随机扩增多态性DNA - 聚合酶链反应显示所有分离株具有相同的图谱。
7名新生儿医院感染败血症的来源是PN溶液。污染可能发生在PN储存期间或制备过程中的反复操作期间。
