Department of Microbiology and Infection Control, The Madras Medical Mission, Mogappair, Chennai 600037, India.
Division of Infectious Disease, Centre for Science Education and Research, Nitte (Deemed to be University), Deralakatte, Mangaluru 575018, India.
J Med Microbiol. 2019 Apr;68(4):616-621. doi: 10.1099/jmm.0.000947. Epub 2019 Mar 6.
We report the use of next generation sequencing (NGS) for investigating an outbreak of 13 cases of Serratia marcescens blood stream infections in a non-Neonatal Intensive Care Unit (non-NICU) setting in a tertiary care hospital in India over 5 months. Thirteen cases of sepsis due to S. marcescens were identified in various Intensive Care Units (ICUs) over 5 months. Environmental surveillance identified isolates in the adult ICU (AICU). Antibiogram did not correlate with timeline. Sequencing libraries were prepared using Nextera XT chemistry (Illumina). Based on NGS, two clusters were identified. Cluster 1 had environmental and clinical isolates from the AICU and cluster 2 were isolates from the Coronary Care Unit (CCU). NICU and Paediatric ICU isolates did not belong to any cluster. Polyclonal outbreaks best identified by NGS can occur simultaneously. Good infection prevention practices like hand hygiene for compounded medicines and surface cleaning helped end the outbreak.
我们报告了使用下一代测序（NGS）来调查印度一家三级医院的非新生儿重症监护病房（非 NICU）环境中发生的 13 例粘质沙雷氏菌血流感染爆发。在 5 个月的时间里，不同的重症监护病房（ICU）共发现了 13 例因粘质沙雷氏菌引起的败血症病例。环境监测在成人 ICU（AICU）中发现了分离株。药敏试验结果与时间线没有相关性。测序文库使用 Nextera XT 化学方法（Illumina）制备。基于 NGS，确定了两个聚类。聚类 1 包括来自 AICU 的环境和临床分离株，聚类 2 则是来自冠心病监护病房（CCU）的分离株。NICU 和儿科 ICU 的分离株不属于任何聚类。多克隆爆发通过 NGS 可以被很好地识别，而且可能同时发生。良好的感染预防措施，如复合药物的手部卫生和表面清洁，有助于结束此次爆发。
