Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
J Hosp Infect. 2021 May;111:148-154. doi: 10.1016/j.jhin.2021.02.006. Epub 2021 Feb 10.
Serratia marcescens is notorious for its increasing antimicrobial resistance and potential to cause outbreaks in neonatal intensive care units (NICUs). A promising tool in outbreak investigations is whole-genome sequencing (WGS).
To describe a S. marcescens outbreak (2018-2019) in an NICU and discuss which infection control measures contributed to containment, addressing the potential of WGS.
S. marcescens isolates from patients and the environment isolated during the 2018-2019 NICU outbreak were analysed. In comparison, isolates from previous presumed NICU outbreaks and adult blood cultures were included. WGS and whole-genome multi-locus sequence typing analysis were performed.
Sixty-three S. marcescens isolates were analysed. The 2018-2019 outbreak was divided into three clusters, including four environmental strains (drains, N=3; baby scale, N=1). The strains differed significantly from those of an NICU outbreak in 2014 and adult blood cultures. Besides standard infection control measures, the siphons were replaced and weekly decontamination was performed with acetic acid 10%. Seven acquired-resistance genes and 29 virulence-associated genes were detected.
It was assumed that both neonates and drains were reservoirs of S. marcescens cross-contamination via the hands of healthcare workers and parents. Initially, standard measures, including hand hygiene, were reinforced. However, definitive containment was achieved only after replacement of the siphons and weekly decontamination with acetic acid. WGS enables faster recognition of an outbreak with accurate mapping of the spread, facilitating the implementation of infection control measures. WGS also provides interesting information about the spread of antibiotic resistance and virulence genes.
粘质沙雷氏菌以其不断增加的抗药性和在新生儿重症监护病房（NICU）引起爆发的潜力而臭名昭著。全基因组测序（WGS）是爆发调查中的一种有前途的工具。
描述 NICU 中粘质沙雷氏菌爆发（2018-2019 年）并讨论哪些感染控制措施有助于控制，解决 WGS 的潜力。
分析了 2018-2019 年 NICU 爆发期间从患者和环境中分离的粘质沙雷氏菌分离株。相比之下，还包括了来自之前假定的 NICU 爆发和成人血培养的分离株。进行了 WGS 和全基因组多位点序列分型分析。
分析了 63 株粘质沙雷氏菌分离株。2018-2019 年爆发分为三个集群，包括四个环境菌株（污水管，N=3；婴儿秤，N=1）。这些菌株与 2014 年 NICU 爆发和成人血培养的菌株有明显差异。除了标准的感染控制措施外，还更换了虹吸管，并每周用 10%的醋酸进行消毒。检测到 7 个获得性耐药基因和 29 个与毒力相关的基因。
据推测，新生儿和污水管都是粘质沙雷氏菌通过医护人员和家长的手交叉污染的储库。最初，加强了包括手卫生在内的标准措施。然而，只有更换虹吸管并每周用醋酸消毒后，才最终控制住了爆发。WGS 能够更快地识别爆发，并准确映射传播情况，从而便于实施感染控制措施。WGS 还提供了有关抗生素耐药性和毒力基因传播的有趣信息。
