Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain.
Enferm Infecc Microbiol Clin (Engl Ed). 2022 May;40(5):248-254. doi: 10.1016/j.eimce.2021.05.014.
Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit.
In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens.
During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens.
A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.
粘质沙雷氏菌是一种革兰氏阴性细菌，存在于医院环境中，通常与新生儿病房的暴发有关。我们医院从一名新生儿的血流培养物中检测到一株粘质沙雷氏菌，随后发生了暴发。本研究旨在描述新生儿病房中粘质沙雷氏菌暴发的分子流行病学情况。
为了调查暴发情况，我们从 2018 年 8 月至 9 月期间入住该病房的所有患者每周提交直肠拭子进行培养。2018 年 9 月，从潜在来源处获得环境样本。通过脉冲场凝胶电泳（PFGE）对分离株进行分型。此外，我们研究了洗必泰对粘质沙雷氏菌的体外活性。
在此期间，我们新生儿病房共有 146 名婴儿住院，其中 16 名患者的样本中粘质沙雷氏菌呈阳性。共采集了 36 个环境监测样本，从一名定植婴儿的孵化器听诊器上采集的一个样本中粘质沙雷氏菌呈阳性。包括来自听诊器的分离株在内的 18 个分离株均属于单个 PFGE 聚类。我们发现，即使洗必泰的浓度非常低，甚至接近 0 时，也能显著减少粘质沙雷氏菌的数量。
一个独特的粘质沙雷氏菌克隆引起了此次暴发，包括患者和一个听诊器上的分离株。通过早期实施特定的控制措施，暴发得到了控制。
