Shaik Ismail B, Toh H X, Seah J H, Tan K Y, Lee L C, Tay Y Y, Khong K C, Seet A W M, Tesalona K C, Ngeow A J H, Ho S K Y, Poon W B, Lai D C M, Ko K K K, Ling M L
Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
J Hosp Infect. 2025 Feb;156:21-25. doi: 10.1016/j.jhin.2024.10.002. Epub 2024 Oct 22.
Serratia marcescens is an aerobic Gram-negative Enterobacterales bacillus that has emerged as a cause of hospital-associated infections.
To report the epidemiological, diagnostic, and genetic investigation of an outbreak involving five neonatal patients infected or colonized with S. marcescens including the infection control interventions.
The outbreak occurred in a 28-bedded neonatal unit in an acute care tertiary hospital in Singapore divided into three areas: two negative-pressure airborne infection isolation rooms with a shared anteroom, 10 neonatal intensive care unit (NICU) beds, and 16 high-dependency beds. In-flight patients and their immediate environment were screened for S. marcescens to determine probable environmental sources. Whole-genome sequencing (WGS) analysis of resulting isolates was performed to determine clone relatedness and possible transmission patterns. Implementation of infection control interventions included prompt isolation of cases, enhanced equipment and environmental disinfection, use of alcohol-based hand rub as the preferred hand hygiene mode, enhanced infection prevention orientation for parents, review of practices, audits, and immediate feedback on non-compliance.
Five neonates infected or colonized with S. marcescens were involved in this outbreak. Four were infection cases and one was identified through contact tracing. Three NICU sinks and the milk preparation room sink were tested positive for S. marcescens. WGS confirmed clonality of strains from two NICU sinks, and milk preparation room sink with that of the five neonates.
A multi-prong strategy was required to contain this outbreak. WGS analysis showed association of biofilms in sinks with the outbreak.
粘质沙雷氏菌是一种需氧革兰氏阴性肠杆菌科杆菌，已成为医院感染的一个病因。
报告一起涉及五名感染或定植粘质沙雷氏菌的新生儿患者的疫情的流行病学、诊断和基因调查，包括感染控制干预措施。
该疫情发生在新加坡一家急性护理三级医院的一个有28张床位的新生儿病房，该病房分为三个区域：两个带共用前室的负压空气传播感染隔离病房、10张新生儿重症监护病房（NICU）床位和16张高依赖病房床位。对在院患者及其直接环境进行粘质沙雷氏菌筛查，以确定可能的环境来源。对分离出的菌株进行全基因组测序（WGS）分析，以确定克隆相关性和可能的传播模式。感染控制干预措施的实施包括及时隔离病例、加强设备和环境消毒、使用酒精类手消毒剂作为首选的手部卫生方式、加强对家长的感染预防指导、审查操作、进行审计以及对违规行为立即反馈。
五名感染或定植粘质沙雷氏菌的新生儿参与了此次疫情。四名是感染病例，一名是通过接触追踪发现的。三个NICU水槽和配奶间水槽粘质沙雷氏菌检测呈阳性。WGS证实来自两个NICU水槽和配奶间水槽菌株与五名新生儿的菌株具有克隆性。
需要采取多管齐下的策略来控制此次疫情。WGS分析显示水槽中的生物膜与疫情有关联。
