Hejazi A, Falkiner F R
Department of Clinical Microbiology, Trinity College, Dublin, Ireland.
J Med Microbiol. 1997 Nov;46(11):903-12. doi: 10.1099/00222615-46-11-903.
Over the last 30 years, Serratia marcescens has become an important cause of nosocomial infection. There have been many reports concerning the identification, antibiotic susceptibility, pathogenicity, epidemiological investigations and typing of this organism. Accurate identification is important in defining outbreaks. The API 20E system has been used widely, but is not individually satisfactory. The growth of S. marcescens in the environment has been investigated in relation to water, disinfectants and plastics such as blood bags. Certain extracellular products are unique to S. marcescens. Pigment (prodigiosin) biosynthesis by S. marcescens has been investigated fully since the emergence of the organism as a cause of infection. Many other aspects of the pathogenicity and virulence of S. marcescens have been studied, including adherence and hydrophobicity, lipopolysaccharide (LPS) and extracellular products. Two modes of adhesion to host epithelial surfaces have been suggested. These are mannose-resistant (MR) pili and mannose-sensitive (MS) pili. LPS, which is responsible for the biological activity of endotoxin, has been investigated fully and 24 somatic antigens have been described. The production of different enzymes by S. marcescens as virulence factors has also been reported, including chitinase, lipase, chloroperoxidase and an extracellular protein, HasA. Antibiotics used to treat serratia infection include beta-lactam agents, aminoglycosides and fluoroquinolones and a variety of different resistance mechanisms have been demonstrated. Typing methods used to study the epidemiology of S. marcescens include biotyping, bacteriocin typing, phage typing, plasmid analysis, polymerase chain reaction amplification of enterobacterial repetitive intergenic consensus sequences (ERIC-PCR) and ribotyping. Serological typing has also been used and this method seems to be a suitable first-line typing method for S. marcescens, although some strains remain untypable. RAPD-PCR has also been applied to a small number of isolates and seems to be a promising method, especially for rapid monitoring of an outbreak and tracing the source of initial infection.
在过去30年里，粘质沙雷氏菌已成为医院感染的一个重要病因。关于该菌的鉴定、抗生素敏感性、致病性、流行病学调查及分型已有许多报道。准确鉴定对于界定疫情暴发很重要。API 20E系统已被广泛使用，但单个使用并不令人满意。已针对水、消毒剂以及血袋等塑料制品研究了粘质沙雷氏菌在环境中的生长情况。某些胞外产物是粘质沙雷氏菌所特有的。自从该菌作为感染病因出现以来，已对其色素（灵菌红素）生物合成进行了充分研究。还研究了粘质沙雷氏菌致病性和毒力的许多其他方面，包括黏附性和疏水性、脂多糖（LPS）及胞外产物。已提出两种黏附宿主上皮表面的方式。即甘露糖抗性（MR）菌毛和甘露糖敏感性（MS）菌毛。对负责内毒素生物活性的LPS已进行了充分研究，并已描述了24种菌体抗原。也有报道称粘质沙雷氏菌产生不同的酶作为毒力因子，包括几丁质酶、脂肪酶、氯过氧化物酶和一种胞外蛋白HasA。用于治疗沙雷氏菌感染的抗生素包括β-内酰胺类药物、氨基糖苷类药物和氟喹诺酮类药物，并且已证明存在多种不同的耐药机制。用于研究粘质沙雷氏菌流行病学的分型方法包括生物分型、细菌素分型、噬菌体分型、质粒分析、肠杆菌重复基因间共有序列聚合酶链反应扩增（ERIC-PCR）和核糖体分型。也已使用血清学分型，尽管一些菌株仍无法分型，但该方法似乎是粘质沙雷氏菌合适的一线分型方法。随机扩增多态性DNA聚合酶链反应（RAPD-PCR）也已应用于少数分离株，似乎是一种有前景的方法，特别是用于疫情暴发的快速监测和追踪初始感染源。
