Serratia marcescens and neonatal infections
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Serratia marcescens and Neonatal Infections. Andrew Daley Microbiology and Infectious Diseases Sue Scott Infection Control Women’s and Children’s Health April 2004. Serratia species. Gram negative bacillus 7 species S. marcescens most common Motile, often red pigment Environmental

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Serratia marcescens and neonatal infections

Serratia marcescens and Neonatal Infections

Andrew Daley

Microbiology and Infectious Diseases

Sue Scott

Infection Control

Women’s and Children’s Health

April 2004


Serratia species
Serratia species

  • Gram negative bacillus

  • 7 species

    • S. marcescens most common

  • Motile, often red pigment

  • Environmental

    • water, soil, plants, insects, animals

  • Extracellular enzymes contribute to pathogenicity

    • elastase, lecithinase, caseinase etc.

  • May be antibiotic multi-resistant


  • The miracle of bolsena
    The Miracle of Bolsena

    • Peter of Prague at the Church of Saint Christina, Bolsena, Italy, 1263

    • Red pigment of Serratia on bread interpreted as the blood of Christ

    Raffaello Sanzio (1483-1520), Vatican

    bar = 5m


    Serratia marcescens infection issues
    Serratia marcescensInfection Issues

    • Transmission on hands of staff most important mode of spread

    • Occasional focal environmental source

    • Infection usually occurs in compromised patients:

      • Pneumonia in ventilated patients

      • UTI in catheterised patients

      • Post-operative wound infections

      • Blood stream infection in patients with intravenous access devices


    Published s marcescens nursery outbreaks implicated sources
    Published S. marcescens Nursery Outbreaks – implicated sources

    • Liquid theophyline

    • Milk from used bottles

    • Ventilator equipment

    • Breast pumps

    • Enteral feed additives

    • Emolient skin cleansers

    • Antiseptic soaps

    • Suction tubing

    • Disinfectants


    Serratia marcescens clinical presentation
    Serratia marcescensClinical Presentation

    • Bacteraemia / septicaemia

    • Meningitis

      • ventriculitis, cysts

      • cell count may be normal

      • mortality 40%

  • Pneumonia

  • Urinary tract infection

  • Soft-tissue infection

  • Overall mortality 14%


  • S marcescens nosocomial infections
    S. marcescens Nosocomial Infections

    • United States CDC-NNIS*

      • 2.0% of blood stream infections

      • 2.8% of surgical site infections

      • 3.6% of pneumonia

    * All age groups


    S marcescens in rch nnu
    S. marcescens in RCH - NNU

    • Sporadic infections occur in Intensive Care Units:

      • 2001 3 cases

        • 1 septicaemia

        • 2 urinary tract infections

    • 2002 2 cases

      • 1 urinary tract infection

      • 1 conjunctivitis


    S marcescens in rwh nicu
    S. marcescens in RWH - NICU

    • Sporadic infections occur in Intensive Care Units:

      • 2001 0 cases

      • 2002 3 conjunctivitis

      • 2003 2 conjunctivitis


    Infection control recommendations for level iii nurseries
    Infection Control Recommendations for Level III Nurseries

    • Cohort colonised babies

      • Weekly screening of non-colonised babies

    • Meticulous hand hygiene practices

    • Gowns & gloves for all patient contact likely to produce contamination


    Infection control recommendations for level iii nurseries1
    Infection Control Recommendations for Level III Nurseries

    • Do not move equipment between rooms

    • Equipment may need to be decontaminated with 500ppm hypochlorite

    • Limit room access to essential personnel

    • Effective discharge planning

    • Communication and Education


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