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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. Gram negative bacillus 7 species S. marcescens most common Motile, often red pigment Environmental

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Serratia marcescens and Neonatal Infections

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  1. Serratia marcescens and Neonatal Infections Andrew Daley Microbiology and Infectious Diseases Sue Scott Infection Control Women’s and Children’s Health April 2004

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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%

  7. 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

  8. 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

  9. S. marcescens in RWH - NICU • Sporadic infections occur in Intensive Care Units: • 2001 0 cases • 2002 3 conjunctivitis • 2003 2 conjunctivitis

  10. 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

  11. 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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