AI Article Synopsis
- The article investigates a S. marcescens outbreak in a neonatal intensive care unit (NICU) and identifies the origin through a case-control study of affected and unaffected neonates.
- Whole-genome sequencing and various software were used to analyze the outbreak and determine significant risk factors, such as proximity to contaminated sinks and staff rotation patterns.
- The study concludes that contaminated handwashing sinks were key in spreading S. marcescens, emphasizing the need for better hygiene practices and monitoring of sink contamination to prevent future outbreaks.
Article Abstract
Purpose: This article describes the origin of a S. marcescens outbreak in a neonatal intensive care unit (NICU).
Materials And Methods: A retrospective case-control study including 12 S. marcescens-positive and 22 S. marcescens-negative neonates in the NICU was performed to identify the source of the outbreak. S. marcescens isolates were collected during the outbreak and analyzed using whole-genome sequencing (WGS). IQ-Tree software, BEAST2 software package and SCOTTI software were used to construct a phylogenetic tree and a propagation path map.
Results: The index case occurred on February 21st and outbreak ended on March 9th, 2021, affecting a total of 12 neonates (2 with S. marcescens infection and 10 with S. marcescens colonization). Multivariate logistic regression identified that the distance of <0.8 m between the bed unit and the sink (odds ratio [OR], 20.50; 95 % confidence interval [CI], 1.09-384.86), a large number of rotating nurses within a week (OR 2.58, 95 % CI, 1.09-6.11) and use of humidification water in the incubator (OR 189.70, 95 % CI, 2.76-13027.31) were significant increased risk factors for S. marcescens infection or colonization in the outbreak. WGS sifted out a predominant clone between contaminated handwashing sinks and patients, suggesting that cross-transmission was involved in the dissemination of S. marcescens.
Conclusion: Contaminated handwashing sinks can be a communication intermediary of S. marcescens infection or colonization of neonates in the NICU. A distance of <0.8 m between the bed unit and the sink, and a large number of rotating nurses might play important roles in this outbreak. Attention should be paid to sinks contamination and contact transmission to prevent outbreaks.
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| http://dx.doi.org/10.1016/j.ijmmb.2024.100741 | DOI Listing |
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[Analysis of risk factors for onset of acquired Serratia marcescens infection in neonatal intensive care unit].
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Department of Neonatal Intensive Care Unit, Women and Children's Hospital of Ningbo University, Ningbo 315012, Zhejiang, China. Corresponding author: Li Yanhong, Email:
Objective: To analyze the clinical characteristics of critically ill neonates in the neonatal intensive care unit (NICU) who acquired Serratia marcescens infection for onset or colonization, and to explore the risk factors contributing to the onset of Serratia marcescens infection.
Methods: A retrospective case-control study was conducted by collecting clinical data from NICU neonates at the Women and Children's Hospital of Ningbo University between January 2017 and December 2023. Forty-four neonates with clinical signs and/or symptoms consistent with Serratia marcescens infection, and with Serratia marcescens isolated from specimens, would be enrolled as the infection onset group, while 45 neonates who tested positive for Serratia marcescens in rectal and/or pharyngeal cultures during the same period, but had no clinical signs or infection symptoms, were enrolled as the colonization control group.
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