Journal Article

Three Consecutive Outbreaks of <i>Serratia marcescens</i> in a Neonatal Intensive Care Unit

Felix Fleisch, Urs Zimmermann-Baer, Reinhard Zbinden, Gian Bischoff, Romaine Arlettaz, Katharina Waldvogel, David Nadal and Ruef Christian

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 6, pages 767-773
Published in print March 2002 | ISSN: 1058-4838
Published online March 2002 | e-ISSN: 1537-6591 | DOI:
Three Consecutive Outbreaks of Serratia marcescens in a Neonatal Intensive Care Unit

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We investigated an outbreak of Serratia marcescens in the neonatal intensive care unit (NICU) of the University Hospital of Zurich. S. marcescens infection was detected in 4 children transferred from the NICU to the University Children's Hospital (Zurich). All isolates showed identical banding patterns by pulsed-field gel electrophoresis (PFGE). In a prevalence survey, 11 of 20 neonates were found to be colonized. S. marcescens was isolated from bottles of liquid theophylline. Despite replacement of these bottles, S. marcescens colonization was detected in additional patients. Prospective collection of stool and gastric aspirate specimens revealed that colonization occurred in some babies within 24 hours after delivery. These isolates showed a different genotype. Cultures of milk from used milk bottles yielded S. marcescens. These isolates showed a third genotype. The method of reprocessing bottles was changed to thermal disinfection. In follow-up prevalence studies, 0 of 29 neonates were found to be colonized by S. marcescens. In summary, 3 consecutive outbreaks caused by 3 genetically unrelated clones of S. marcescens could be documented. Contaminated milk could be identified as the source of at least the third outbreak.

Journal Article.  4235 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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