Abstract
A population-based laboratory surveillance was conducted during a six-year period to define the incidence, demographic risk factors for acquisition, and anti-microbial susceptibilities of Serratia species isolates. A total of 715 incident Serratia species isolates were identified for an annual incidence of 10.8 per 100,000 residents; bacteremic disease occurred in 0.9 per 100,000 residents annually. The incidence increased with advancing age and males were at the highest risk. Ninety-two percent of the isolates were Serratia marcescens, and the majority (65%) of incident Serratia species isolates were of community onset. Ninety-five percent of isolates were susceptible to ciprofloxacin, 98% to gentamicin, 98% to trimethoprim/sulfamethoxazole, and >99% to imipenem. No yearly increase in resistance was observed. Serratia species isolation is most commonly of community onset and older patients and males are at increased risk. Despite reports of increasing resistance among Serratia species, the incidence in our region remains at a low stable rate.
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Kim BN, Choi SI, Ryoo NH (2006) Three-year follow-up of an outbreak of Serratia marcescens bacteriuria in a neurosurgical intensive care unit. J Korean Med Sci 21(6):973–978
Yoon HJ, Choi JY, Park YS, Kim CO, Kim JM, Yong DE, Lee KW, Song YG (2005) Outbreaks of Serratia marcescens bacteriuria in a neurosurgical intensive care unit of a tertiary care teaching hospital: a clinical, epidemiologic, and laboratory perspective. Am J Infect Control 33(10):595–601
Dubouix A, Roques C, Segonds C, Jeannot MJ, Malavaud S, Daude S, Chabanon G, Marty N (2005) Epidemiological investigation of a Serratia liquefaciens outbreak in a neurosurgery department. J Hosp Infect 60(1):8–13
Su L-H, Ou JT, Leu H-S, Chiang P-C, Chiu Y-P, Chia J-H, Kuo A-J, Chiu C-H, Chu C, Wu T-L, Sun C-F, Riley TV, Chang BJ; The Infection Control Group (2003) Extended epidemic of nosocomial urinary tract infections caused by Serratia marcescens. J Clin Microbiol 41(10):4726–4732
Casolari C, Pecorari M, Fabio G, Cattani S, Venturelli C, Piccinini L, Tamassia MG, Gennari W, Sabbatini AM, Leporati G, Marchegiano P, Rumpianesi F, Ferrari F (2005) A simultaneous outbreak of Serratia marcescens and Klebsiella pneumoniae in a neonatal intensive care unit. J Hosp Infect 61(4):312–320
Sarvikivi E, Lyytikäinen O, Salmenlinna S, Vuopio-Varkila J, Luukkainen P, Tarkka E, Saxén H (2004) Clustering of Serratia marcescens infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol 25(9):723–729
Ellabib MS, Ordonez A, Ramali A, Walli A, Benayad T, Shebrlo H (2004) Changing pattern of neonatal bacteremia. Microbiology and antibiotic resistance. Saudi Med J 25(12):1951–1956
Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39(3):309–317
Bagattini M, Crispino M, Gentile F, Barretta E, Schiavone D, Boccia MC, Triassi M, Zarrilli R (2004) A nosocomial outbreak of Serratia marcescens producing inducible Amp C-type beta-lactamase enzyme and carrying antimicrobial resistance genes within a class 1 integron. J Hosp Infect 56(1):29–36
Horcajada JP, Martinez JA, Alcón A, Marco F, De Lazzari E, de Matos A, Zaragoza M, Sallés M, Zavala E, Mensa J (2006) Acquisition of multidrug-resistant Serratia marcescens by critically ill patients who consumed tap water during receipt of oral medication. Infect Control Hosp Epidemiol 27(7):774–777
Uduman SA, Farrukh AS, Nath KN, Zuhair MY, Ifrah A, Khawla AD, Sunita P (2002) An outbreak of Serratia marcescens infection in a special-care baby unit of a community hospital in United Arab Emirates: the importance of the air conditioner duct as a nosocomial reservoir. J Hosp Infect 52(3):175–180
Ostrowsky BE, Whitener C, Bredenberg HK, Carson LA, Holt S, Hutwagner L, Arduino MJ, Jarvis WR (2002) Serratia marcescens bacteremia traced to an infused narcotic. N Engl J Med 346(20):1529–1537
de Vries JJ, Baas WH, van der Ploeg K, Heesink A, Degener JE, Arends JP (2006) Outbreak of Serratia marcescens colonization and infection traced to a healthcare worker with long-term carriage on the hands. Infect Control Hosp Epidemiol 27(11):1153–1158
Civen R, Vugia DJ, Alexander R, Brunner W, Taylor S, Parris N, Wasserman R, Abbott S, Werner SB, Rosenberg J (2006) Outbreak of Serratia marcescens infections following injection of betamethasone compounded at a community pharmacy. Clin Infect Dis 43(7):831–837
Pan A, Dolcetti L, Barosi C, Catenazzi P, Ceruti T, Ferrari L, Magri S, Roldan EQ, Soavi L, Carnevale G (2006) An outbreak of Serratia marcescens bloodstream infections associated with misuse of drug vials in a surgical ward. Infect Control Hosp Epidemiol 27(1):79–82
Vonberg RP, Gastmeier P (2007) Hospital-acquired infections related to contaminated substances. J Hosp Infect 65(1):15–23
Grohskopf LA, Roth VR, Feikin DR, Arduino MJ, Carson LA, Tokars JI, Holt SC, Jensen BJ, Hoffman RE, Jarvis WR (2001) Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center. N Engl J Med 344(20):1491–1497
Cheng KC, Chuang YC, Wu LT, Huang GC, Yu WL (2006) Clinical experiences of the infections caused by extended-spectrum beta-lactamase-producing Serratia marcescens at a medical center in Taiwan. Jpn J Infect Dis 59(3):147–152
Lee HK, Park YJ, Kim JY, Chang E, Cho SG, Chae HS, Kang CS (2005) Prevalence of decreased susceptibility to carbapenems among Serratia marcescens, Enterobacter cloacae, and Citrobacter freundii and investigation of carbapenemases. Diagn Microbiol Infect Dis 52(4):331–336
Shih HI, Lee HC, Lee NY, Chang CM, Wu CJ, Wang LR, Ko NY, Ko WC (2005) Serratia marcescens bacteremia at a medical center in southern Taiwan: high prevalence of cefotaxime resistance. J Microbiol Immunol Infect 38(5):350–357
Naumiuk L, Baraniak A, Gniadkowski M, Krawczyk B, Rybak B, Sadowy E, Samet A, Kur J (2004) Molecular epidemiology of Serratia marcescens in two hospitals in Gdańsk, Poland, over a 5-year period. J Clin Microbiol 42(7):3108–3116
Bouza E, Garcia de la Torre M, Erice A, Cercenado E, Loza E, Rodriguez-Créixems M (1987) Serratia bacteremia. Diagn Microbiol Infect Dis 7(4):237–247
Haddy RI, Mann BL, Nadkarni DD, Cruz RF, Elshoff DJ, Buendia FC, Domers TA, Oberheu AM (1996) Nosocomial infection in the community hospital: severe infection due to Serratia species. J Fam Pract 42(3):273–277
Watanakunakorn C (1989) Serratia bacteremia: a review of 44 episodes. Scand J Infect Dis 21(5):477–483
Schuchat A, Hilger T, Zell E, Farley MM, Reingold A, Harrison L, Lefkowitz L, Danila R, Stefonek K, Barrett N, Morse D, Pinner R; Active Bacterial Core Surveillance Team of the Emerging Infections Program Network (2001) Active bacterial core surveillance of the emerging infections program network. Emerg Infect Dis 7(1):92–99
Laupland KB (2004) Population-based epidemiology of intensive care: critical importance of ascertainment of residency status. Crit Care 8(6):R431–436
Sartor C, Jacomo V, Duvivier C, Tissot-Dupont H, Sambuc R, Drancourt M (2000) Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap. Infect Control Hosp Epidemiol 21(3):196–199
Friedman ND, Kaye KS, Stout JE, McGarry SA, Trivette SL, Briggs JP, Lamm W, Clark C, MacFarquhar J, Walton AL, Reller LB, Sexton DJ (2002) Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 137(10):791–797
Smellie WS, Clark G, McNulty CA (2003) Inequalities of primary care microbiology testing between hospital catchment areas. J Clin Pathol 56(12):933–936
Choi SH, Kim YS, Chung JW, Kim TH, Choo EJ, Kim MN, Kim BN, Kim NJ, Woo JH, Ryu J (2002) Serratia bacteremia in a large university hospital: trends in antibiotic resistance during 10 years and implications for antibiotic use. Infect Control Hosp Epidemiol 23(12):740–747
Laupland KB, Parkins MD, Church DL, Gregson DB, Louie TJ, Conly JM, Elsayed S, Pitout JD (2005) Population-based epidemiological study of infections caused by carbapenem-resistant Pseudomonas aeruginosa in the Calgary Health Region: importance of metallo-beta-lactamase (MBL)-producing strains. J Infect Dis 192(9):1606–1612
Pitout JD, Hanson ND, Church DL, Laupland KB (2004) Population-based laboratory surveillance for Escherichia coli-producing extended-spectrum beta-lactamases: importance of community isolates with blaCTX-M genes. Clin Infect Dis 38(12):1736–1741
Gilbert M, MacDonald J, Gregson D, Siushansian J, Zhang K, Elsayed S, Laupland K, Louie T, Hope K, Mulvey M, Gillespie J, Nielsen D, Wheeler V, Louie M, Honish A, Keays G, Conly J (2006) Outbreak in Alberta of community-acquired (USA300) methicillin-resistant Staphylococcus aureus in people with a history of drug use, homelessness or incarceration. CMAJ 175(2):149–154
Nakamura T, Shibata N, Doi Y, Okuda K, Nakata C, Heijyo H, Matsuo N, Masuda M, Takahashi H, Arakawa Y (2002) IMP-1 type metalo-beta-lactamase producing Serratia marcescens strains isolated from blood culture between 1991 to 2000. Kansenshogaku Zasshi 76(4):246–253
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No external financial support was obtained for this study. None of the authors had financial, professional, or personal competing interests that would influence the conduct or reporting of this study.
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Laupland, K.B., Parkins, M.D., Gregson, D.B. et al. Population-based laboratory surveillance for Serratia species isolates in a large Canadian health region. Eur J Clin Microbiol Infect Dis 27, 89–95 (2008). https://doi.org/10.1007/s10096-007-0400-7
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DOI: https://doi.org/10.1007/s10096-007-0400-7