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Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013–2014

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Abstract

Purpose

In 2013, the German Commission for Hospital Hygiene and Infectious Disease Prevention (KRINKO) stated that extending weekly colonisation screening from very low birth weight (VLBW) infants (<1500 g) to all patients in the Neonatal Intensive Care Unit (NICU) might be useful.

Methods

After implementing this recommendation, we detected a previously unnoticed cluster of Serratia marcescens. Strains were typed by Pulsed Field Gel Electrophoresis (PFGE).

Results

Over 6 months, 19 out of 159 infants acquired S. marcescens. Twelve of the nineteen patients with S. marcescens were non-VLBW infants, and they were colonised significantly earlier than were VLBW infants (median 17 vs. 28 days; p < 0.01). Molecular typing revealed a polyclonal outbreak with multiple strain types leading to one or two transmissions each and a dominating outbreak strains being involved in an explosive outbreak involving eight neonates.

Conclusion

The revised KRINKO recommendation may help identify unnoticed outbreaks. Colonised non-VLBW patients may be an underestimated source of S. marcescens.

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Acknowledgments

MWP and SH were supported by the German Ministry of Education and Research (BMBF), Grant number 01KI1501. We thank Sybille Müller-Bertling and Kirstin Ganske for their excellent technical assistance.

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Authors and Affiliations

  1. Unit Neonatology, Department of Paediatrics, Jena University Hospital, Jena, Germany

    Kristin Dawczynski & Hans Proquitté

  2. Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07740, Jena, Germany

    Helke Dobermann, Stefan Hagel & Mathias W. Pletz

  3. Institute for Medical Microbiology, Jena University Hospital, Jena, Germany

    Jürgen Roedel & Brigit Edel

  4. Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany

    Yvonne Pfeifer

  5. Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany

    Heike Hoyer

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  1. Kristin Dawczynski
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Correspondence to Mathias W. Pletz.

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Dawczynski, K., Proquitté, H., Roedel, J. et al. Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013–2014. Infection 44, 739–746 (2016). https://doi.org/10.1007/s15010-016-0922-y

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