Epidemiological investigation of a Serratia liquefaciens outbreak in a neurosurgery department

• Published in: The Journal of hospital infection 2005-05, Vol.60 (1), p.8-13
• Main Authors: Dubouix, A., Roques, C., Segonds, C., Jeannot, M.J., Malavaud, S., Daude, S., Chabanon, G., Marty, N.
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents, Local; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiseptics; Bacterial Typing Techniques; Biological and medical sciences; Carrier State - epidemiology; Carrier State - microbiology; Carrier State - prevention & control; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Disease Outbreaks - prevention & control; Disease Outbreaks - statistics & numerical data; Disease Reservoirs - statistics & numerical data; DNA Fingerprinting; DNA, Bacterial - analysis; DNA, Bacterial - genetics; Drug Contamination - statistics & numerical data; Drug Resistance, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; Environmental Monitoring; Epidemiological Monitoring; Epidemiology. Vaccinations; Equipment Contamination - statistics & numerical data; France; General aspects; Gentamicin resistance; Hospitals, University; Humans; Infection Control - methods; Infectious diseases; Length of Stay - statistics & numerical data; Medical sciences; Microbial Sensitivity Tests; Molecular Epidemiology; Neurosurgery; Neurosurgical Procedures - adverse effects; Outbreak; Pharmacology. Drug treatments; Risk Factors; Serratia Infections - epidemiology; Serratia Infections - microbiology; Serratia Infections - prevention & control; Serratia liquefaciens; Serratia liquefaciens - classification; Serratia liquefaciens - genetics; Time Factors; Ventilators, Mechanical - microbiology
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2004.09.029

Between February 2001 and March 2003, 17 patients from the neurosurgery department of the University Hospital of Rangueil (Toulouse, Southern France) developed Serratia liquefaciens infections. Due to the atypical antibiotype displayed by the clinical isolates (i.e. gentamicin resistance), an outbreak was suspected. Molecular analysis carried out by pulsed-field gel electrophoresis demonstrated a genetic link for all patients. Furthermore, the patient who introduced the epidemic Serratia strain was also identified and shown to be related to the two epidemic peaks observed during the outbreak period. Investigation failed to reveal a reservoir among the antiseptics and soaps, or among the mechanical ventilators used. However, when the colonization of patients was investigated, positive carriage was observed and could be considered as a potential risk for the spread of the epidemic strain. Due to the delay between antibiotherapy and S. liquefaciens colonization, a selection effect had to be considered. Finally, implementation of hygiene measures was accompanied by control of the outbreak.