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

• Published in: The Journal of hospital infection 2002-11, Vol.52 (3), p.175-180
• Main Authors: Uduman, S.A., Farrukh, A.S., Nath, K.N.R., Zuhair, M.Y.H., Ifrah, A., Khawla, A.D., Sunita, P.
• Format: Article
• Language: English
• Subjects: Air Conditioning - adverse effects; Air Conditioning - instrumentation; Air Microbiology; Biological and medical sciences; Birth Weight; Cross Infection - epidemiology; Cross Infection - etiology; Cross Infection - microbiology; Cross Infection - prevention & control; Disease Outbreaks - prevention & control; Disease Outbreaks - statistics & numerical data; Disease Reservoirs; Disinfection; Environmental Monitoring - methods; Epidemiological Monitoring; Epidemiology. Vaccinations; Equipment Contamination - prevention & control; Equipment Contamination - statistics & numerical data; General aspects; Gestational Age; Hospital Mortality; Hospitals, Community; Hospitals, University; Humans; Infant; Infant, Newborn; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - etiology; Infant, Premature, Diseases - prevention & control; Infection Control - methods; Infectious diseases; Intensive Care Units, Neonatal; Medical sciences; Risk Factors; Serratia Infections - epidemiology; Serratia Infections - etiology; Serratia Infections - prevention & control; Serratia marcescens; Serratia marcescens, nosocomial, environmental source, airborne, invasive illness, handwashing, prevention, robotic cleaning; Tropical medicine; United Arab Emirates - epidemiology
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1053/jhin.2002.1308

We report an outbreak of Serratia marcescens infection in a special-care baby unit (SCBU) of a university-affiliated community hospital in the United Arab Emirates. The outbreak involved 36 infants and lasted for 20 weeks. Seven of the colonized infants developed invasive illnesses in the form of bacteraemia (four cases), bacteraemic meningitis (two) and clinical sepsis (one). Three other term infants had purulent conjunctivitis. There were five deaths with an overall mortality of 14%. S. marcescens was cultured from airflow samples from the air conditioning (AC) which was the reservoir of infection in this outbreak. Elimination of the nosocomial source and outbreak containment were eventually achieved by specialized robotic cleaning of the entire AC duct system of the SCBU. Strict adherence to the infection control policies was reinforced to prevent transmission of cross-infection.