Sequential epidemic outbreaks of septicaemias by Serratia and Klebsiella species on a medical intensive care unit

• Published in: Intensive care medicine 1988-02, Vol.14 (2), p.136-140
• Main Authors: CORTES, J. L, DOMINGUEZ-DE VILLOTA, E, ALGORA-WEBER, A, CHAMORRO, C, TORRECILIA, M. C, MOSQUERA, J. M
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - microbiology; Disease Outbreaks; Emergency and intensive care: infection, septic shock; Enterobacteriaceae Infections - epidemiology; Humans; Intensive care medicine; Intensive Care Units; Klebsiella Infections - epidemiology; Medical sciences; Sepsis - epidemiology; Sepsis - microbiology; Serratia - isolation & purification
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/BF00257467

The high rate of septicaemias (20%, 19% and 14%) observed in our Intensive Care Unit (ICU) during the first 3 years was due to an epidemic incidence of Serratia sp. (S) (26% during the first year) and Klebsiella sp. (K) (25% during the third) and decreased significantly in the following 6 years (mean incidence of 11%) (p less than 0.01). During this epidemic phase these organisms were isolated quite frequently (between a 14% and a 6%) from all patients admitted. The K was more regularly present, for the mean time intervals free of its bacteriological presence were shorter (11 days) than those of S (27 days) (p less than 0.01). The K was isolated in more patients (160) than S (79) (p less than 0.01) and in more samples (360) than S (235) (p less than 0.01), but caused less secondary septicaemias per colonized patient (7% versus 29%) (p less than 0.01). In 59% of all S septicaemias the organism was previously isolated in other culture, while this was observed in only 34% of K septicaemias (x2 = 3.78, p = 0.052). The large variations in the incidence of septicaemias within our ICU, the appearance of sequential epidemic outbreaks, with a different behaviour of S and K and the individual risk of septicaemia of patients colonized by these organisms are noted.