Serratia marcescens transmission in a pediatric intensive care unit: a multifactorial occurrence.

Abstract:

BACKGROUND:Fourteen patients in the pediatric cardiac intensive care unit (CICU) had > or =1 positive culture for a single strain of Serratia marcescens from April through December 1995 (study period). OBJECTIVES:To identify risk factors for S marcescens infection or colonization in a pediatric CICU. METHODS:Retrospective case-control study. Assessment of CICU infection control practices and patient exposure to CICU health care workers (HCWs). Epidemiologic-directed cultures of the environment and HCWs' hands were obtained. SETTING:Pediatric CICU. PATIENTS:Fourteen patients in the pediatric CICU had > or =1 positive culture for a single strain of S marcescens from April through December 1995 (study period). CICU patients who did not have S marcescens infection or colonization during the study period were randomly selected as controls. RESULTS:A case patient was more likely than a noncase patient to have exposure to a single HCW (odds ratio [OR], 19.5; 95% CI, 2.6-416; P<.003); however, this association was not adequately explained by epidemiologic or microbiologic studies. Interviews suggested that during the outbreak period, handwashing frequency among HCWs might have been reduced because of severe hand dermatitis. CONCLUSIONS:A combination of factors, including breaks in aseptic technique, reduced frequency of handwashing among HCWs before and between caring for patients, decreased attention to infection control practices, and environmental contamination may have indirectly contributed to this S marcescens infections outbreak.

journal_name

Am J Infect Control

authors

Manning ML,Archibald LK,Bell LM,Banerjee SN,Jarvis WR

doi

10.1067/mic.2001.114222

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

115-9

issue

2

eissn

0196-6553

issn

1527-3296

pii

S0196-6553(01)74178-8

journal_volume

29

pub_type

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