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Outbreak of Serratia marcescens Colonization and Infection Traced to a Healthcare Worker With Long-Term Carriage on the Hands

Published online by Cambridge University Press:  21 June 2016

Jutte J. C. de Vries ,
Willy H. Baas ,
Kees van der Ploeg ,
Albêrt Heesink ,
John E. Degener  and
Jan P. Arends
Jutte J. C. de Vries*
Affiliation:
Departments of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands
Willy H. Baas
Affiliation:
Departments of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands
Kees van der Ploeg
Affiliation:
Occupational Health, University Medical Center Groningen, Groningen, The Netherlands
Albêrt Heesink
Affiliation:
Neurosurgery, University Medical Center Groningen, Groningen, The Netherlands
John E. Degener
Affiliation:
Departments of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands
Jan P. Arends
Affiliation:
Departments of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands
*
Department of Medical Microbiology, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands (j.j.c.de.vries@mmb.umcg.nl)
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Abstract

Objective.

To reveal the source of a nosocomial outbreak of colonization and infection with a strain of Serratia marcescens positive for Guiana extended-spectrum β-lactamase 1 (GES-1) that occurred among patients in a neurosurgical intensive care unit (ICU) in a Dutch university medical center from May 2002 through March 2003.

Methods.

Samples from the environment and from the hands of healthcare workers (HCWs) were cultured. A retrospective case-control study was carried out.

Results.

Fifteen neurosurgical ICU patients who had 1 or more cultures that yielded the epidemic strain of S. marcescens from May 2002 through March 2003 were defined as case patients and matched with 30 control patients. Environmental cultures did not reveal a prominent source of S. marcescens. Cultures of specimens from the hands of 100 HCWs revealed colonization of a single HCW with the epidemic strain. Although this HCW instantly went on leave, serial cultures detected prolonged carriage of the epidemic strain on the hands of the HCW for 3 months. The skin of the HCW's hands was psoriatic. The epidemic abruptly ended after the colonized HCW went on leave. Retrospective case-control analysis showed that the patients colonized or infected with S. marcescens received significantly more nursing care from the colonized HCW than did control patients (P<.05). From February 2004 through October 2004, a second cluster of 3 patients was detected with the epidemic strain of S. marcescens. In October 2004, the formerly colonized HCW appeared to have carriage of the epidemic strain on the hands again.

Conclusions.

A single HCW with the epidemic strain of S. marcescens on the hands was considered the source of this outbreak.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 11 , November 2006 , pp. 1153 - 1158
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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