{"title":"Nosocomial outbreak caused by disinfectant-resistant <i>Serratia marcescens</i> in an adult intensive care unit, Hungary, February to March 2022.","authors":"Adrienn Hanczvikkel, Ákos Tóth, Irén Anna Kopcsóné Németh, Orsolya Bazsó, Lőrinc Závorszky, Lilla Buzgó, Virág Lesinszki, Dániel Göbhardter, Erika Ungvári, Ivelina Damjanova, Attila Erőss, Ágnes Hajdu","doi":"10.2807/1560-7917.ES.2024.29.26.2300492","DOIUrl":null,"url":null,"abstract":"<p><p>In 2022, an outbreak with severe bloodstream infections caused by <i>Serratia marcescens</i> occurred in an adult intensive care unit (ICU) in Hungary. Eight cases, five of whom died, were detected. Initial control measures could not stop the outbreak. We conducted a matched case-control study. In univariable analysis, the cases were more likely to be located around one sink in the ICU and had more medical procedures and medications than the controls, however, the multivariable analysis was not conclusive. Isolates from blood cultures of the cases and the ICU environment were closely related by whole genome sequencing and resistant or tolerant against the quaternary ammonium compound surface disinfectant used in the ICU. Thus, <i>S. marcescens</i> was able to survive in the environment despite regular cleaning and disinfection. The hospital replaced the disinfectant with another one, tightened the cleaning protocol and strengthened hand hygiene compliance among the healthcare workers. Together, these control measures have proved effective to prevent new cases. Our results highlight the importance of multidisciplinary outbreak investigations, including environmental sampling, molecular typing and testing for disinfectant resistance.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":null,"pages":null},"PeriodicalIF":9.9000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212457/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eurosurveillance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2807/1560-7917.ES.2024.29.26.2300492","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
In 2022, an outbreak with severe bloodstream infections caused by Serratia marcescens occurred in an adult intensive care unit (ICU) in Hungary. Eight cases, five of whom died, were detected. Initial control measures could not stop the outbreak. We conducted a matched case-control study. In univariable analysis, the cases were more likely to be located around one sink in the ICU and had more medical procedures and medications than the controls, however, the multivariable analysis was not conclusive. Isolates from blood cultures of the cases and the ICU environment were closely related by whole genome sequencing and resistant or tolerant against the quaternary ammonium compound surface disinfectant used in the ICU. Thus, S. marcescens was able to survive in the environment despite regular cleaning and disinfection. The hospital replaced the disinfectant with another one, tightened the cleaning protocol and strengthened hand hygiene compliance among the healthcare workers. Together, these control measures have proved effective to prevent new cases. Our results highlight the importance of multidisciplinary outbreak investigations, including environmental sampling, molecular typing and testing for disinfectant resistance.
期刊介绍:
Eurosurveillance is a European peer-reviewed journal focusing on the epidemiology, surveillance, prevention, and control of communicable diseases relevant to Europe.It is a weekly online journal, with 50 issues per year published on Thursdays. The journal includes short rapid communications, in-depth research articles, surveillance reports, reviews, and perspective papers. It excels in timely publication of authoritative papers on ongoing outbreaks or other public health events. Under special circumstances when current events need to be urgently communicated to readers for rapid public health action, e-alerts can be released outside of the regular publishing schedule. Additionally, topical compilations and special issues may be provided in PDF format.