title: [An epidemic of primary bacteremia due to an endemic strain of Serratia marcescens in an intensive care unit].
abstract: An outbreak of Serratia marcescens bacteremia detected in the intensive care unit (ICU) of a tertiary care center on the last days of October, 1985, is described. The rate of primary S. marcescens nosocomial bacteremia during the pre-epidemic period (January-September 1985) was 6.25 per cent; and for the post-epidemic period compared with the epidemic were significantly different (p < 0.0001). The outbreak strains belonged to the biotype A8b, which has been endemic in our hospital. The responsible organism exhibited an unusual antimicrobial resistance pattern associated to the presence of a specific plasmid (greater than 50 kilobases), which showed similar fragments after restriction endonuclease digestion. No specific risk factors were identified in the case-control study. The outbreak was probably related to a greater influx of infected patients, resulting in less careful infection control measures, due to the emergency situation which suffered the hospital after the earthquakes in 1985. The unusual high rate of blood isolation of S. marcescens at the ICU was the first sign of the outbreak. The prompt reinforcement of infection control policies facilitated its resolution.
authors.affiliation: Departamento de Infectología, Instituto Nacional de Cancerología, Secretaría Salud (SSA), México.
authors.forename: P
authors.initials: P
authors.lastname: Volkow-Fernández
authors.forename: S
authors.initials: S
authors.lastname: Ponce de León-Rosales
authors.forename: J
authors.initials: J
authors.lastname: Sifuentes-Osornio
authors.forename: J J
authors.initials: JJ
authors.lastname: Calva-Mercado
authors.forename: G M
authors.initials: GM
authors.lastname: Ruiz-Palacios
authors.forename: M A
authors.initials: MA
authors.lastname: Cerbón
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D016012:Poisson Distribution; D015995:Prevalence; D012307:Risk Factors; D016868:Serratia Infections / Q000453:epidemiology* / Q000235:genetics / Q000382:microbiology; D012706:Serratia marcescens / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D004269:DNA, Bacterial
vernacular_title: Epidemia de bacteremias primarias por una cepa endémica de Serratia marcescens en una unidad de terapia intensiva.