title: An outbreak of Serratia marcescens infection in a special-care baby unit of a community hospital in United Arab Emirates: the importance of the air conditioner duct as a nosocomial reservoir.
abstract: We report an outbreak of Serratia marcescens infection in a special-care baby unit (SCBU) of a university-affiliated community hospital in the United Arab Emirates. The outbreak involved 36 infants and lasted for 20 weeks. Seven of the colonized infants developed invasive illnesses in the form of bacteraemia (four cases), bacteraemic meningitis (two) and clinical sepsis (one). Three other term infants had purulent conjunctivitis. There were five deaths with an overall mortality of 14%. S. marcescens was cultured from airflow samples from the air conditioning (AC) which was the reservoir of infection in this outbreak. Elimination of the nosocomial source and outbreak containment were eventually achieved by specialized robotic cleaning of the entire AC duct system of the SCBU. Strict adherence to the infection control policies was reinforced to prevent transmission of cross-infection.
authors.affiliation: Department of Paediatrics, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates. udumans@uaeu.ac.ae
authors.forename: S A
authors.initials: SA
authors.lastname: Uduman
authors.forename: A S
authors.initials: AS
authors.lastname: Farrukh
authors.forename: K N R
authors.initials: KN
authors.lastname: Nath
authors.forename: M Y H
authors.initials: MY
authors.lastname: Zuhair
authors.forename: A
authors.initials: A
authors.lastname: Ifrah
authors.forename: A D
authors.initials: AD
authors.lastname: Khawla
authors.forename: P
authors.initials: P
authors.lastname: Sunita
mesh_terms: D000389:Air Conditioning / Q000009:adverse effects* / Q000295:instrumentation; D000391:Air Microbiology; D001724:Birth Weight; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D004197:Disease Reservoirs; D004203:Disinfection; D004784:Environmental Monitoring / Q000379:methods; D062665:Epidemiological Monitoring; D004866:Equipment Contamination / Q000517:prevention & control / Q000706:statistics & numerical data; D005865:Gestational Age; D017052:Hospital Mortality; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D017053:Infection Control / Q000379:methods; D007363:Intensive Care Units, Neonatal; D012307:Risk Factors; D016868:Serratia Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012706:Serratia marcescens; D014479:United Arab Emirates / Q000453:epidemiology