title: Three-year follow-up of an outbreak of Serratia marcescens bacteriuria in a neurosurgical intensive care unit.
abstract: We report on the investigations and interventions conducted to contain an extended outbreak of Serratia marcescens bacteriuria that lasted for years in a neurosurgical intensive care unit (NSICU). A case-control study was performed to identify the risk factors for S. marcescens acquisition in urine. In case patients, urine sampling for tests and central venous catheterization were performed more frequently before the isolation of S. marcescens. Case patients were more frequently prescribed third-generation cephalosporins. Adherence to hand antisepsis was encouraged through in-service educational meetings and infection control measures, especially concerning the manipulation of indwelling urinary catheters, were intensified. The outbreak persisted despite the reinforcement of infection control measures. However, no patient has newly acquired the organism in the NSICU since December 2004. Multiple factors, including inadequate infection control practices and inappropriate antimicrobial usage, possibly contributed to the persistence of this S. marcescens outbreak. Healthcare workers should consistently follow infection control policies to ensure quality care.
authors.affiliation: Department of Internal Medicine, Inje University, Sanggyepaik Hospital, 761-1 Sanggye 7-Dong, Nowon-Gu, Seoul, Korea. kimbn@sanggyepaik.ac.kr
authors.forename: Baek-Nam
authors.initials: BN
authors.lastname: Kim
authors.forename: Soon-Im
authors.initials: SI
authors.lastname: Choi
authors.forename: Nam-Hee
authors.initials: NH
authors.lastname: Ryoo
mesh_terms: D001437:Bacteriuria / Q000453:epidemiology* / Q000517:prevention & control*; D016022:Case-Control Studies; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D018562:Disease Transmission, Infectious / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000706:statistics & numerical data*; D011159:Population Surveillance; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016868:Serratia Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission