title: Hand washing soap as a source of neonatal Serratia marcescens outbreak.
abstract: OBJECTIVE
  To describe an outbreak of Serratia marcescens infections in a neonatal intensive care unit (NICU) and to report investigations and interventions having led to the cessation of the outbreak.
  
  
  METHODS
  Observational study of microbiological and epidemiological investigations realised during a S. marcescens outbreak between March and October 2006.
  
  
  METHODS
  Nine cases were observed in a 5 months period. A Serratia outbreak was therefore identified, and all the strains were compared by pulsed-field gel electrophoresis (PFGE). Data from medical notes were gathered retrospectively. Environmental samples were gathered prospectively.
  
  
  RESULTS
  Four infants were colonized and five infants were infected by S. marcescens. PFGE revealed that three different strains were present. Seven of the nine babies were infected by only one of these strains. This same strain was found in a nonantimicrobial soap bottle (NAS) that could be the source of contamination.
  
  
  CONCLUSIONS
  It is the first time that S. marcescens is found in a NAS during a neonatal nosocomial outbreak. Molecular analysis is a method of choice to compare different strains. Identification and elimination of the nosocomial source and adherence to the infection control policies are essential to succeed in the containment of a nosocomial epidemic.
authors.affiliation: Service de maladies infectieuses et tropicales, CHU d'Angers, Université d'Angers, Angers, France. VaRabier@chu-angers.fr
authors.forename: V
authors.initials: V
authors.lastname: Rabier
authors.forename: S
authors.initials: S
authors.lastname: Bataillon
authors.forename: A
authors.initials: A
authors.lastname: Jolivet-Gougeon
authors.forename: J-M
authors.initials: JM
authors.lastname: Chapplain
authors.forename: A
authors.initials: A
authors.lastname: Beuchée
authors.forename: P
authors.initials: P
authors.lastname: Bétrémieux
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005602:France / Q000453:epidemiology; D006235:Hand Disinfection; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016868:Serratia Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D012706:Serratia marcescens / Q000302:isolation & purification*; D012915:Soaps
chemical_list: D012915:Soaps