title: Outbreak of bloodstream infections because of Serratia marcescens in a pediatric department.
abstract: BACKGROUND
  Serratia marcescens can cause health care-associated infections. We herewith report the investigation and control of an outbreak of S marcescens bloodstream infections (BSI) in a general pediatric department.
  
  
  METHODS
  From April to May 2009, temporally related cases of S marcescens BSI occurred in a 40-bed general pediatric department of a tertiary care hospital. An outbreak investigation including case identification, review of medical records, environmental cultures, patients' surveillance cultures, personnel hand cultures, pulsed-field gel electrophoresis, and a case-control study were conducted. Controls were patients without S marcescens BSI but hospitalized in the department for at least 48 hours during the outbreak. Enhanced infection control measures were immediately implemented by the Infection Control Committee.
  
  
  RESULTS
  During the study period, 4 patients developed BSI because of a S marcescens strain demonstrating the same antimicrobial susceptibility pattern as well as the same molecular profile. Patients' surveillance cultures and personnel hand cultures were negative. In 1 case-patient, S marcescens grew from cultures of intravenous infusion systems. In the case-control study performed, there were no differences in demographics, intravenously administered medications, or place of hospital stay. Case patients had changes in vascular access significantly more frequently than controls. No S marcescens infections occurred in the department during the 18 months following implementation of the enhanced infection control measures.
  
  
  CONCLUSIONS
  Prompt recognition and strict adherence to infection control measures are of paramount importance in combating an outbreak of S marcescens bloodstream infection.
authors.affiliation: Third Department of Pediatrics, Aristotle University, Thessaloniki, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Iosifidis
authors.forename: Evangelia
authors.initials: E
authors.lastname: Farmaki
authors.forename: Natalia
authors.initials: N
authors.lastname: Nedelkopoulou
authors.forename: Maria
authors.initials: M
authors.lastname: Tsivitanidou
authors.forename: Maria
authors.initials: M
authors.lastname: Kaperoni
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Pentsoglou
authors.forename: Spyros
authors.initials: S
authors.lastname: Pournaras
authors.forename: Miranta
authors.initials: M
authors.lastname: Athanasiou-Metaxa
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roilides
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods; D008297:Male; D017720:Molecular Epidemiology; D058889:Molecular Typing; D016868:Serratia Infections / Q000453:epidemiology* / Q000382:microbiology; D012706:Serratia marcescens / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*