title: Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013-2014.
abstract: OBJECTIVE
  In 2013, the German Commission for Hospital Hygiene and Infectious Disease Prevention (KRINKO) stated that extending weekly colonisation screening from very low birth weight (VLBW) infants (<1500 g) to all patients in the Neonatal Intensive Care Unit (NICU) might be useful.
  
  
  METHODS
  After implementing this recommendation, we detected a previously unnoticed cluster of Serratia marcescens. Strains were typed by Pulsed Field Gel Electrophoresis (PFGE).
  
  
  RESULTS
  Over 6 months, 19 out of 159 infants acquired S. marcescens. Twelve of the nineteen patients with S. marcescens were non-VLBW infants, and they were colonised significantly earlier than were VLBW infants (median 17 vs. 28 days; p < 0.01). Molecular typing revealed a polyclonal outbreak with multiple strain types leading to one or two transmissions each and a dominating outbreak strains being involved in an explosive outbreak involving eight neonates.
  
  
  CONCLUSIONS
  The revised KRINKO recommendation may help identify unnoticed outbreaks. Colonised non-VLBW patients may be an underestimated source of S. marcescens.
authors.affiliation: Unit Neonatology, Department of Paediatrics, Jena University Hospital, Jena, Germany.
authors.forename: Kristin
authors.initials: K
authors.lastname: Dawczynski
authors.affiliation: Unit Neonatology, Department of Paediatrics, Jena University Hospital, Jena, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Proquitté
authors.affiliation: Institute for Medical Microbiology, Jena University Hospital, Jena, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Roedel
authors.affiliation: Institute for Medical Microbiology, Jena University Hospital, Jena, Germany.
authors.forename: Brigit
authors.initials: B
authors.lastname: Edel
authors.affiliation: Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Pfeifer
authors.affiliation: Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Hoyer
authors.affiliation: Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07740, Jena, Germany.
authors.forename: Helke
authors.initials: H
authors.lastname: Dobermann
authors.affiliation: Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07740, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hagel
authors.affiliation: Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07740, Jena, Germany. mathias.pletz@med.uni-jena.de.
authors.forename: Mathias W
authors.initials: MW
authors.lastname: Pletz
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008826:Microbial Sensitivity Tests; D016868:Serratia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012706:Serratia marcescens
keywords: Clonal transmission; Neonatology; Outbreak; Screening