title: An outbreak of Serratia liquefaciens at a rural health center in The Gambia.
abstract: BACKGROUND
  Healthcare-associated infections (HAIs) are better documented in developed than in developing countries. There are emerging reports regarding the high frequency of HAIs in developing countries. We aimed to report an outbreak of an HAI caused by Serratia liquefaciens at a rural health center in The Gambia.
  
  
  METHODS
  Following an abrupt increase in the isolation of S. liquefaciens in clinical samples, laboratory and clinical consumables, as well as staff, were screened for contamination with S. liquefaciens. Conventional microbiological techniques and biochemical identification tests were used. A phenotypic typing was achieved using the Kirby-Bauer antibiotic susceptibility method. Strategies to control the outbreak were implemented.
  
  
  RESULTS
  A total of 794 samples were processed during the outbreak; 44 (6%) grew S. liquefaciens. Five (25%) of the 20 suspected contaminated materials (hospital consumables and equipment) screened yielded growth of the organism. The primary source of the outbreak was hospital consumables. Three (7%) of the 44 infected children died with no other known cause than S. liquefaciens infection. Ninety-nine percent similarity of the antibiogram phenotypic typing suggests the isolates were from the same clonal origin. The outbreak was successfully controlled after the removal and sterilization of the respective contaminated fluids and equipment.
  
  
  CONCLUSIONS
  This HAI was caused by poor practice in the preparation of medications for nebulization and intravenous infusion, hygiene practices, and a lack of awareness among staff about infection control. We recommend further studies to delineate the role played by HAIs in the developing world.
authors: Medical Research Council Unit, Fajara, Gambia. uikumapayi@mrc.gm.
authors: Usman Nurudeen
authors: UN
authors: Ikumapayi
authors: Abdoulie
authors: A
authors: Kanteh
authors: Jarra
authors: J
authors: Manneh
authors: Modou
authors: M
authors: Lamin
authors: Grant Austin
authors: GA
authors: Mackenzie
mesh_terms: D001291:Attitude of Health Personnel; D001431:Bacteriological Techniques; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D004340:Drug Contamination; D004783:Environmental Microbiology; D004866:Equipment Contamination; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011361:Professional Competence; D019035:Rural Health Services; D016868:Serratia Infections / Q000453:epidemiology* / Q000382:microbiology; D044090:Serratia liquefaciens / Q000302:isolation & purification*