Implementation of a PCR-based strategy to control an outbreak by Serratia marcescens in a Neonatal Intensive Care Unit

Springer Science and Business Media LLC
Ángel Rodríguez-Villodres1,2,3, José Manuel Ortiz de la Rosa1,2, Raquel Valencia-Martín4,5, Francisco Jiménez Parrilla6, Guillermo Martín-Gutiérrez1,2,3, Nataly Patino1, Evelyn Gloria Acuña Cruz4, María Teresa Sánchez Jiménez6, Antonio Pavón Delgado6, José Miguel Cisneros7,2,3,1, José Antonio Lepe1,2,3,8
1Clinical Unit of Infectious Diseases, Microbiology and Parasitology, University Hospital Virgen del Rocío, Seville, Spain
2Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
3Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
4Clinical Unit of Preventive Medicine and Public Health, University Hospital Virgen del Rocío, Seville, Spain
5Department of Preventive Medicine, University of Seville, Seville, Spain
6Clinical Unit of Neonatology, University Hospital Virgen del Rocío, Seville, Spain
7Faculty of Medicine, University of Seville, Seville, Spain
8Department of Microbiology, University of Seville, Seville, Spain

Tóm tắt

Abstract Objectives

To evaluate the clinical and epidemiological impact of a new molecular surveillance strategy based on qPCR to control an outbreak by Serratia marcescens in a Neonatal Intensive Care Unit (NICU).

 Methods

We design a specific qPCR for the detection of S. marcescens in rectal swabs of patients admitted to a NICU. We divided the surveillance study into two periods: (a) the pre-PCR, from the outbreak declaration to the qPCR introduction, and (b) the PCR period, from the introduction of the qPCR until the outbreak was solved. In all cases, S. marcescens isolates were recovered and their clonal relationship was analysed by PFGE. Control measures were implemented during the outbreak. Finally, the number of bloodstream infections (BSI) was investigated in order to evaluate the clinical impact of this molecular strategy.

 Results

Nineteen patients colonized/infected by S. marcescens were detected in the pre-PCR period (October 2020–April 2021). On the contrary, after the PCR implementation, 16 new patients were detected. The PFGE revealed 24 different pulsotypes belonging to 7 different clonal groups, that were not overlapping at the same time. Regarding the clinical impact, 18 months after the qPCR implementation, no more outbreaks by S. marcescens have been declared in the NICU of our hospital, and only 1 episode of BSI has occurred, compared with 11 BSI episodes declared previously to the outbreak control.

 Conclusions

The implementation of this qPCR strategy has proved to be a useful tool to control the nosocomial spread of S. marcescens in the NICU.

Từ khóa


Tài liệu tham khảo

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