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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1983 Dec 3;287(6406):1701–1705. doi: 10.1136/bmj.287.6406.1701

Infection with netilmicin resistant Serratia marcescens in a special care baby unit.

D A Lewis, P M Hawkey, WattsJA, D C Speller, R J Primavesi, P J Fleming, T L Pitt
PMCID: PMC1550087  PMID: 6315130

Abstract

An outbreak of colonisation and infection with a netilmicin resistant strain of Serratia marcescens occurred in a special care baby unit. S marcescens was isolated from a total of 13 babies; significant infection occurred in five, of whom two died. Epidemiological investigation failed to detect a common source but gastrointestinal colonisation of babies formed a prolonged and possibly important reservoir for infection. Containment proved difficult until the unit was closed to new admissions, and even then spread to a temporary unit ensued. O Serotyping and bacteriophage typing disclosed a single epidemic strain. This produced an aminoglycoside acetylating enzyme (AAC(6')) conferring resistance to netilmicin and tobramycin and moderate resistance to amikacin. Use of gentamicin resulted in the isolation of serratia with increased resistance to all aminoglycosides, and, similarly, increased resistance to third generation cephalosporins emerged with their use.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bullock D. W., Bidwell J. L., Reeves D. S., White L. O., Turner A., Speller D. C., Wilkinson P. J. Outbreaks of hospital infection in southwest England caused by gentamicin-resistant Serratia marcescens. J Hosp Infect. 1982 Sep;3(3):263–273. doi: 10.1016/0195-6701(82)90045-7. [DOI] [PubMed] [Google Scholar]
  2. Chakravarti A., Mandal A., Sharma K. B. An outbreak due to multiple drug resistant Serratia marcescens in a children's hospital. Indian J Med Res. 1981 Aug;74:196–201. [PubMed] [Google Scholar]
  3. Christensen G. D., Korones S. B., Reed L., Bulley R., McLaughlin B., Bisno A. L. Epidemic Serratia marcescens in a neonatal intensive care unit: importance of the gastrointestinal tract as a reservoir. Infect Control. 1982 Mar-Apr;3(2):127–133. doi: 10.1017/s0195941700055909. [DOI] [PubMed] [Google Scholar]
  4. Cook L. N., Davis R. S., Stover B. H. Outbreak of amikacin-resistant Enterobacteriaceae in an intensive care nursery. Pediatrics. 1980 Feb;65(2):264–268. [PubMed] [Google Scholar]
  5. Craven P. C., Jorgensen J. H., Kaspar R. L., Drutz D. J. Amikacin therapy of patients with multiply antibiotic-resistant Serratia marcescens infections: development of increasing resistance during therapy. Am J Med. 1977 Jun;62(6):902–910. doi: 10.1016/0002-9343(77)90659-3. [DOI] [PubMed] [Google Scholar]
  6. Farmer J. J., 3rd, Davis B. R., Hickman F. W., Presley D. B., Bodey G. P., Negut M., Bobo R. A. Detection of Serratia outbreaks in hospital. Lancet. 1976 Aug 28;2(7983):455–459. doi: 10.1016/s0140-6736(76)92539-3. [DOI] [PubMed] [Google Scholar]
  7. Farmer J. J., 3rd, Silva F., Williams D. R. Isolation of Serratia marcescens on deoxyribonuclease-toluidine blue-cephalothin agar. Appl Microbiol. 1973 Jan;25(1):151–152. doi: 10.1128/am.25.1.151-152.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. John J. F., Jr, McNeill W. F. Characteristics of Serratia marcescens containing a plasmid coding for gentamicin resistance in nosocomial infections. J Infect Dis. 1981 Jun;143(6):810–817. doi: 10.1093/infdis/143.6.810. [DOI] [PubMed] [Google Scholar]
  9. John J. F., Jr, McNeill W. F., Price K. E., Kresel P. A. Evidence for a chromosomal site specifying amikacin resistance in multiresistant Serratia marcescens. Antimicrob Agents Chemother. 1982 Apr;21(4):587–591. doi: 10.1128/aac.21.4.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Langstaff D., Schueler S., Righter J. Netilmicin: in-vitro activity compared with that of other aminoglycosides against Serratia marcescens. J Antimicrob Chemother. 1983 Feb;11(2):187–189. doi: 10.1093/jac/11.2.187. [DOI] [PubMed] [Google Scholar]
  11. Maki D. G., Hennekens C. G., Phillips C. W., Shaw W. V., Bennett J. V. Nosocomial urinary tract infection with Serratia marcescens: an epidemiologic study. J Infect Dis. 1973 Nov;128(5):579–587. doi: 10.1093/infdis/128.5.579. [DOI] [PubMed] [Google Scholar]
  12. McCormack R. C., Kunin C. M. Control of a single source nursery epidemic due to Serratia marcescens. Pediatrics. 1966 May;37(5):750–755. [PubMed] [Google Scholar]
  13. Meyer R. D., Lewis R. P., Halter J., White M. Gentamicin-resistant Pseudomonas aeruginosa and Serratia marcescens in a general hospital. Lancet. 1976 Mar 13;1(7959):580–583. doi: 10.1016/s0140-6736(76)90370-6. [DOI] [PubMed] [Google Scholar]
  14. Michalsen H., Halvorsen K., Bergan T. Netilmicin in the treatment of neonates with moderate and severe infections. Scand J Infect Dis Suppl. 1980;Suppl 23:146–150. [PubMed] [Google Scholar]
  15. Pitt T. L., Erdman Y. J., Bucher C. The epidemiological type identification of Serratia marcescens from outbreaks of infection in hospitals. J Hyg (Lond) 1980 Apr;84(2):269–283. doi: 10.1017/s0022172400026772. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Primavesi R., Lewis D. A., Fleming P. J., Speller D. C. Serratia marcescens in a special baby unit. Lancet. 1982 Nov 20;2(8308):1164–1164. doi: 10.1016/s0140-6736(82)92824-0. [DOI] [PubMed] [Google Scholar]
  17. Sanders C. C. Novel resistance selected by the new expanded-spectrum cephalosporins: a concern. J Infect Dis. 1983 Mar;147(3):585–589. doi: 10.1093/infdis/147.3.585. [DOI] [PubMed] [Google Scholar]
  18. Stamm W. E., Kolff C. A., Dones E. M., Javariz R., Anderson R. L., Farmer J. J., 3rd, de Quinones H. R. A nursery outbreak caused by Serratia marcescens--scalp-vein needles as a portal of entry. J Pediatr. 1976 Jul;89(1):96–99. doi: 10.1016/s0022-3476(76)80940-7. [DOI] [PubMed] [Google Scholar]
  19. Stenderup A., Faergeman O., Ingerslev M. Serratia marcescens infections in premature infants. Acta Pathol Microbiol Scand. 1966;68(1):157–160. doi: 10.1111/apm.1966.68.1.157. [DOI] [PubMed] [Google Scholar]

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