Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1989 Nov;27(11):2433–2436. doi: 10.1128/jcm.27.11.2433-2436.1989

Epidemic of Serratia marcescens bacteremia in a cardiac intensive care unit.

M E Villarino 1, W R Jarvis 1, C O'Hara 1, J Bresnahan 1, N Clark 1
PMCID: PMC267052  PMID: 2681247

Abstract

From 16 July through 27 September 1988, seven cases of nosocomial Serratia marcescens bacteremia occurred in a cardiac care unit. In all seven case patients, S. marcescens was isolated from blood cultures. Two of the seven had other microorganisms identified in the blood culture in which S. marcescens was recovered; one had Enterobacter cloacae, and one had Klebsiella pneumoniae. A case-control study was conducted to identify risk factors for bloodstream infection. Case patients were more likely than controls to have been exposed to an intra-aortic balloon pump pressure transducer (7 of 7 versus 6 of 21; P = 0.001) and to a pulmonary arterial pressure transducer (7 of 7 versus 8 of 21; P = 0.005). Cultures of in-use and in-storage transducers revealed bacterial contamination of the pressure-sensitive membranes of the transducers. S. marcescens blood culture isolates obtained from five of the seven case patients, as well as six S. marcescens isolates from cultured transducers, belonged to serotypes Oundetermined:H1 and Oundetermined:H18. E. cloacae isolates from one case patient and from two stored and two in-use transducers had identical antimicrobial suceptibility patterns. Review of cardiac care unit disinfection practices revealed that the transducers were not processed with high-level disinfection or sterilization between patient uses. We concluded that the transducers had served as reservoirs for this outbreak of bloodstream infection. Because intra-aortic balloon pumps with pressure transducers are being used more frequently in the management of critically ill cardiac patients, their role as infectious reservoirs should be considered in the investigation of nosocomial bacteremia.

Full text

PDF
2433

Selected References

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

  1. Beck-Sague C. M., Jarvis W. R. Epidemic bloodstream infections associated with pressure transducers: a persistent problem. Infect Control Hosp Epidemiol. 1989 Feb;10(2):54–59. doi: 10.1086/645961. [DOI] [PubMed] [Google Scholar]
  2. Birnboim H. C., Doly J. A rapid alkaline extraction procedure for screening recombinant plasmid DNA. Nucleic Acids Res. 1979 Nov 24;7(6):1513–1523. doi: 10.1093/nar/7.6.1513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Donowitz L. G., Marsik F. J., Hoyt J. W., Wenzel R. P. Serratia marcescens bacteremia from contaminated pressure transducers. JAMA. 1979 Oct 19;242(16):1749–1751. [PubMed] [Google Scholar]
  4. Donowitz L. G., Wenzel R. P., Hoyt J. W. High risk of hospital-acquired infection in the ICU patient. Crit Care Med. 1982 Jun;10(6):355–357. doi: 10.1097/00003246-198206000-00001. [DOI] [PubMed] [Google Scholar]
  5. Henderson D. K., Baptiste R., Parrillo J., Gill V. J. Indolent epidemic of Pseudomonas cepacia bacteremia and pseudobacteremia in an intensive care unit traced to a contaminated blood gas analyzer. Am J Med. 1988 Jan;84(1):75–81. doi: 10.1016/0002-9343(88)90011-3. [DOI] [PubMed] [Google Scholar]
  6. McClish D. K., Russo A., Franklin C., Jackson D. L., Lewandowski W., Alcover I. Profile of medical ICU vs. ward patients in an acute care hospital. Crit Care Med. 1985 May;13(5):381–386. doi: 10.1097/00003246-198505000-00002. [DOI] [PubMed] [Google Scholar]
  7. Platt R., Lehr J. L., Marino S., Munoz A., Nash B., Raemer D. B. Safe and cost-effective cleaning of pressure-monitoring transducers. Infect Control Hosp Epidemiol. 1988 Sep;9(9):409–416. doi: 10.1086/645900. [DOI] [PubMed] [Google Scholar]
  8. Traub W. H., Kleber I. Serotyping of Serratia marcescens: evaluation of Le Minor's H-immobilization test and description of three new flagellar H antigens. J Clin Microbiol. 1977 Feb;5(2):115–121. doi: 10.1128/jcm.5.2.115-121.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Wenzel R. P., Thompson R. L., Landry S. M., Russell B. S., Miller P. J., Ponce de Leon S., Miller G. B., Jr Hospital-acquired infections in intensive care unit patients: an overview with emphasis on epidemics. Infect Control. 1983 Sep-Oct;4(5):371–375. doi: 10.1017/s0195941700059774. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES