粘质沙雷菌是一种革兰氏阴性细菌,在医院环境中发现,通常与新生儿病房的爆发有关。从我们医院一名新生儿的血流培养物中检测到一种粘质沙菌分离物,随后爆发。这项研究的目的是描述新生儿病房粘质沙菌暴发的分子流行病学。
为了调查疫情,本单位2018年8月至9月收治的所有患者每周进行直肠拭子监测培养.环境样本于2018年9月从潜在来源获得。通过脉冲场凝胶电泳(PFGE)进行分离株的分型。此外,我们研究了氯己定对粘质沙门氏菌的体外活性。
在此期间,146名婴儿在我们的新生儿病房住院,其中16例患者的粘质链球菌阳性样本。共收集36个环境监测样本,来自定植婴儿培养箱的听诊器的一个样本对粘质沙菌呈阳性。所有18个分离株,包括听诊器的隔离物,属于一个PFGE集群。我们发现浓度很低的氯己定,即使施用时间接近0,也实现了粘质沙棘的量的显著减少。
一个独特的粘质沙菌克隆引起了这次爆发,包括患者和一个听诊器的分离株。随着具体控制措施的提前实施,疫情得到控制。
Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit.
In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens.
During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens.
A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.