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Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package

OBJECTIVE: This report describes a cluster of patients infected by Serratia marcescens in a metropolitan neonatal intensive care unit (NICU) and a package of infection control interventions that enabled rapid, effective termination of the outbreak. DESIGN: Cross-sectional analytical study using whol...

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Autores principales: Howard-Jones, Annaleise R., Janto, Catherine, Jennings, Zoe, Branley, James, Wang, Qinning, Sintchenko, Vitali, Samarasekara, Harsha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726519/
https://www.ncbi.nlm.nih.gov/pubmed/36483351
http://dx.doi.org/10.1017/ash.2022.234
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author Howard-Jones, Annaleise R.
Janto, Catherine
Jennings, Zoe
Branley, James
Wang, Qinning
Sintchenko, Vitali
Samarasekara, Harsha
author_facet Howard-Jones, Annaleise R.
Janto, Catherine
Jennings, Zoe
Branley, James
Wang, Qinning
Sintchenko, Vitali
Samarasekara, Harsha
author_sort Howard-Jones, Annaleise R.
collection PubMed
description OBJECTIVE: This report describes a cluster of patients infected by Serratia marcescens in a metropolitan neonatal intensive care unit (NICU) and a package of infection control interventions that enabled rapid, effective termination of the outbreak. DESIGN: Cross-sectional analytical study using whole-genome sequencing (WGS) for phylogenetic cluster analysis and identification of virulence and resistance genes. SETTING: NICU in a metropolitan tertiary-care hospital in Sydney, Australia. PATIENTS: All neonates admitted to the level 2 and level 3 neonatal unit. INTERVENTIONS: Active inpatient and environmental screening for Serratia marcescens isolates with WGS analysis for identification of resistance genes as well as cluster relatedness between isolates. Planning and implementation of a targeted, multifaceted infection control intervention. RESULTS: The cluster of 10 neonates colonized or infected with Serratia marcescens was identified in a metropolitan NICU. Two initial cases involved devastating intracranial infections with brain abscesses, highlighting the virulence of this organism. A targeted and comprehensive infection control intervention guided by WGS findings enabled termination of this outbreak within 15 days of onset. WGS examination demonstrated phylogenetic linkage across the cluster, and genomic unrelatedness of later strains identified in the neonatal unit and elsewhere. CONCLUSIONS: A comprehensive, multipronged, infection control package incorporating close stakeholder engagement, frequent microbiological patient screening, environmental screening, enhanced cleaning, optimization of hand hygiene and healthcare worker education was paramount to the prompt control of Serratia marcescens transmission in this neonatal outbreak. WGS was instrumental in establishing relatedness between isolates and identification of possible transmission pathways in an outbreak setting.
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spelling pubmed-97265192022-12-07 Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package Howard-Jones, Annaleise R. Janto, Catherine Jennings, Zoe Branley, James Wang, Qinning Sintchenko, Vitali Samarasekara, Harsha Antimicrob Steward Healthc Epidemiol Original Article OBJECTIVE: This report describes a cluster of patients infected by Serratia marcescens in a metropolitan neonatal intensive care unit (NICU) and a package of infection control interventions that enabled rapid, effective termination of the outbreak. DESIGN: Cross-sectional analytical study using whole-genome sequencing (WGS) for phylogenetic cluster analysis and identification of virulence and resistance genes. SETTING: NICU in a metropolitan tertiary-care hospital in Sydney, Australia. PATIENTS: All neonates admitted to the level 2 and level 3 neonatal unit. INTERVENTIONS: Active inpatient and environmental screening for Serratia marcescens isolates with WGS analysis for identification of resistance genes as well as cluster relatedness between isolates. Planning and implementation of a targeted, multifaceted infection control intervention. RESULTS: The cluster of 10 neonates colonized or infected with Serratia marcescens was identified in a metropolitan NICU. Two initial cases involved devastating intracranial infections with brain abscesses, highlighting the virulence of this organism. A targeted and comprehensive infection control intervention guided by WGS findings enabled termination of this outbreak within 15 days of onset. WGS examination demonstrated phylogenetic linkage across the cluster, and genomic unrelatedness of later strains identified in the neonatal unit and elsewhere. CONCLUSIONS: A comprehensive, multipronged, infection control package incorporating close stakeholder engagement, frequent microbiological patient screening, environmental screening, enhanced cleaning, optimization of hand hygiene and healthcare worker education was paramount to the prompt control of Serratia marcescens transmission in this neonatal outbreak. WGS was instrumental in establishing relatedness between isolates and identification of possible transmission pathways in an outbreak setting. Cambridge University Press 2022-06-27 /pmc/articles/PMC9726519/ /pubmed/36483351 http://dx.doi.org/10.1017/ash.2022.234 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Original Article
Howard-Jones, Annaleise R.
Janto, Catherine
Jennings, Zoe
Branley, James
Wang, Qinning
Sintchenko, Vitali
Samarasekara, Harsha
Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title_full Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title_fullStr Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title_full_unstemmed Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title_short Prompt control of a Serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
title_sort prompt control of a serratia marcescens outbreak in a neonatal intensive care unit informed by whole-genome sequencing and comprehensive infection control intervention package
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726519/
https://www.ncbi.nlm.nih.gov/pubmed/36483351
http://dx.doi.org/10.1017/ash.2022.234
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