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- Title
Clustering of Serratia marcescens infections during six years: Epidemiology and risk factors for mortality.
- Authors
Ulu-Kilic, Aysegul; Alp, Emine; Orhan, Tülay; Cevahir, Fatma; Ersoy, Safiye; Altun, Dilek; Mclaws, Mary-Louise
- Abstract
Background: Serratia marcescens is responsible for hospital-associated infections found in clusters and outbreaks. Based on a previous outbreak in our institution, we aimed to evaluate epidemiological characteristics and risk factors for mortality of patients with S. marcescens infection in the previous five-year period. Method: A retrospective analysis of the patients with S. marcescens colonization and infection between January 2008 and December 2012 was included. Data included demographical characteristics, co-morbidities, and invasive procedures performed were obtained from the computer databases, the microbiology laboratory, and infection control surveillance data. Data were plotted monthly on process control charts including Exponentially Weighted Moving Average (EWMA) statistics. Results: We identified 378 patients colonized or infected with S. marcescens between January 2008 and December 2012. The median age of patients was 57 years (0-90 years). Of all hospitalized patients 60 (21.7%) expired and 216 (78.2%) survived. Previous ICU stay, respiratory failure, loss of consciousness, total parenteral nutrition, mechanical ventilation, intubation, central catheterization, urinary catheterization, hemodialysis, previous use of antibiotics were significant risk factors for mortality. Multivariate analysis showed that mortality risk of Serratia infection increased threefold for hemodialysis patients and fivefold for intubated patients. A mean monthly level of Serratia infections hospital-wide identified from process control chart statistics was 6.3 and ranged from 5.2-8.8 over five years. For ICU cases the mean was 1.9 and ranged over five years from 1.1 to 3.3. Conclusions: S. marcescens is an opportunistic pathogen associated with significant mortality. We documented that S. marcescens strains persisted over prolonged periods causing cluster of infections. Clinicians should consider that small clusters of S. marcescens infections are the tip of the iceberg and may be a predictor of an outbreak.
- Subjects
TURKEY; ACADEMIC medical centers; CHI-squared test; CROSS infection; DRUG resistance in microorganisms; EPIDEMICS; PROBABILITY theory; SERRATIA diseases; RETROSPECTIVE studies; DATA analysis software; MANN Whitney U Test
- Publication
Canadian Journal of Infection Control / Revue Canadienne de Prévention des Infections, 2017, Vol 32, Issue 2, p104
- ISSN
1183-5702
- Publication type
Article