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Original ArticleOpen Access
The Outbreak of Seatia marcescens Bacteremia in a Pediatric Ward
Siriraj 
,
Chokephaibulkit K ,
Danchaivijitr S ,
Boonpragaigaew G ,
Dhiraputra C ,
Vanprapa N ,
Visitsunthom N ,
Trakulsomboon S
,
Chokephaibulkit K ,
Danchaivijitr S ,
Boonpragaigaew G ,
Dhiraputra C ,
Vanprapa N ,
Visitsunthom N ,
Trakulsomboon S Between October 20 and November 11, 1997,
Serratia marcescens
bacteremia was iden-
tified in 8 patients in a pediatric ward at Siriraj Hospital. The organism was isolated from 17 blood
and 3 bone marrow specimens. The only common associated factor in these patients was that
they all had received an intravenous fluid infusion. In the attempt to investigate the source of
S.marcescens
implicated in the outbreak,l08 specimens of intravenous fluid, 3 intravenous fluid
bottle caps, 4 specimens from intravenous fluid tubing sets, 21 specimens of antiseptics used on
the ward, 28 specimens of rectal swabs from patients on the ward, 1 sample of blood culture media
prepared by the hospital for routine use, and 62 environmental specimens including hand swabs of
the medical personnel, refrigerator, air conditioning, milk samples, room air, water sink, wooden
splint and adhesive tape used to immobilize the intravenous access. Of 227 specimens sent for
culture,
S.marcescens
was isolated from only one specimen collected from the in-use intravenous
fluid given to a patient with
Serratia
bacteremia.
S.marcescens
was not found in any other surveil-
lance culture. The 8 patients were placed under quarantine in the same room with an exclusive
nursing team. With the investigation and intervention including monitoring for meticulous hand
washing of the ward staff, the outbreak was stopped within 7 days. Although the investigation failed
to discover the environmental reservoir of
S.marcescens
in this outbreak, the data suggested that
intravenous fluid was probably the route of transmission and the medical personnel played an
important role in spreading the infection.
Key word :
Serratia Marcescens,
Outbreak, Bacteremia, Children, Nosocomial Infection
Serratia marcescens
bacteremia was iden-
tified in 8 patients in a pediatric ward at Siriraj Hospital. The organism was isolated from 17 blood
and 3 bone marrow specimens. The only common associated factor in these patients was that
they all had received an intravenous fluid infusion. In the attempt to investigate the source of
S.marcescens
implicated in the outbreak,l08 specimens of intravenous fluid, 3 intravenous fluid
bottle caps, 4 specimens from intravenous fluid tubing sets, 21 specimens of antiseptics used on
the ward, 28 specimens of rectal swabs from patients on the ward, 1 sample of blood culture media
prepared by the hospital for routine use, and 62 environmental specimens including hand swabs of
the medical personnel, refrigerator, air conditioning, milk samples, room air, water sink, wooden
splint and adhesive tape used to immobilize the intravenous access. Of 227 specimens sent for
culture,
S.marcescens
was isolated from only one specimen collected from the in-use intravenous
fluid given to a patient with
Serratia
bacteremia.
S.marcescens
was not found in any other surveil-
lance culture. The 8 patients were placed under quarantine in the same room with an exclusive
nursing team. With the investigation and intervention including monitoring for meticulous hand
washing of the ward staff, the outbreak was stopped within 7 days. Although the investigation failed
to discover the environmental reservoir of
S.marcescens
in this outbreak, the data suggested that
intravenous fluid was probably the route of transmission and the medical personnel played an
important role in spreading the infection.
Key word :
Serratia Marcescens,
Outbreak, Bacteremia, Children, Nosocomial Infection
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