Antimicrobial resistance and infection control · 2025
Understanding Serratia bockelmannii transmission during a neonatal intensive care unit outbreak: a combined genotyping and case-control study.
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Jaakkola Kaisa, Fischer Aurélie, Piquart Louise, Cassier Pierre, Dauwalder Olivier, Picaud Jean-Charles, Colomb-Cotinat Mélanie, Haÿs Stéphane, Rasigade Jean-Philippe, Dananché Cédric
Аннотация
BACKGROUND: Serratia marcescens complex (SMC) is a group of opportunistic pathogens frequent in neonatal intensive care unit (NICU) outbreaks. We report a seven-month NICU outbreak of multidrug-resistant (MDR) SMC strain and assess the acquisition risk factors.
METHODS: Bacterial isolates were sequenced using Illumina technology and profiled for antimicrobial resistance (AMR). Cases (culture positive for SMC) were compared with birth date and ward-matched controls (SMC negative) to identify clinical and environmental factors associated with SMC acquisition.
RESULTS: A single strain of Serratia bockelmannii caused 42 cases from June 2022 to January 2023. All sequenced isolates (n = 49) carrued the same AMR genes, while the antibiogram (n = 32) assigned 15 strains as MDR, and 17 as non-MDR. The outbreak strain was recovered from ward surfaces and an analytical study revealed that beds used by several cases increased the acquisition odds by 3.27 (95%CI 1.71-8.77, p-value = 0.003) after adjusting for sex and length of stay.
CONCLUSIONS: The genomic typing was pivotal in confirming clonality across S. bockelmannii isolates with varied antibiograms, and identifying the bacterial species. Serratia bockelmannii should be considered during SMC outbreaks. Incubator-related within-ward transmission highlights the need for tailored risk assessments and disinfection protocols to prevent pathogen transmission and to improve infection prevention protocols.
METHODS: Bacterial isolates were sequenced using Illumina technology and profiled for antimicrobial resistance (AMR). Cases (culture positive for SMC) were compared with birth date and ward-matched controls (SMC negative) to identify clinical and environmental factors associated with SMC acquisition.
RESULTS: A single strain of Serratia bockelmannii caused 42 cases from June 2022 to January 2023. All sequenced isolates (n = 49) carrued the same AMR genes, while the antibiogram (n = 32) assigned 15 strains as MDR, and 17 as non-MDR. The outbreak strain was recovered from ward surfaces and an analytical study revealed that beds used by several cases increased the acquisition odds by 3.27 (95%CI 1.71-8.77, p-value = 0.003) after adjusting for sex and length of stay.
CONCLUSIONS: The genomic typing was pivotal in confirming clonality across S. bockelmannii isolates with varied antibiograms, and identifying the bacterial species. Serratia bockelmannii should be considered during SMC outbreaks. Incubator-related within-ward transmission highlights the need for tailored risk assessments and disinfection protocols to prevent pathogen transmission and to improve infection prevention protocols.