NICU

Neonatal Intensive Care Unit (NICU)



Neonatal Intensive Care Unit (NICU)

Annotated Bibliography

Anderson et al., 2008 B. Anderson, S. Nicholas, B. Sprague, J. Campos, B. Short and N. Singh, Molecular and descriptive epidemiology of multidrug-resistant Enterobacteriaceae in hospitalized infants *, Infect. Control Hosp. Epidemiol. 29 (2008), pp. 250-255.

The aim of this review is to describe important characteristics of S. marcescens outbreaks in neonatal and pediatric intensive care units. Hitherto, several nosocomial outbreaks of S. marcescens have been published, but no systematic analysis is available. The conclusions for clinical practice derived from this analysis are presented to support clinical decision making by the attending physicians, pediatric infectious disease specialists and hospital infection control teams in case of a S. marcescens outbreak in the NICU or PICU setting.

Bates and Pearse, 2005 C.J. Bates and R. Pearse, Use of hydrogen peroxide vapour for environmental control during a Serratia outbreak in a neonatal intensive care unit, J. Hosp. Infect. 61 (2005), pp. 364-366.

Risk factors derived from case control studies and confirmed in multivariate analysis were reported in 8 studies. Assadian et al. (2002) emphasized that the indications for antibiotic treatment of mothers should be reevaluated to avoid unnecessary exposure to antibiotics with the potential of over-growth of resistant organisms. The results of Crivaro et al. (2007) confirmed antibiotic combination therapy in the medical history of the patient as a risk factor for colonization/infection with S. marcescens.

Berger et al., 2002 A. Berger, K. Rohrmeister, N. Haiden, O. Assadian, V. Kretzer and C. Kohlhauser, Serratia marcescens in the neonatal intensive care unit: re-emphasis of the potentially devastating sequelae, Wien. Klin. Wochenschr. 114 (2002), pp. 1017-1022.

This investigation served to emphasize that an outbreak may occur with more than one epidemic strain and that strain heterogeneity itself does not exclude an outbreak. Ribotyping of specimens revealed that not all outbreaks were clonal in origin (Friedman et al., 2008). The three consecutive outbreaks reported by Fleisch et al. (2002) were caused by 3 genetically unrelated clones of S. marcescens.

Casolari et al., 2005 C. Casolari, M. Pecorari, G. Fabio, S. Cattani, C. Venturelli, L. Piccinini, M.G. Tamassia, W. Gennari, A.M. Sabbatini and G.etal. Leporati, A simultaneous outbreak of Serratia marcescens and Klebsiella pneumoniae in a neonatal intensive care unit, J. Hosp. Infect. 61 (2005), pp. 312-320.

In most studies, in vitro antimicrobial susceptibility patterns did not prove to be an accurate predictor of strain relatedness for S. marcescens since genotypically related isolates showed different antibiotic susceptibility patterns (Milisavljevic et al., 2004). No valid correlation was found between the PFGE patterns, and in vitro susceptibility profiles by Miranda et al. (1996). On the other hand, Steppberger et al. (2002) detected an identical in vitro antimicrobial susceptibility pattern in two genetically distinct S.marcescens strains related to the outbreak.

Hota et al., 2009 S. Hota, Z. Hirji, K. Stockton, C. Lemieux, H. Dedier, G. Wolfaardt and M.A. Gardam, Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design, Infect. Control Hosp. ...