Abstract
(1) Background: We determined the relevance of intestinal dominance by Serratia spp. during a neonatal outbreak over 13 weeks. (2) Methods: Rectal swabs (n = 110) were obtained from 42 neonates. Serratia spp. was cultured from swabs obtained from 13 neonates (Group 1), while the other 29 neonates were culture-negative (Group 2). Total DNA was extracted from rectal swabs, and quantitative PCRs (qPCRs) using Serratia- and 16SrRNA-gene-specific primers were performed. relative intestinal loads (RLs) were determined using ΔΔCt. Clonality was investigated by random amplified polymorphic DNA analysis and whole-genome sequencing. (3) Results: The outbreak was caused by Serratia marcescens during the first eight weeks and Serratia ureilytica during the remaining five weeks. Serratia spp. were detected by qPCR in all Group 1 neonates and eleven Group 2 neonates. RLs of Serratia spp. were higher in Group 1 as compared to Group 2 (6.31% vs. 0.09%, p < 0.05) and in the first swab compared to the last (26.9% vs. 4.37%, p < 0.05). Nine neonates had extraintestinal detection of Serratia spp.; eight of them were infected. RLs of the patients with extraintestinal spread were higher than the rest (2.79% vs. 0.29%, p < 0.05). (4) Conclusions: Intestinal dominance by Serratia spp. plays a role in outbreaks and extraintestinal spread.
Highlights
Serratia species have had a long history of causing nosocomial outbreaks
Serratia infections may be challenging due to their intrinsic non-susceptibilities to antimicrobial agents that include second-generation cephalosporins and tetracyclines [4]
We demonstrate a link between intestinal dominance by Serratia spp
Summary
Serratia species have had a long history of causing nosocomial outbreaks This is mainly due to their ability to persist for long periods of time in water environments and having the potential to cause a full spectrum of clinical infections [1]. These opportunistic pathogens, and especially Serratia marcescens, are a common cause of outbreaks in paediatric units, with significant rates of morbidity and mortality in immunocompromised patients and preterm infants [2,3]. Serratia infections may be challenging due to their intrinsic non-susceptibilities to antimicrobial agents that include second-generation cephalosporins and tetracyclines [4] They have the potential to acquire resistances to additional antimicrobial agents, including the broad spectrum carbapenems [5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
