Serratia marcescens (

Transcription

1 103 Serratia marcescens 1 1,2 1,3 1,4 1, Serratia marcescens ( ) df = 1, 2 = 1.474, P < S. marcescens :28: Serratia marcescens Serratia marcescens ( ) (Enterobacteriaceae) 5~40 ph () [1-5] ampicillin, macrolides cephalosporins [3-5] S. marcescens (02) DOI: /ICJ _28(3)

2 104 Serratia marcescens (laryngoscope) [1-3,6-7] [8,9] [10] 715 Serratia species % [11] S. marcescens 1.4% [3] (7 /820 ) ( 3 /654 ) ( ) df = 1, 2 = 1.474, P < S. marcescens S. marcescens ~120 80%~90% 3 3 5~ S. marcescens

3 105 ( ) ( ) 28 ( ) Z - (Identification and Susceptibility Testing) BBL Crystal S. marcescens % % 3, % % ( ) ~ ( ) ~ ( ) S. marcescens 107 6

4 106 Serratia marcescens BR Serratia marcescens (N = 5) (gm) - -1 C/S 3,053 4 Serratia marcescens -2 C/S 3,311 6 Serratia marcescens -3 C/S 3,311 5 Serratia marcescens -4 C/S 2,815 3 Serratia marcescens -5 NSD 3,195 5 Serratia marcescens BR: Baby Room; C/S: Cesarean section; NSD: Normal spontaneous delivery BR (P <.0001) Serratia marcescens amikacin gemtamicin piperacillin/tazobactam levofloxacin imipenem cefotaxime ceftriaxone ampicillin amoxicillin cefalothin cefuroxime ( ) 28 3 S. marcescens ( ) S. marcescens 3 (Genotyping)

5 107 個案 -1 5/15 5/20 住院日 感染日 出院日 個案 -2 個案 -3 個案 -4 個案 -5 5/18 5/22 5/23 住院日感染日出院日 5/20 5/22 5/24 住院日感染日出院日 5/21 5/25 住院日 感染日 出院日 5/23 5/26 5/29 住院日 感染日 出院日 Serratia marcescens Serratia marcescens /5/20 5/22 5/22 5/25 5/26 (C) 5/25 (D) 5/25 (E) 5/ /1/27 2/6 2/29 8/2 Amikacin S S S S S S S S S S S S Ampicillin/subactam R R R R R R R R R R R R Gemtamicin S S S S S S S S S S S S Piperacillin/Tazobactam S S S S S S S S S S S S Amoxicillin R R R R R R R R R R R R Levofloxacin S S S S S S S S S S S S Sulfamethoxazole-Trimetho R S S I S R R S S S S R Imipenem S S S S S S S S S S S S Cefalothin R R R R R R R R R R R R Cefuroxime R R R R R R R R R R R R Cefotaxime S S S S S S S S S S S S Ceftriaxone S S S S S S S S S S S S (Sensitive; S) (Intermittent; I) (Resistant; R) 107 6

6 108 Serratia marcescens Serratia marcescens (N = 28) 1 Other ( ) 1 Other 1 No Growth 1 Other 1 Other 2 Other 2 Other 1 Other -3 1 Other -3 1 Other -3 Stool 1 Normal flora A 1 No Growth B 1 No Growth C 1 Serratia marcescens D 1 Serratia marcescens E 1 Serratia marcescens 1 Other 1 Other 1 Other 1 Other 1 Other 1 No Growth 1 Other 1 No Growth N3 1 Other 1 Other S. marcescens

7 109 [1-11] S. marcescens 5 5 S. marcescens 1,000 ml S. marcescens 3 3 S. marcescens [8,9] [8] (colonization) [12] gentamycin [10] 107 6

8 110 Serratia marcescens S. marcescens Serratia marcescens 2013;23: () 2011;05 : Mahlen SD: Serratia infections: from military experiments to current practice. Clin Microbiol Rev 2011;24: : : ;25: Archibald LK, Corl A, Shah B, et al: Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol 1997;18: van der Sar-van der Brugge S, Arend SM, Bernards AT, et al: Risk factors for acquisition of Serratia marcescens in a surgical intensive care unit. J Hosp Infect 1999;41: (Serratia marcescens) 2003;42: Laupland KB, Parkins MD, Gregson DB, et al: Population-based laboratory surveillance for Serratia species isolates in a large Canadian health region. Eur J Clin Microbiol Infect Dis 2008;27:89-95 (2018, Jan 1). 12. Jacobs DS: Conjunctivitis. Available uptodate.com/

9 111 Survey Analysis of Serratia Marcescens Bacterial Eye Colony Cluster Infection in Neonates Hsiow-Yun Hsue 1, Huei-Ying Chen 1,2, Wen-Po Tseng 1,3, Shy-Ming Lee 1,4, Wy-Chan Lee 1,5 1 Infection Control Committee Leader, 2 Department of Laboratory, 3 Department of Medicine, 4 Department of Gynecology, 5 Superintendent, Chung Shan Hospital, Taipei,Taiwan Serratia marcescens is an opportunistic pathogen that is frequently observed in hospitals. In May 2017, the incidence of infection with this organism increased to 8.54, which was much higher than the incidence of 4.59 noted in April Statistical analysis of the number of hospital days using the chi-squared test revealed significant differences (df = 1, X 2 = 1474, P < 0.000). To avoid spreading the disease, further investigation was conducted. Results of the investigation showed that 5 cases of neonatal eye infections were due to S. marcescens. After environmental inspection, culture of 3 bottles of bath solutions showed the same bacteria. The bacteria was determined to be from the bath solution; the staff were infected through their hands, and they, in turn, infected the neonates eyes with their hands. Conclusion: The standard neonatal bath solution must not be divided or diluted, and the bath tub must be maintained clean and dry at all times when not in use. An increase in personnel education may stop this infection from spreading. Key words: Newborn, Serratia marcescens, infection 107 6