ORIGINAL ARTICLE   

Minerva Pediatrics 2023 April;75(2):180-7

DOI: 10.23736/S2724-5276.17.04856-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Epidemiology of Serratia marcescens infections in NICU of a Teaching and Research Hospital in Northern Italy

Elisa BUTTINELLI ¹ ✉, Ilaria ARDOINO ², Monica LANZONI ³, Giulia DOMENICONI ¹, Lorenza PUGNI ⁴, Andrea RONCHI ⁴, Fabio MOSCA ⁴, Elia BIGANZOLI ², Silvana CASTALDI ^{2, 3}

¹ Post Graduate School in Public Health, University of Milan, Milan, Italy; ² Department of Clinical Science and Community Health, University of Milan, Milan, Italy; ³ Quality Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; ⁴ Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

BACKGROUND: Serratia marcescens (Sm) is a known cause of infection and colonization in neonates receiving intensive care. The aim of this study was to identify the risk factors for colonization and infection with Sm in Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital.
METHODS: A case-control study was conducted from January to December 2011 in neonates admitted to the NICU. Cases are patients with a microbiologically confirmed infection or colonization, controls were randomly chosen among patients admitted to the same NICU.
RESULTS: Globally, 39 acquired infections or colonizations were identified. Among factors related to pregnancy, only premature delivery was independently associated to the risk of infection; as well as mechanical ventilation and catheterization for parenteral nutrition, considering indwelling devices. Prolonged administration with antibiotics were also related to the risk of infection. Among Sm strains which have been tested to antibiotics, all have been resistant to amoxicillin/clavulanic acid and to colistin.
CONCLUSIONS: This study confirms the association between Sm infection or colonization and low gestational age. Invasive medical devices and medications, strictly necessary in care-support of preterm neonates, are likely related to Sm infection too. Preventive control strategies are expected to be effective in the control of Sm spread in NICUs.

KEY WORDS: Serratia marcescens; Neonatal intensive care units; Cross infection