P Leng1, W L Huang2, T He3, Y Z Wang4, H N Zhang5. 1. Department of Pharmacy, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; Department of Pharmacology, Medical College of Qingdao University, Qingdao, Shandong, China. 2. Department of Nosocomial Infection Control, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. 3. Department of Orthopaedics and Traumatology, Yantai Yuhuangding Hospital, Affiliated to Qingdao University Medical College, Yantai, Shandong, China. 4. Department of Joint Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China. 5. Department of Joint Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shangdong, China. Electronic address: zhhaining@hotmail.com.
Abstract
BACKGROUND: Fourteen postoperative infections caused by Serratia marcescens were detected in patients on the neurosurgical wards and spinal surgery ward of a 2640-bed hospital between 26th December 2012 and 5th June 2013. AIM: To investigate the source of the outbreak, identify risk factors and implement infection control measures. METHODS: Cultures were collected from healthcare workers and potential environmental sources. S. marcescens isolates were characterized by antibiotic susceptibility testing and pulsed-field gel electrophoresis (PFGE). A retrospective case-control study was performed to identify the risk factors. FINDINGS: The outbreak involved 14 patients, five of whom required more than one surgical procedure. S. marcescens was isolated from cerebrospinal fluid, brain tissue, sputum and other secretions. S. marcescens was also cultured from samples taken from the hands of two barbers and their razors. Exposure to the two barbers [odds ratio (OR) 78.0, P < 0.0001] and wound drainage (OR 4.889, P = 0.028) were risk factors. Pre-operative shaving by the barbers was the only independent risk factor (OR 78.0, P < 0.0001). Isolates of S. marcescens from patients, barbers and razors were indistinguishable by PFGE and antibiotic susceptibility pattern. The outbreak ended after removal of the implicated barbers, extensive re-inforcement of infection control procedures and re-education. CONCLUSION: These results underscore the risk of postoperative infection associated with pre-operative wet shaving.
BACKGROUND: Fourteen postoperative infections caused by Serratia marcescens were detected in patients on the neurosurgical wards and spinal surgery ward of a 2640-bed hospital between 26th December 2012 and 5th June 2013. AIM: To investigate the source of the outbreak, identify risk factors and implement infection control measures. METHODS: Cultures were collected from healthcare workers and potential environmental sources. S. marcescens isolates were characterized by antibiotic susceptibility testing and pulsed-field gel electrophoresis (PFGE). A retrospective case-control study was performed to identify the risk factors. FINDINGS: The outbreak involved 14 patients, five of whom required more than one surgical procedure. S. marcescens was isolated from cerebrospinal fluid, brain tissue, sputum and other secretions. S. marcescens was also cultured from samples taken from the hands of two barbers and their razors. Exposure to the two barbers [odds ratio (OR) 78.0, P < 0.0001] and wound drainage (OR 4.889, P = 0.028) were risk factors. Pre-operative shaving by the barbers was the only independent risk factor (OR 78.0, P < 0.0001). Isolates of S. marcescens from patients, barbers and razors were indistinguishable by PFGE and antibiotic susceptibility pattern. The outbreak ended after removal of the implicated barbers, extensive re-inforcement of infection control procedures and re-education. CONCLUSION: These results underscore the risk of postoperative infection associated with pre-operative wet shaving.
Authors: John W A Rossen; Jill Dombrecht; Diederik Vanfleteren; Katrien De Bruyne; Alex van Belkum; Sigrid Rosema; Mariette Lokate; Erik Bathoorn; Sandra Reuter; Hajo Grundmann; Julia Ertel; Paul G Higgins; Harald Seifert Journal: J Clin Microbiol Date: 2019-03-28 Impact factor: 5.948
Authors: Eun Jin Kim; Wan Beom Park; Jung-Ki Yoon; Won-Sang Cho; Su Jung Kim; Young Rok Oh; Kang Il Jun; Chang Kyung Kang; Pyeong Gyun Choe; Jong-Il Kim; Eun Hwa Choi; Myoung Don Oh; Nam Joong Kim Journal: Antimicrob Resist Infect Control Date: 2020-05-12 Impact factor: 4.887