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Infection Control Fact Sheet 2007

Serratia

Serratia is a gram-negative rod shaped bacteria found in soil, water, plants and the gut in humans. It belongs to a group of bacteria known as Enterobacteriaceae which also includes Escherichia coli and Klebsiella species. Serratia thrives in moist environments and frequently contaminates solutions and hospital equipment. It often colonises the respiratory and urinary tracts of adults in hospital. Enterobacteriaceae cause nearly one third of nosocomial infections and serratia marcescens is the most common species of Serratia found in hospitals. Clinical significance The most common sites for Serratia infection include the urinary tract, respiratory tract, bloodstream, gastrointestinal tract and central nervous system (CNS). In adults, CNS infection mostly occurs following neurosurgery. Serratia is a virulent organism. When it enters the bloodstream, endotoxins are released and can cause fever, septic shock, thrombocytopaenia and DIC (Disseminated intravascular Coagulation). The mortality from Serratia bacteraemia is high. Serratia is naturally resistant to some antibiotics and can quickly become resistant to other antibiotics due to enzyme production. Transmission Nosocomial transmission of Serratia most often occurs from contaminated hands of health care workers (HCWs). HCWs with skin disorders such as paronychia or dermatitis are more likely to carry Serratia. Contaminated equipment is another source. Infections If a person is colonised with Serratia, they may become infected due to invasive devices, surgery and the severity of any underlying illness. Urinary tract infections are almost always associated with indwelling catheters. Important risks include diabetes, urinary tract obstruction and renal failure. Respiratory tract infections are common in ventilated patients. Pathogenesis involves oropharyngeal colonisation followed by aspiration of contaminated secretions via the ETT (endotracheal tube). Prevention · · · · · · Strict adherence to Standard Precautions Good handwashing practices Aseptic technique when performing procedures Minimising water reservoirs in patient care areas Disinfection of equipment after patient use Minimal use of invasive devices and timely removal of such

For further information contact The Alfred Hospital Infection Control & Hospital Epidemiology Unit on 03 9076 3139 between 8.00 ­ 4.30 Monday to Friday or visit our web site at www.alfred.org.au/departments/index.h tml Or contact your site-specific Infection Control nurse.

Image obtained from wwwmaths.gla.acc.uk

References www.bacteriamuseum.org/ www.emedicine.com www.health.vic.gov.au/

Infection Control and Hospital Epidemiology Unit, The Alfred, 2007

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Serratia is a gram negative rod shaped bacteria

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