Background In October 1999, 7 patients, with postoperative infections caused by Serratia marcescens were identified at a community hospital in Ontario, Canada. We describe the investigation of this outbreak. Methods. ...
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Background In October 1999, 7 patients, with postoperative infections caused by Serratia marcescens were identified at a community hospital in Ontario, Canada. We describe the investigation of this outbreak. Methods. We undertook a case-control study to determine risk factors associated with infection. Case subjects consisted of patients who had under-one surgery and acquired bacteremia or wound infections that, when cultured, grew S marcescens. Control subjects were selected from the cohort of patients who underwent surgery at the same hospital during the outbreak period. Chart reviews were conducted for case and control subjects. Environmental samples were taken from medications and liquids in the operating rooms and from one health care professional who was involved in all the cases. S marcescens isolates were forwarded to a reference laboratory for pulsed field gel electrophoresis. Results: We identified 7 case subjects and 29 control subjects. Five patients had bacteremia and 2 patients had wound infections. Two patients with bacteremia died. All patients with bacteremia or wound infections were exposed to a single anesthetist (anesthetist A) and were administered the anesthetic medication propofol. These patients were more than 40 times more likely to have had anesthetist A administer their anesthetic (OR 41.6 95% Cl 3.6-1120) and 22 times more likely to have received propofol (OR 22, 95% Cl 2.1-550) than were control subjects. None of the environmental samples or cultures from anesthetist A were positive for S marcescens. Six of the 7 human isolates had an identical pulsed field gel electrophoresis pattern, and the seventh was untypeable. Conclusions: This outbreak of postoperative infections was very. strongly linked to the use of propofol by one anesthetist. Health care professionals must follow strict aseptic techniques when using propofol and should review these techniques regularly.
PURPOSE: To report a case of Serratia Marcescens corneal ulcer as a complication of orthokeratology treatment. METHODS: Case report. RESULTS: A 9-year,old male who underwent orthokeratology treatment for 6 months suff...
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PURPOSE: To report a case of Serratia Marcescens corneal ulcer as a complication of orthokeratology treatment. METHODS: Case report. RESULTS: A 9-year,old male who underwent orthokeratology treatment for 6 months suffered from a corneal ulcer. The refractive state of lesion eye was -5.5D/-1.25D X 180 degrees, and visual acuity was hand motion at 30 cm. He wore a retainer lens, rigid gas permeable lens, overnight for 2 months before the corneal ulcer occurred. Ulcer became worse after tobramycin and gentamycin treatment for 2 days. After ciprofloxacin treatment, the ulcer healed and visual acuity recovered to 20/20 with spectacle correction. Cultures of the cornea tissue and contact lens storage solution both grew Serratia Marcescens, Which was sensitive to ciprofloxacin. CONCLUSION: Overnight wearing of a rigid contact lens is a risk factor for a corneal ulcer. (C) 2001 by Elsevier Science Inc. All rights reserved.
Electrocuting insect traps (EIT) are popular devices frequently used by homeowners and food handlers attempting to localize the control of flying insects, including the ubiquitous house fly (Musca domestica L.). The t...
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Electrocuting insect traps (EIT) are popular devices frequently used by homeowners and food handlers attempting to localize the control of flying insects, including the ubiquitous house fly (Musca domestica L.). The traps contain a visual attractant and a high-voltage metal grid. Upon contact with the grids, the insects are disintegrated by the high voltage. As part of a systematic evaluation of EITs and their role in infectious disease spread, we quantitated spread of bacteria and a bacterial virus during electrocution or house flies. We loaded flies with Serratia marcescens or with the Escherichia coli phage Phi X174 and placed sprayed or fed flies into a room containing an EIT. While flies were being electrocuted, liberated particles and bacteria were assayed via agar plates or via air filtration samplers. Sprayed flies released one of every 10,000 of the added bacteria or viruses, and fed flies released one of every 1,000,000 of the consumed bacteria or viruses. Results of our studies suggest EITs could play a role in the spread of infectious disease agents, but the potential is influenced by the insect's route of contamination.
PURPOSE: To report a Serratia marcescens infection that clinically simulated a conjunctival neoplasm. METHOD: Case report. RESULTS: A healthy 80-year-old man without contact lenses presented with a pink-yellow conjunc...
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PURPOSE: To report a Serratia marcescens infection that clinically simulated a conjunctival neoplasm. METHOD: Case report. RESULTS: A healthy 80-year-old man without contact lenses presented with a pink-yellow conjunctival mass that resembled a solid neoplasm. Stains and cultures of material that exuded from the mass during surgery revealed S marcescens. Histopathology disclosed an epithelial-lined cyst with macrophages containing S marcescens. CONCLUSION: Although S marcescens usually affects the eye as a keratoconjunctivitis in patients with contact lenses, it can also present as a mass simulating a neoplasm in a patient who does not wear contact lenses. (Am J Ophthalmol 2000;129:247-248, (C) 2000 by Elsevier Science Inc. All rights reserved.).
A total of 66 Serratia marcescens isolates from 46 patients was investigated by macrorestriction using XbaI followed by pulsed-field gel electrophoresis. 7 restriction fragment patterns attributable to more than one p...
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A total of 66 Serratia marcescens isolates from 46 patients was investigated by macrorestriction using XbaI followed by pulsed-field gel electrophoresis. 7 restriction fragment patterns attributable to more than one patient and 9 individual patterns were identified. The isolates were additionally characterized by multilocus enzyme electrophoresis and Fourier-transform infrared spectroscopy. The macrorestriction patterns and the multilocus enzyme electrophoresis patterns corresponded fairly well while the classifications derived from these methods were not completely congruent. The grouping achieved by Fourier-transform infrared spectroscopy on the basis of high (> 1000) and moderately high heterogeneity values (300) was consistent with the macrorestriction results. Grouping on a lower heterogeneity level did not contribute to further discrimination. In general, Fourier-transform infrared spectroscopy was less discriminatory than the two Other methods, but easier to perform. Therefore, laboratories equipped with the necessary devices may use it to rapidly select bacterial isolates for macrorestriction or other well established characterization procedures.
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