Management of multidrug-resistant Serratia marcescens outbreak in a tertiary cardiac care center’s pediatric ward: a comprehensive analysis

Background: S. marcescens is the one most commonly associated with human infections, known for causing serious hospital acquired infections, particularly in those who are immunocompromised, critically ill patients, mainly in settings such as intensive care units (ICUs), especially neonatal units (NICUs). Outbreaks of Serratia marcescens are often linked to poor environmental disinfection. The primary objective of this study was the identification of the source of infection and management of this outbreak. Material and Methods: A prospective cross-sectional study was carried out from September to November 2022 to investigate the increase in Carbapenem-resistant Serratia marcescens bloodstream infections. (BSIs) Results: A total of 21 patients meeting the case definition of Carbapenem-resistant Serratia marcescens bloodstream infections were identified during the outbreak period. Three main groups of observations were identified through detailed rounds and audits that could have contributed to this outbreak: overcrowding, antibiotic use and limitations in implementation of satisfactory infection prevention and control practices especially poor hand hygiene. Environmental Cultures findings showed isolation of Pseudomonas species, MRSA and Burkholderia cepacia however Serratia marcescens was not detected. Conclusion: A concerted effort involving healthcare facilities, healthcare workers, patients, and public health agencies is essential for the effective prevention of Serratia outbreaks, requiring continuous vigilance, education, and adherence to infection control measures.