A Nosocomial Epidemic of Antibiotic-Resistant Serratia Marcescens Urinary Tract Infections

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Abstract
S. marcescens is an important pathogen in hospitalized urologic patients. An epidemic of 134 urinary tract infections caused by a multiple antibiotic-resistant S. marcescens is described. A common source in the cystoscopy area was responsible for 105 infections. Cross-contamination on patient floors amplified the magnitude of the epidemic. There was significant patient morbidity, although no deaths could be attributed directly to the outbreak. Particular attention is directed to patient risk factors and the clinical significance of nosocomial S. marcescens infections. The clinical approach to epidemic antibiotic-resistant Serratia urinary tract infections should not rely primarily on antibiotic therapy. Stress is placed on the importance of an interdisciplinary approach to hospital-acquired infections in general and S. marcescens urinary tract infections in particular.