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Unveiling Serratia Marcescens Outbreak Control in a High-Risk Pregnancy Ward: A Study in Environmental Management and WGS Interaction

A recent retrospective study has revealed a significant outbreak of the bacterium, Serratia marcescens, within an obstetric ward housing high-risk pregnant women. Endemic and wide-ranging in the environment, such bacterial invasion can be fatal during pregnancy, potentially inducing persistent chorioamnionitis. This particular report sheds light on the outbreak’s impact and subsequent control over it, with a focus on the practical applications of the Adenosine Triphosphate (ATP) test in hospital environmental management.

Furthermore, the infections among patients caused by similar bacterial strains were verified through whole-genome sequencing (WGS) techniques. These methods were combined within a comprehensive infection control approach, including 1-month of on-site staff training and monitoring, resulting in no further outbreaks for six months post-intervention. Although S. marcescens was not confirmed in the environmental cultures – likely due to intense environmental cleaning and disposal of possibly contaminated specimens prior to culture testing- Interestingly, ATP-test indicated that high-contact and injection preparation areas remained unclean, based on relative light units.

Despite the outbreak, the sample analysis via WGS revealed a correlation among the individual S. marcescens isolates from the patients involved, indicating a common strain. This highlights the importance of WGS in determining the spread of bloodstream infections by the same bacterium. Ultimately, improvements in environmental cleaning and behavioral modifications within healthcare teams are fundamental in controlling such bacterial manifestations, underscoring the importance of comprehensive, consistently applied infection prevention strategies. In essence, effective hospital environmental management and the innovative use of the ATP test, combined with the technical power of WGS to verify interrelated infections, are substantial tools in the fight against infection outbreaks. The results from the study show how effective controls, alongside technology utilization, can contribute significantly to infection prevention in obstetric wards and beyond.

Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09134-1

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