{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:03:15Z","timestamp":1785297795424,"version":"3.55.0"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22001878_as1\"><jats:title>Objective:<\/jats:title><jats:p>Investigation of the origin of a <jats:italic>Serratia marcescens<\/jats:italic> outbreak in a neonatal intensive care unit.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective case\u2013control study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as3\"><jats:title>Setting:<\/jats:title><jats:p>Regional level 3 perinatal center in Germany.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as4\"><jats:title>Patients:<\/jats:title><jats:p>This study included 4 <jats:italic>S. marcescens<\/jats:italic>\u2013positive and 19 <jats:italic>S. marcescens<\/jats:italic>\u2013negative neonates treated between February 1 and February 26, 2019, in the neonatal intensive care unit.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as5\"><jats:title>Methods:<\/jats:title><jats:p>A case\u2013control study was performed to identify the source of the outbreak. The molecular investigation of S. marcescens isolates collected during the outbreak was performed using pulsed-field gel electrophoresis and next-generation sequencing.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as6\"><jats:title>Results:<\/jats:title><jats:p>The retrospective case\u2013control study showed a significant correlation (P &lt; .0001) between S. marcensens infection or colonization and consumption of donor milk that had tested negative for pathogenic bacteria from a single breast milk donor. Pulsed-field gel electrophoresis and next-generation sequencing retrospectively confirmed an S. marcescens strain isolated from the breast milk of this donor as the possible origin of the initial outbreak. The outbreak was controlled by the implementation of an infection control bundle including a multidisciplinary infection control team, temporary nutrition of infants with formula only and\/or their mother\u2019s own milk, repeated screening of all inpatients, strict coat and glove care, process observation, retraining of hand hygiene and continuous monitoring of environmental cleaning procedures.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22001878_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>Low-level contaminated raw donor milk can be a source of infection and colonization of preterm infants with S. marcescens even if it tests negative for bacteria.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.187","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T06:31:57Z","timestamp":1659681117000},"page":"891-897","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":23,"title":["<i>Serratia marcescens<\/i> outbreak in a neonatal intensive care unit associated with contaminated donor milk"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8144-5033","authenticated-orcid":false,"given":"Lukas","family":"Bechmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"B\u00f6ttger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claas","family":"Baier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2602-2040","authenticated-orcid":false,"given":"Aljoscha","family":"Tersteegen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6659-6738","authenticated-orcid":false,"given":"Achim J.","family":"Kaasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Geginat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,8,5]]},"reference":[{"key":"S0899823X22001878_ref15","doi-asserted-by":"publisher","DOI":"10.1177\/0890334409333425"},{"key":"S0899823X22001878_ref17","first-page":"42","article-title":"Praktische Umsetzung sowie krankenhaushygienische und infektionspr\u00e4ventive Konsequenzen des mikrobiellen Kolonisationsscreenings bei intensivmedizinisch behandelten Fr\u00fch- und Neugeborenen","year":"2013","journal-title":"Epidemiologisches Bull"},{"key":"S0899823X22001878_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-016-0922-y"},{"key":"S0899823X22001878_ref13","doi-asserted-by":"publisher","DOI":"10.3390\/nu8080477"},{"key":"S0899823X22001878_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0463.2012.02879.x"},{"key":"S0899823X22001878_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000383"},{"key":"S0899823X22001878_ref4","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4867134"},{"key":"S0899823X22001878_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(86)90057-5"},{"key":"S0899823X22001878_ref14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1055\/s-0042-116443","article-title":"Wie wertvoll ist Muttermilch? 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}