{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:20:31Z","timestamp":1790882431153,"version":"4.1.0"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":4841,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2001,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0195941700069526_abs1\"><jats:title><jats:bold>Objective:<\/jats:bold><\/jats:title><jats:p>To investigate and control a biphasic outbreak of<jats:italic>Serratia marcescens<\/jats:italic>in a neonatal intensive care unit (NICU).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs2\"><jats:title><jats:bold>Design:<\/jats:bold><\/jats:title><jats:p>Epidemiological and laboratory investigation of the outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs3\"><jats:title><jats:bold>Setting:<\/jats:bold><\/jats:title><jats:p>The NICU of the 1,470-bed teaching hospital of the University \u201cFederico II,\u201d Naples, Italy.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs4\"><jats:title><jats:bold>Patients:<\/jats:bold><\/jats:title><jats:p>The outbreak involved 56 cases of colonization by S<jats:italic>marcescens<\/jats:italic>over a 15-month period, with two epidemic peaks of 6 and 3 months, respectively. Fourteen (25%) of the 56 colonized infants developed clinical infections, 50% of which were major (sepsis, meningitis, or pneumonia).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs5\"><jats:title><jats:bold>Methods:<\/jats:bold><\/jats:title><jats:p>Epidemiological and microbiological investigations, analysis of macrorestriction pattern of genomic DNA through pulsed-field gel electrophoresis (PFGE) of clinical and environmental isolates, and institution of infection control measures.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs6\"><jats:title><jats:bold>Results:<\/jats:bold><\/jats:title><jats:p>Analysis of macrorestriction patterns of genomic DNA by PFGE demonstrated that the vast majority of S<jats:italic>marcescens<\/jats:italic>isolates, including three environmental strains isolated from two handwashing disinfectants and the hands of a nurse, were of the same clonal type. The successful control of the outbreak was achieved through cohorting of noncolonized infants, isolation of S<jats:italic>marcescens-infected<\/jats:italic>and -colonized infants, and an intense educational program that emphasized the need for adherence to glove use and handwashing policies. The NICU remained open to new admissions.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700069526_abs7\"><jats:title><jats:bold>Conclusions:<\/jats:bold><\/jats:title><jats:p>Outbreaks caused by S<jats:italic>marcescens<\/jats:italic>are very difficult to eradicate. An infection control program that includes molecular typing of microorganisms and the proper dissemination among staff members of the typing results is likely to be very effective in reducing NICU-acquired infections and in controlling outbreaks caused by S<jats:italic>marcescens,<\/jats:italic>as well as other multiresistant bacteria.<\/jats:p><\/jats:sec>","DOI":"10.1086\/501834","type":"journal-article","created":{"date-parts":[[2006,2,17]],"date-time":"2006-02-17T20:26:35Z","timestamp":1140207995000},"page":"630-634","source":"Crossref","is-referenced-by-count":60,"title":["Molecular Epidemiology of an Outbreak of<i>Serratia marcescens<\/i>in a Neonatal Intensive Care Unit"],"prefix":"10.1017","volume":"22","author":[{"given":"Paolo","family":"Villari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Crispino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Salvadori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alda","family":"Scarcella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700069526_ref011","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-198503000-00010"},{"key":"S0195941700069526_ref017","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(94)90005-1"},{"key":"S0195941700069526_ref008","doi-asserted-by":"publisher","DOI":"10.3109\/00313028409059103"},{"key":"S0195941700069526_ref024","first-page":"1017","volume-title":"Hospital Epidemiology and Infection Control","author":"Gaynes","year":"1996"},{"key":"S0195941700069526_ref028","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing. 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