Abstract
We describe a nosocomial outbreak of extended-spectrum beta-lactamase (ESBL)-producing Serratia marcescens in a Bulgarian university hospital affecting nine patients on four wards. Phenotypic and genotypic (plasmid profile, randomly amplified polymorphic DNA analysis and amplified ribosomal DNA restriction analysis) analysis of the isolates indicated a single clone. The epidemic strain was resistant to oxyimino beta-lactams, aztreonam, aminoglycosides, tetracycline and chloramphenicol. It produced CTX-M-3 ESBL as demonstrated by isoelectric focusing, CTX-M PCR-RFLP and gene sequencing. The isolate was also found in the environment and from a nurse's hands, suggesting transmission by staff handling. The outbreak was controlled by patient isolation and intensified hand washing. This is the first report from Bulgaria describing a hospital outbreak caused by CTX-M-3 ESBL-producing S. marcescens.
Publication types
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Adult
-
Aged
-
Anti-Bacterial Agents / pharmacology
-
Bacterial Typing Techniques
-
Bulgaria / epidemiology
-
Cross Infection / epidemiology*
-
Cross Infection / microbiology*
-
DNA Fingerprinting / methods
-
DNA, Bacterial / genetics
-
Disease Outbreaks*
-
Drug Resistance, Bacterial
-
Environmental Microbiology
-
Genotype
-
Hand / microbiology
-
Hand Disinfection
-
Hospitals
-
Humans
-
Infectious Disease Transmission, Professional-to-Patient
-
Isoelectric Focusing
-
Microbial Sensitivity Tests
-
Middle Aged
-
Nurses
-
Patient Isolation
-
Plasmids
-
Serratia Infections / classification
-
Serratia Infections / epidemiology*
-
Serratia Infections / microbiology*
-
Serratia marcescens / enzymology*
-
Serratia marcescens / isolation & purification
-
beta-Lactamases / chemistry
-
beta-Lactamases / isolation & purification*
Substances
-
Anti-Bacterial Agents
-
DNA, Bacterial
-
beta-Lactamases