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Introduction: Serratia marcescens (Sm) is a non-lactose fermenting gram-negative bacilli responsible for serious nosocomial infection and death. Characteristics of patients who become infected with Sm while in the SICU were examined for the time period January 1, 1984 - December 31, 1997.
Methods: The SICU registry was queried for patients who developed any infection (1) during their stay and those who developed Sm infection. Statistics: Students t-test, and chi-square with Fisher exact test.
Results: Of 10091 SICU admissions, 2398 became infected in the SICU (I patients). Sm was cultured in 69 patients. Sm and I were equal in age, APACHE II, GCS, and the comorbid factors of diabetes, COPD, renal failure, and alcohol use. SICU stay was longer for Sm than I (22.5d vs. 13.2d, p<.001). Sm were more likely to be intubated (80% vs. 64%, p<.05) and spent more days on mechanical ventilation (22.6d vs. 13.3d, p<.001). Sm developed 10.9d following hospital and 7.7d following SICU admission. 70% of Sm were injury patients (78% blunt, 15% penetrating). Sites of Sm were tracheobronchial (75.4%), blood (14.5%), urinary (11.6%), wound (10.1%), and paranasal sinus (5.8%). 11Sm (15.9%) and 357 I (14.9%) patients died. Of 10 patients with Sm bacteremia, 4 died. Infection clustering was identified in 12 separate instances. 35 Sm patients became infected while another Sm patient was in the SICU. 34 patients developed Sm as an isolated event.
Conclusion: Though uncommon. Sm is a significant nosocomial pathogen. The frequency of infection clustering suggests ready patient to patient transmission.
