Current Epidemiological Status and Antibiotic Resistance Profile of Serratia marcescens

Author:

Cosimato Ilaria1,Santella Biagio2ORCID,Rufolo Sandra2,Sabatini Paola3,Galdiero Massimiliano1ORCID,Capunzo Mario24,Boccia Giovanni24ORCID,Folliero Veronica2ORCID,Franci Gianluigi24ORCID

Affiliation:

1. U.O.C. of Virology and Microbiology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy

2. Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy

3. Unit of Virology and Microbiology, Nocera Inferiore, Umberto I Hospital, 84018 Salerno, Italy

4. Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa, U.O.C. Patologia Clinica e Microbiologia, A.O.U. San Giovanni di Dio e Ruggi D’Aragona, Largo Città di Ippocrate, 84131 Salerno, Italy

Abstract

The spread of antibiotic resistance represents a serious worldwide public health issue, underscoring the importance of epidemiology research in determining antimicrobial strategies. The purpose of this research was to investigate antibiotic resistance in Serratia marcescens isolates from clinical samples over seven years at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona” in Salerno, Italy. S. marcescens is an important opportunistic pathogen associated with a wide spectrum of clinical diseases, including pneumonia, keratitis, meningitis, and urinary tract and wound infections. Outbreaks of nosocomial infections by S. marcescens strains have been documented in high-risk settings, mainly affecting immunocompromised patients and newborns. The primary objective of this study is to assess the rates of antibiotic resistance over the years to deal with a future emergency which includes the failure of various therapies due to antibiotic resistance. During the investigation, a total of 396 species of S. marcescens were isolated from various clinical samples, mainly from broncho-aspirates and sputum (31.6%) and blood cultures (21.5%). Antibiotics that showed the greatest susceptibility included ceftazidime/avibactam, amikacin, trimethoprim/sulfamethoxazole, and selected members of the cephalosporin class. However, a disconcerting trend of increasing rates of carbapenem resistance was outlined over the observation period. The absence of effective countermeasures, combined with growing antibiotic resistance that negates the effectiveness of multiple antibiotics, highlights the potential for S. marcescens infections to trigger serious clinical complications and increased mortality rates. The surveillance of Serratia marcescens infections constitutes a pivotal element in refining empiric therapy to mitigate the dissemination of antimicrobial resistance.

Publisher

MDPI AG

Reference23 articles.

1. Cristina, M.L., Sartini, M., and Spagnolo, A.M. (2019). Serratia marcescens Infections in Neonatal Intensive Care Units (NICUs). Int. J. Environ. Res. Public Health, 16.

2. European Centre for Disease Prevention and Control (2023, May 05). Annual Epidemiological Report for 2018—Healthcare-Associated Infections Acquired in Intensive Care Units. Available online: https://www.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-intensive-care-units-annual-report-2018.

3. European Centre for Disease Prevention and Control (2023, April 26). Estimated Incidence of Bloodstream Infections with Three Key Pathogens in the EU/EEA in 2019. Available online: https://www.ecdc.europa.eu/en/publications-data/estimated-incidence-bloodstream-infections-three-key-pathogens-eueea-2019.

4. The intertwining of healthcare-associated infections and COVID-19 in Italian intensive care units: An analysis of the SPIN-UTI project from 2006 to 2021;Barchitta;J. Hosp. Infect.,2023

5. Outbreak of a cluster with epidemic behavior due to Serratia marcescens after colistin administration in a hospital setting;Merkier;J. Clin. Microbiol.,2013

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