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Extended-spectrum beta-lactamase-producing Serratia marcescens outbreak in a Bulgarian hospital
Authors:Ivanova D  Markovska R  Hadjieva N  Schneider I  Mitov I  Bauernfeind A
Affiliation:Laboratory of Clinical Microbiology, Second Multiprofile Active Treatment Hospital, Sofia, Bulgaria.
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.
Keywords:Nosocomial infections   Outbreak   Serratia marcescens   Extended-spectrum β  -lactamase (ESBL)   CTX-M-3   Molecular epidemiology
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