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A Hospital Outbreak of Serratia marcescens Associated with Ultrasonic Nebulizers

ROBERT E. RINGROSE, M.D.; BEVERLY MCKOWN, M.S.; FRANCES G. FELTON, PH.D.; BILLY O. BARCLAY, B.S.; HAROLD G. MUCHMORE, M.D., F.A.C.P.; and EVERETT R. RHOADES, M.D.
Ann Intern Med. 1968;69(4):719-729. doi:10.7326/0003-4819-69-4-719
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SUMMARY:

A sevenfold increase in the frequency of isolation of Serratia marcescens was noted during a 2-month period. Nineteen patients were involved, and the majority of these patients acquired the organism during hospitalization. Two of the patients had signs and symptoms of definite infection. Seven others probably had infections, and the remainder appeared to have had simple colonization. All 19 patients had associated medical conditions or prior therapy. S. marcescens should be considered pathogenic for man, especially in the presence of underlying disease, antibiotic, or immunosuppressive therapy.

The probable source of the outbreak was contaminated ultrasonic nebulizers. The previous routine of cleansing ultrasonic nebulizers was not adequate for removal of S. marcescens. Ultrasonic nebulizers should be considered another potenital method of transmitting gram-negative organisms.

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