Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-18T05:19:06.275Z Has data issue: false hasContentIssue false
  • English
  • Français

Nosocomial Serratia marcescens Infections Associated With Extrinsic Contamination of a Liquid Nonmedicated Soap

Published online by Cambridge University Press:  02 January 2015

Catherine Sartor ,
Véronique Jacomo ,
Cédric Duvivier ,
Hervé Tissot-Dupont ,
Roland Sambuc  and
Michel Drancourt
Catherine Sartor
Affiliation:
Comité de Lutte contre les Infections Nosocomiales, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Cédric Duvivier
Affiliation:
Hôpital de la Conception and Laboratoire de Bactériologie, Hygiène et Epidémiologie Hospitalière, Hôpital Salvator, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Hervé Tissot-Dupont
Affiliation:
Service des Maladies Infectieuses, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Roland Sambuc
Affiliation:
Département d’Information Médicale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Michel Drancourt*
Affiliation:
Hôpital de la Conception and Laboratoire de Bactériologie, Hygiène et Epidémiologie Hospitalière, Hôpital Salvator, Assistance Publique-Hôpitaux de Marseille, Marseille, France
*
Laboratoire de Bactériologie, Hygiène et Epidémiologie Hospitalière, Hôpital Salvator, 149 bvd Sainte Marguerite, 13009 Marseille, France
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the role of nonmedicated soap as a source of Serratia marcescens nosocomial infections (NIs) in hospital units with endemic S marcescens NI and to examine the mechanisms of soap colonization.

Setting:

University-affiliated tertiary-care hospitals.

Methods:

A prospective case-control study and an environmental investigation were performed to assess the relationship between S marcescens NIs in hospital units and S marcescens-contaminated soap. Soap-bottle use and handwashing practices were reviewed. Cultures of healthcare workers’ (HCWs) hands were obtained before and after hand washing with soap.

Results:

5 of 7 hospital units with S marcescens NIs had soap bottles contaminated with S marcescens, compared to 1 of 14 other units (P =.006). After hand washing with an S marcescens-contaminated soap pump, HCWs' hands were 54 times more likely to be contaminated with S marcescens (P<.001).

Conclusions:

Extrinsic contamination of a non-medicated liquid soap by S marcescens resulted in handborne transmission of S marcescens NIs by HCWs in our setting. This finding led to the application of strict guidelines for nonmedicated soap use and to the reinforcement of alcoholic hand disinfection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 3 , March 2000 , pp. 196 - 199
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Larson, E. A causal link between handwashing and risk of infection? Examination of the evidence. Infect Control Hosp Epidemiol 1988;9:28–36.CrossRefGoogle ScholarPubMed
2.Centers for Disease Control and Prevention. Guideline for Handwashing and Hospital Environmental Control, 1985. Atlanta, GA: US Department of Health and Human Services, 1985.Google Scholar
3.Larson, E. Guideline for use of topical antimicrobial products. Am J Infect Control 1988;16:253–266.CrossRefGoogle Scholar
4.Garner, JS, the Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:53–80.Google Scholar
5.Lowbury, EJL, Lilly, HA, Bull, JP. Disinfection of hands: removal of transient organisms. BMJ 1964;2:230–233.CrossRefGoogle ScholarPubMed
6.Ojajärvi, J. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing. J Hyg Camb 1980;85:193–203.Google Scholar
7.Newsom, SWB. Pioneers in infection control: Ignaz Philipp Semmelweis. J Hosp Infect 1993;23:175–187.Google Scholar
8.Ehrenkranz, NJ, Alfonso, BC. Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral catheters. Infect Control Hosp Epidemiol 1991;12:654–662.Google Scholar
9.Watanakunakorn, C, Wang, C, Hazy, J. An observational study of hand washing and infection control practices by healthcare workers. Infect Control Hosp Epidemiol 1998;19:858–860.Google Scholar
10.Doebbeling, BN, Stanley, GL, Sheetz, CT, Pfaller, MA, Houston, AK, Ning Li, LA, et al. Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N Engl J Med 1992;327:88–93.Google Scholar
11.Conseil de l’Europe. Efficacité de la conservation antimicrobienne. Pharmacopée Européenne. 3éme édition 1997. Conseil de l’Europe, Strasbourg, France; 1996:296–298.Google Scholar
12.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.Google Scholar
13.Larson, E. Handwashing and skin. Physiologic and bacteriologic aspects. Infect Control 1985;6:14–23.Google Scholar
14.Yu, VL. Serratia marcescens: historical perspective and clinical review. N Engl J Med 1979;300:887–893.Google Scholar
15.Nakashima, AK, McCarthy, MA, Martone, WJ, Anderson, RLEpidemic septic arthritis caused by Serratia marcescens and associated with a benzalkonium chloride antiseptic. J Clin Microbiol 1987;25:1014–1018.CrossRefGoogle ScholarPubMed
16.Sautter, RL, Mattman, LH, Legaspi, RC. Serratia marcescens meningitidis associated with a contaminated benzalkonium chloride solution. Infect Control 1984;5:223–225.Google Scholar
17.McNaughton, M, Mazinke, N, Thomas, E. Newborn conjunctivitis associated with triclosan 0.5% antiseptic intrinsically contaminated with Serratia marcescens. Can J Infect Control 1995;10:7–8.Google Scholar
18.Barry, MA, Craven, DE, Goularte, TA, Lichtenberg, DASerratia marcescens contamination of antiseptic soap containing triclosan: implications for nosocomial infection. Infect Control 1984;5:427–430.Google Scholar
19.Morse, LJ, Schonbeck, LF. Hand lotions—a potential nosocomial hazard. N Engl J Med 1968;278:376–378.CrossRefGoogle ScholarPubMed
20.Sanford, JP. Disinfectants that don’t. Ann Intern Med 1970;72:282–283.Google Scholar
21.Bosi, C, Davin-Regli, A, Charrel, R, Rocca, B, Monnet, D, Bollet, C. Serratia marcescens nosocomial outbreak due to contamination of hexetidine solution. J Hosp Infect 1996;33:217–224.Google Scholar
22.Vigeant, P, Loo, VG, Bertrand, C, Dixon, C, Hollis, R, Pfaller, MA, et al. An outbreak of Serratia marcescens infections related to contaminated chlorhexi-dine. Infect Control Hosp Epidemiol 1998;19:791–794.Google Scholar
23.Archibald, LK, Corl, A, Shah, B, Schutle, M, Arduino, MJ, Aguero, S, et al. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol 1997;18:704–709.Google Scholar
24.Rotter, ML, Roller, W, Neumann, R. The influence of cosmetic additives on the acceptability of alcohol based hand disinfectants. J Hosp Infect 1991;18(suppl B):57–63.Google Scholar
25.Rotter, ML. Hand washing and hand disinfection. In: Mayhall, GC, ed. Hospital Epidemiology and Infection Control. Baltimore, MD: Williams & Wilkins; 1996:1052–1068.Google Scholar
26.Voss, A, Widmer, AF. No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205–208.Google Scholar