Study: Improved hand hygiene helped end bacterial outbreak in Swiss NICU

Increased adherence to hand hygiene protocols and best practice infection control measures likely helped end an outbreak of Serratia marcescens in a neonatal unit at a tertiary care center in Switzerland in 2013, according to a study published in the journal Antimicrobial Resistance & Infection Control.

S. marcescens is a species of gram-negative Enterobacteriaceae that can incite a number of clinical manifestations in infants, including urinary tract infections, pneumonia and sepsis. It is the third most common pathogen documented in outbreaks in the neonatal intensive care unit.

Between February and March of 2013, clinicians at the Swiss tertiary care unit identified two infants in the NICU and two infants in the child development unit as being colonized with S. marcescens. By May, clinicians had identified 20 infants colonized with the bacteria. No invasive infections occurred as a result of the bacterial colonization.

In response to the outbreak, providers performed audits on environmental disinfectant practices and hand hygiene, then implemented improvement initiatives. Hand hygiene compliance among providers improved from 51 percent in April to 79 percent in May. Clinicians detected no colonization of the bacteria among infants between June and October.

"Improving best practices and particularly hand hygiene proved effective in terminating the outbreak," concluded the study's authors.

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