Three challenging cases of infections by multidrug-resistant Serratia marcescens in patients admitted to intensive care units

• Published in: Brazilian journal of microbiology Vol. 52; no. 3; pp. 1341 - 1345
• Main Authors: da Silva, Kesia Esther, Rossato, Luana, Jorge, Sérgio, de Oliveira, Natasha Rodrigues, Kremer, Frederico Schmitt, Campos, Vinícius Farias, da Silva Pinto, Luciano, Dellagostin, Odir Antonio, Simionatto, Simone
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-09-2021; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Antimicrobial agents; Antimicrobial resistance; Bacteria; Biomedical and Life Sciences; Carbapenems; Clinical Microbiology - Short Communication; Drug Resistance, Multiple, Bacterial; Ertapenem; Food Microbiology; Gene sequencing; Genes; Genome, Bacterial; Genomes; Health risks; Hospitals; Humans; Infections; Intensive Care Units; Life Sciences; Medical Microbiology; Microbial Ecology; Microbial Genetics and Genomics; Microbial Sensitivity Tests; Microbiology; Multidrug resistance; Multidrug resistant organisms; Mycology; Patients; Public health; Serratia marcescens; Serratia marcescens - drug effects; Serratia marcescens - genetics; Tigecycline; Virulence; Whole Genome Sequencing; Bacterial infection; Resistance; Genome sequencing; Virulence
• ISSN: 1517-8382; 1678-4405
• DOI: 10.1007/s42770-021-00477-4

The occurrence of multidrug-resistant
Serratia marcescens
strains represents a serious public health threat. The purpose here is to report three cases of carbapenem-resistant
S. marcescens
infections with unfavorable clinical outcomes and provide a molecular description of the antibiotic resistance determinants at a genomic level. We performed bacterial identification by VITEK 2 and MALDI-TOF. The minimal inhibitory concentrations of antimicrobials were determined according to the Clinical and Laboratory Standards Institute guidelines, except for tigecycline, for which they were determined using Etest strips. Preliminary screening for the presence of carbapenemases was performed by ertapenem hydrolysis using MALDI-TOF MS. Whole-genome sequencing was provided to identify genes responsible for virulence and antimicrobial resistance. Here we report three challenging cases of
S. marcescens
that were resistant to the most commonly used antibiotics. Otherwise, we performed a genome description, which includes several genes involved in the resistance and virulence. These cases illustrate serious infection due to multidrug-resistant organisms and the complexity of treatment. Our results highlight the need to evaluate isolates regularly during long-term hospital stay to achieve optimal quality of clinical care and thus improve patient outcomes.