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

Published online by Cambridge University Press:  02 January 2015

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

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
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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