Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3535-3548
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3535
First Italian outbreak of VIM-producing Serratia marcescens in an adult polyvalent intensive care unit, August-October 2018: A case report and literature review
Maria Rosaria Iovene, Vincenzo Pota, Massimiliano Galdiero, Giusy Corvino, Federica Maria Di Lella, Debora Stelitano, Maria Beatrice Passavanti, Maria Caterina Pace, Aniello Alfieri, Sveva Di Franco, Caterina Aurilio, Pasquale Sansone, Vettakkara Kandy Muhammed Niyas, Marco Fiore
Maria Rosaria Iovene, Massimiliano Galdiero, Giusy Corvino, Federica Maria Di Lella, Debora Stelitano, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
Vincenzo Pota, Maria Beatrice Passavanti, Maria Caterina Pace, Aniello Alfieri, Sveva Di Franco, Caterina Aurilio, Pasquale Sansone, Marco Fiore, Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy
Vettakkara Kandy Muhammed Niyas, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Iovene MR and Fiore M designed the study; Pota V, Di Lella FM, Stelitano D, Passavanti MB, Sansone P performed the research; Aurilio C, Pace MC and Galdiero M supervised the manuscript; Niyas VKM gave critical comments and revised the manuscript in order to improve and polish language; Corvino G, Niyas VKM, Alfieri A, Di Franco S and Fiore M wrote the paper.
Informed consent statement: Although no personal details are revealed in the present report, informed consent was obtained for publication of this case report along with the related clinical details and images. All clinical data contained in this case report can be made available, in an absolutely anonymized form, upon request to marco.fiore@unicampania.it.
Conflict-of-interest statement: All authors declare no conflict of interest.
CARE Checklist (2016) statement: The guidelines of the “CARE Checklist – 2016: Information for writing a case report” have been adopted.
Open-Access: This article is an open-access article which was selected by an in house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Marco Fiore, MD, Academic Fellow, Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia, 2, Naples 80138, Italy. marco.fiore@unicampania.it
Telephone: +39-81-5665180 Fax: +39-81-455426
Received: March 8, 2019
Peer-review started: March 11, 2019
First decision: April 18, 2019
Revised: May 15, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: November 6, 2019
Abstract
BACKGROUND

Carbapenem-resistant Enterobacteriaceae has become a significant public health concern as hospital outbreaks are now being frequently reported and these organisms are becoming difficult to treat with the available antibiotics.

CASE SUMMARY

An outbreak of VIM-producing Serratia marcescens occurred over a period of 11 wk (August, 1 to October, 18) in patients admitted to the adult polyvalent intensive care unit of the University of Campania “Luigi Vanvitelli” located in Naples. Four episodes occurred in three patients (two patients infected, and one patient colonized). All the strains revealed the production of VIM.

CONCLUSION

After three decades of carbapenem antibiotics use, the emergence of carbapenem-resistance in Enterobacteriaceae has become a significant concern and a stricter control to preserve its clinical application is mandatory. This is, to our knowledge, the first outbreak of VIM-producing Serratia marcescens in Europe. Surveillance policies must be implemented to avoid future outbreaks.

Keywords: Serratia marcescens, Carbapenamase, VIM, Intensive care unit, Outbreak, Case report

Core Tip: An outbreak of VIM-producing Serratia marcescens occurred in patients admitted to the adult polyvalent intensive care unit of the University of Campania “Luigi Vanvitelli” located in Naples. All the strains revealed the production of VIM. After three decades of carbapenem antibiotics use, the emergence of carbapenem-resistant Enterobacteriaceae has become a significant concern and is mandatory a stricter control to preserve its clinical application. This is, to our knowledge, the first outbreak of VIM-producing Serratia marcescens occurred in a European hospital.