Serratia Medication

  • Author: Basilio J Anía, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Aug 12, 2011
 

Medication Summary

S marcescens is naturally resistant to ampicillin, macrolides, and first-generation cephalosporins. In Taiwan, 92% of the strains are resistant to cefotaxime, but 99% are still susceptible to ceftazidime. Extended spectrum beta-lactamases are produced by most S marcescens strains.[25]

Serratia infections should be treated with an aminoglycoside plus an antipseudomonal beta-lactam, as the single use of a beta-lactam can select for resistant strains. Most strains are susceptible to amikacin, but reports indicate increasing resistance to gentamicin and tobramycin. Quinolones also are highly active against most strains.

Definitive therapy should be based on the results of susceptibility testing because multiresistant strains are common.

Next

Antibiotics

Class Summary

Empiric antimicrobial therapy should cover all likely pathogens in the context of the clinical setting.

View full drug information

Levofloxacin (Levaquin)

 

For pseudomonal infections and infections due to multidrug-resistant gram-negative organisms.

View full drug information

Cefepime (Maxipime)

 

Fourth-generation cephalosporin. Gram-negative coverage comparable to ceftazidime but has better gram-positive coverage (comparable to ceftriaxone). Cefepime is a zwitter ion; rapidly penetrates gram-negative cells. Best beta-lactam for IM administration. Poor capacity to cross blood-brain barrier precludes use for treatment of meningitis.

View full drug information

Ertapenem (Invanz)

 

Bactericidal activity results from inhibition of cell wall synthesis and is mediated through ertapenem binding to penicillin-binding proteins. Stable against hydrolysis by various beta-lactamases including penicillinases, cephalosporinases, and extended-spectrum beta-lactamases. Hydrolyzed by metallo-beta-lactamases.

View full drug information

Amikacin (Amikin)

 

Preferred aminoglycoside. Usually synergistic with antipseudomonal beta-lactams. Use both in combination, pending results of susceptibility testing. For gram-negative bacterial coverage of infections resistant to gentamicin and tobramycin. Effective against Pseudomonas aeruginosa. Irreversibly binds to 30S subunit of bacterial ribosomes. Blocks recognition step in protein synthesis. Causes bacterial growth inhibition.

View full drug information

Aztreonam (Azactam)

 

Usually synergistic with amikacin. Use both in combination, pending results of susceptibility testing. A monobactam that inhibits cell wall synthesis during bacterial growth. Active against gram-negative bacilli.

View full drug information

Meropenem (Merrem IV)

 

Preferred therapy for Serratia meningitis. Bactericidal broad-spectrum carbapenem antibiotic that inhibits cell wall synthesis. Effective against most gram-positive and gram-negative bacteria. Has increased activity against gram-negative bacteria and slightly decreased activity against staphylococci and streptococci compared to imipenem.

View full drug information

Imipenem-cilastatin (Primaxin)

 

Comparable in activity to meropenem.

View full drug information

Ciprofloxacin (Cipro)

 

Greatest anti-P aeruginosa activity among the quinolones. May be particularly useful for isolates resistant to the aminoglycosides.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Basilio J Anía, MD  Associate Professor of Infectious Diseases, Universidad de Las Palmas de Gran Canaria; Consultant in Internal Medicine, Hospital Universitario Dr. Negrín, Spain

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas E Herchline, MD  Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, and Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

John L Brusch, MD, FACP  Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Donnenberg MS. Enterobacteriaceae. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. Vol 2. 7th. Philadelphia, Pa: Churchill Livingstone - Elsevier; 2010:2815-2833.

  2. Carrero P, Garrote JA, Pacheco S, et al. Report of six cases of human infection by Serratia plymuthica. J Clin Microbiol. Feb 1995;33(2):275-6. [Medline].

  3. Grohskopf LA, Roth VR, Feikin DR, et al. Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center. N Engl J Med. May 17 2001;344(20):1491-7. [Medline].

  4. Ursua PR, Unzaga MJ, Melero P, et al. Serratia rubidaea as an invasive pathogen. J Clin Microbiol. Jan 1996;34(1):216-7. [Medline].

  5. Julie G, Julie C, Anne G, Bernard F, Philippe V, Madeleine C, et al. Childhood delayed septic arthritis of the knee caused by Serratia fonticola. Knee. Dec 2009;16(6):512-4. [Medline].

  6. Anonymous. The miracle microbe: Serratia marcescens. [Full Text].

  7. Yu VL. Serratia marcescens: historical perspective and clinical review. N Engl J Med. Apr 19 1979;300(16):887-93. [Medline].

  8. Pérez-Tomás R, Viñas M. New insights on the antitumoral properties of prodiginines. Curr Med Chem. 2010;17(21):2222-31. [Medline].

  9. Chang CC, Chen WC, Ho TF, Wu HS, Wei YH. Development of natural anti-tumor drugs by microorganisms. J Biosci Bioeng. May 2011;111(5):501-11. [Medline].

  10. Engel HJ, Collignon PJ, Whiting PT, Kennedy KJ. Serratia sp. bacteremia in Canberra, Australia: a population-based study over 10 years. Eur J Clin Microbiol Infect Dis. Jul 2009;28(7):821-4. [Medline].

  11. Samonis G, Vouloumanou EK, Christofaki M, Dimopoulou D, Maraki S, Triantafyllou E, et al. Serratia infections in a general hospital: characteristics and outcomes. Eur J Clin Microbiol Infect Dis. May 2011;30(5):653-60. [Medline].

  12. Jones RN. Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia. Clin Infect Dis. Aug 1 2010;51 Suppl 1:S81-7. [Medline].

  13. Posluszny JA Jr, Conrad P, Halerz M, Shankar R, Gamelli RL. Surgical burn wound infections and their clinical implications. J Burn Care Res. Mar-Apr 2011;32(2):324-33. [Medline]. [Full Text].

  14. Rastogi V, Purohit P, Peters BP, et al. Pulmonary infection with serratia marcescens. Indian J Med Microbiol. Jul-Sep 2002;20(3):167-8. [Medline].

  15. Hiremath S, Biyani M. Technique survival with Serratia peritonitis. Adv Perit Dial. 2006;22:73-6. [Medline].

  16. Friend JC, Hilligoss DM, Marquesen M, Ulrick J, Estwick T, Turner ML, et al. Skin ulcers and disseminated abscesses are characteristic of Serratia marcescens infection in older patients with chronic granulomatous disease. J Allergy Clin Immunol. Jul 2009;124(1):164-6. [Medline].

  17. al Hazzaa SA, Tabbara KF, Gammon JA. Pink hypopyon: a sign of Serratia marcescens endophthalmitis. Br J Ophthalmol. Dec 1992;76(12):764-5. [Medline].

  18. Faro J, Katz A, Berens P, Ross PJ. Premature termination of nursing secondary to Serratia marcescens breast pump contamination. Obstet Gynecol. Feb 2011;117(2 Pt 2):485-6. [Medline].

  19. Ostrowsky BE, Whitener C, Bredenberg HK, et al. Serratia marcescens bacteremia traced to an infused narcotic. N Engl J Med. May 16 2002;346(20):1529-37. [Medline].

  20. Sunenshine RH, Tan ET, Terashita DM, et al. A multistate outbreak of Serratia marcescens bloodstream infection associated with contaminated intravenous magnesium sulfate from a compounding pharmacy. Clin Infect Dis. Sep 1 2007;45(5):527-33. [Medline].

  21. Horcajada JP, Martinez JA, Alcon A, et al. Acquisition of multidrug-resistant Serratia marcescens by critically ill patients who consumed tap water during receipt of oral medication. Infect Control Hosp Epidemiol. Jul 2006;27(7):774-7. [Medline].

  22. Mills J, Drew D. Serratia marcescens endocarditis: a regional illness associated with intravenous drug abuse. Ann Intern Med. Jan 1976;84(1):29-35. [Medline].

  23. Pinna A, Usai D, Sechi LA, Carta A, Zanetti S. Detection of virulence factors in Serratia strains isolated from contact lens-associated corneal ulcers. Acta Ophthalmol. Jun 2011;89(4):382-7. [Medline].

  24. Friedman ND, Peterson NB, Sumner WT, et al. Spontaneous dermal abscesses and ulcers as a result of Serratia marcescens. J Am Acad Dermatol. Aug 2003;49(2 Suppl Case Reports):S193-4. [Medline].

  25. Mlynarczyk A, Mlynarczyk G, Pupek J, et al. Serratia marcescens isolated in 2005 from clinical specimens from patients with diminished immunity. Transplant Proc. Nov 2007;39(9):2879-82. [Medline].

  26. Curtis L. Handwashing and other environmental controls needed to prevent hospital-acquired serratia infections. J Chemother. Aug 2009;21(4):470. [Medline].

  27. de Vries JJ, Baas WH, van der Ploeg K, et al. Outbreak of Serratia marcescens colonization and infection traced to a healthcare worker with long-term carriage on the hands. Infect Control Hosp Epidemiol. Nov 2006;27(11):1153-8. [Medline].

  28. Alonso Fernandez R, Baquero Mochales F. [The genus Serratia: its biology, clinical effects and epidemiology]. Rev Clin Esp. Apr 1994;194(4):294-9. [Medline].

  29. Aron M, Goel R, Gupta NP, et al. Incidental detection of purulent fluid in kidney at percutaneous nephrolithotomy for branched renal calculi. J Endourol. Mar 2005;19(2):136-9. [Medline].

  30. Bosi C, Davin-Regli A, Charrel R, et al. Serratia marcescens nosocomial outbreak due to contamination of hexetidine solution. J Hosp Infect. Jul 1996;33(3):217-24. [Medline].

  31. Bruckner DA, Colonna P, Bearson BL. Nomenclature for aerobic and facultative bacteria. Clin Infect Dis. Oct 1999;29(4):713-23. [Medline].

  32. Buffet-Bataillon S, Rabier V, Bétrémieux P, Beuchée A, Bauer M, Pladys P, et al. Outbreak of Serratia marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors. J Hosp Infect. May 2009;72(1):17-22. [Medline].

  33. Capitano B, Nicolau DP, Potoski BA, et al. Meropenem administered as a prolonged infusion to treat serious gram-negative central nervous system infections. Pharmacotherapy. Jun 2004;24(6):803-7. [Medline].

  34. Civen R, Vugia DJ, Alexander R, et al. Outbreak of Serratia marcescens infections following injection of betamethasone compounded at a community pharmacy. Clin Infect Dis. Oct 1 2006;43(7):831-7. [Medline].

  35. Cohen SM, Flynn HW Jr, Miller D. Endophthalmitis caused by Serratia marcescens. Ophthalmic Surg Lasers. Mar 1997;28(3):195-200. [Medline].

  36. Cunha G, Leão L, Pimenta F. Bacterial contamination of random-donor platelets in a university hospital in the midwestern region of Brazil. Transfusion. Feb 2008;48(2):282-5. [Medline].

  37. de Boer MG, Brunsveld-Reinders AH, Salomons EM, Dijkshoorn L, Bernards AT, van den Berg PC, et al. Multifactorial origin of high incidence of Serratia marcescens in a cardio-thoracic ICU: analysis of risk factors and epidemiological characteristics. J Infect. Jun 2008;56(6):446-53. [Medline].

  38. Demetriou CA, Cunha BA. Serratia marcescens bacteremia after carotid endarterectomy and coronary artery bypass grafting. Heart Lung. Jul-Aug 1999;28(4):293-4. [Medline].

  39. Dominguez Herrera JM, Jimenez Mejias ME, et al. [Acute bacterial parotitis caused by Serratia marcescens]. Rev Clin Esp. Apr 1996;196(4):271-2. [Medline].

  40. Edmond MB, Wallace SE, McClish DK, et al. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin Infect Dis. Aug 1999;29(2):239-44. [Medline].

  41. Edson RS, Terrell CL. The aminoglycosides. Mayo Clin Proc. May 1999;74(5):519-28. [Medline].

  42. Gurevich I, Tafuro PA, Cunha BA. Serratia peritonitis in hemodialysis patients. Clinical Microbiology Newsletter. 1987;9:55-56.

  43. Haddy RI, Mann BL, Nadkarni DD, et al. Nosocomial infection in the community hospital: severe infection due to Serratia species. J Fam Pract. Mar 1996;42(3):273-7. [Medline].

  44. Hejazi A, Falkiner FR. Serratia marcescens. J Med Microbiol. Nov 1997;46(11):903-12. [Medline].

  45. Hellinger WC, Brewer NS. Carbapenems and monobactams: imipenem, meropenem, and aztreonam. Mayo Clin Proc. Apr 1999;74(4):420-34. [Medline].

  46. Heltberg O, Skov F, Gerner-Smidt P, et al. Nosocomial epidemic of Serratia marcescens septicemia ascribed to contaminated blood transfusion bags. Transfusion. Mar 1993;33(3):221-7. [Medline].

  47. Hertle R, Schwarz H. Serratia marcescens internalization and replication in human bladder epithelial cells. BMC Infect Dis. Jun 9 2004;4:16. [Medline].

  48. Hsieh S, Babl FE. Serratia marcescens cellulitis following an iguana bite. Clin Infect Dis. May 1999;28(5):1181-2. [Medline].

  49. Jean SS, Hsueh PR, Lee WS, Chang HT, Chou MY, Chen IS, et al. Nationwide surveillance of antimicrobial resistance among Enterobacteriaceae in intensive care units in Taiwan. Eur J Clin Microbiol Infect Dis. Feb 2009;28(2):215-20. [Medline].

  50. Johnson DH, Cunha BA, Klein NC. Serratia. Infect Dis Pract. 1993;17:6-8.

  51. Johnson JS, Croall J, Power JS, et al. Fatal Serratia marcescens meningitis and myocarditis in a patient with an indwelling urinary catheter. J Clin Pathol. Oct 1998;51(10):789-90. [Medline].

  52. Kirschke DL, Jones TF, Craig AS, et al. Pseudomonas aeruginosa and Serratia marcescens contamination associated with a manufacturing defect in bronchoscopes. N Engl J Med. Jan 16 2003;348(3):214-20. [Medline].

  53. Manfredi R, Nanetti A, Ferri M, et al. Clinical and microbiological survey of Serratia marcescens infection during HIV disease. Eur J Clin Microbiol Infect Dis. Apr 2000;19(4):248-53. [Medline].

  54. McLeod SD, Goei SL, Taglia DP, et al. Nonulcerating bacterial keratitis associated with soft and rigid contact lens wear. Ophthalmology. Mar 1998;105(3):517-21. [Medline].

  55. Munoz G, Alio JL, Perez-Santonja JJ, et al. Ulcerative keratitis caused by Serratia marcescens after laser in situ keratomileusis. J Cataract Refract Surg. Feb 2004;30(2):507-12. [Medline].

  56. Pai HH, Chen WC, Peng CF. Cockroaches as potential vectors of nosocomial infections. Infect Control Hosp Epidemiol. Nov 2004;25(11):979-84. [Medline].

  57. Royo P, del Valle O, Boquete T. [Epidemiology of Serratia marcescens between 1987 and 1995 at Vall d'Hebron Hospital]. Enferm Infecc Microbiol Clin. Dec 1997;15(10):519-27. [Medline].

  58. Sehdev PS, Donnenberg MS. Arcanum: The 19th-century Italian pharmacist pictured here was the first to characterize what are now known to be bacteria of the genus Serratia. Clin Infect Dis. Oct 1999;29(4):770, 925. [Medline].

  59. Shigemura K, Arakawa S, Tanaka K, Fujisawa M. Clinical investigation of isolated bacteria from urinary tracts of hospitalized patients and their susceptibilities to antibiotics. J Infect Chemother. Feb 2009;15(1):18-22. [Medline].

  60. Shih HI, Lee HC, Lee NY, et al. Serratia marcescens bacteremia at a medical center in southern Taiwan: high prevalence of cefotaxime resistance. J Microbiol Immunol Infect. Oct 2005;38(5):350-7. [Medline].

  61. Sickbert-Bennett EE, Weber DJ, Gergen-Teague MF, et al. Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses. Am J Infect Control. Mar 2005;33(2):67-77. [Medline].

  62. Sokalski SJ, Jewell MA, Asmus-Shillington AC, et al. An outbreak of Serratia marcescens in 14 adult cardiac surgical patients associated with 12-lead electrocardiogram bulbs. Arch Intern Med. Apr 1992;152(4):841-4. [Medline].

  63. Su JR, Blossom DB, Chung W, Gullion JS, Pascoe N, Heseltine G, et al. Epidemiologic investigation of a 2007 outbreak of Serratia marcescens bloodstream infection in Texas caused by contamination of syringes prefilled with heparin and saline. Infect Control Hosp Epidemiol. Jun 2009;30(6):593-5. [Medline].

  64. Tanaka T, Takahashi H, Kobayashi JM, et al. A nosocomial outbreak of febrile bloodstream infection caused by heparinized-saline contaminated with Serratia marcescens, Tokyo, 2002. Jpn J Infect Dis. Oct 2004;57(5):189-92. [Medline].

  65. van der Vorm ER, Woldring-Zwaan C. Source, carriers, and management of a Serratia marcescens outbreak on a pulmonary unit. J Hosp Infect. Dec 2002;52(4):263-7. [Medline].

  66. Weinstein RA. Lessons from an epidemic, again. N Engl J Med. May 17 2001;344(20):1544-5. [Medline].

  67. Yannelli B, Schoch PA, Cunha BA. Serratia infections in the hospital. Clinical Microbiology Newsletter. 1987;9:157-160.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.