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Stephen J. Sokalski, DO; Mark A. Jewell, MPH, PhD; Alicia C. Asmus-Shillington, MPH; Joan Mulcahy, RN; John Segreti, MD

Arch Intern Med. 1992;152(4):841-844.

Abstract
Two clusters of Serratia marcescens in 14 adult cardiac surgical patients occurred over 10 months in an 876-bed teaching hospital. The 14 infections that were studied were as follows: one sternal and five leg incisions, five pneumonias, one bacteremia, one urinary tract infection, and one infected internal defibrillator site. The first cluster included four pneumonias, one urinary tract infection, and one bacteremia. Corrective actions were taken based on outbreak data though no source was identified. No further infections occurred during the following 2 months. The second cluster included one sternal and five leg incisions, an infected internal defibrillator incision site, and one pneumonia. Serratia marcescens was isolated from six electrocardiogram rubber welsh bulbs with sensitivities identical to patient isolates that indicated a common source outbreak in at least the second cluster of infections. Disposable electrocardiogram leads were introduced and the problem was resolved. We conclude that reusable electrocardiogram welsh bulbs are a vector for postoperative infections.

(Arch Intern Med. 1992;152:841-844)

Author Affiliations
From the Departments of Epidemiology (Dr Jewell and Mss Asmus-Shillington and Mulcahy) and Infectious Disease (Dr Sokalski), Christ Hospital and Medical Center, Oak Lawn, III; and Department of Infectious Disease, Rush University Medical Center, Chicago, Ill (Dr Segreti).

Footnotes
Accepted for publication October 14, 1991.

Presented at the Third Decennial International Conference on Nosocomial Infections, Atlanta, Ga, August 1, 1990.

Reprint requests to Epidemiology/Quality Management, Christ Hospital and Medical Center, 4440 W 95th St, Oak Lawn, IL 60453 (Dr Jewell).

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