Child ; Endocarditis, Bacterial ; etiology ; Foreign Bodies ; complications ; Heart ; Humans ; Male ; Serratia Infections ; etiology ; Serratia marcescens

An outbreak of nosocomial infections caused by Serratia marcescens is described. There were 40 bacterial isolates from 21 patients during a 3 month period at pediatric ward and sick baby room. Bacterial cultures from blood revealed positive in 19 patients out of 21, but one from urine and the other from bronchial secretions. 16 cases among 19 Serratia septicemia were completely recovered, but 3 patients were discharged without adequate treatment. We lost two patients in spite of vigorous medical treatment. Factors associated with Serratia infections were previous multiple and ?road-spectrum antimicrobial therapy and underlying chronic debilitating disese. Indwelling intravenous catheter and previously instrumented urinary tract were the most frequent portals of entry. The isolated strains were resisant to most antibiotics, but most frequently sensitvive to gentamicin, amikacin and chloramphenicoI. It is recommended that until specific antibiotic sensitivities can be obtained, patients with Serratia septicemia should be treated with chloramphenciol in combination with gentamicin or amikacin. Dust collection of the sick baby room, the incubators of the pediatric ward and the nurse room were contaminated with serratia marcescens. The distilled water of the cold steam and incubator were also contaminated. The culture of the specimens from the hands of doctors and nurses revealed many Serratia organisms. The control measures were instituted and the outbreak stopped. These data demonstrate that the organism can become pathogenic for man in certain clinical situations, especially in patients with chronic debilitating disease who have been treated with multiple antibiotics. These experience emphasized the problems in recognition of hospital associated infections.
Amikacin ; Anti-Bacterial Agents ; Catheters ; Cross Infection ; Dust ; Gentamicins ; Hand ; Humans ; Incubators ; Sepsis ; Serratia Infections ; Serratia marcescens* ; Serratia* ; Steam ; Urinary Tract ; Water

Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

This study was performed for the assessing the distribution, drug resistance and its transferability, and cell agglutinating ability of Enterobacteriaceae isolated from urine of patients with urinary tract infection. Total 164 strains of Strains of Enterobacteriaceae including, 91 strains of E. coli, 35 strains of klebsiella, 23 strains of Proteus, 6 strains of Serratia, 6 strains of Citrobacter, 3 strains of Enterobacteriaceae were isolated from urine. In the cell agglutinating test, most organisms, except Proteus, showed mannose resistant agglutination. Among organisms tested more than 20 strains, E. coli showed highest frequency of cell agglutination. In the comparison of cell agglutinating characteristics of E. coli and Klebsiella isolated from urine and other sources urinary isolates of E. coli showed higher frequency of agglutination and greater agglutinating potency than isolates from other sources, but Klebsiella showed little difference between isolates of urine and other sources. Urinary isolates usually showed high frequency of resistance to penicillin(90%), ampicillin(89%). sulfamethoxazole(69%), tetracycline(66%), chloramphenicol(53%), but showed low frequency of resistance to moxalactam(1%), amikacin(2%), and nalidixic acid (9%), and these resistance were highly transferable resistance mediated by R plasmid.
Agglutination ; Citrobacter ; Drug Resistance* ; Enterobacteriaceae ; Humans ; Klebsiella ; Mannose ; Nalidixic Acid ; Plasmids ; Proteus ; Serratia ; Urinary Tract Infections

Effect of Enoxacin (Flumark), an oral pyridone carboxylic acid, in the urinary tract infection was evaluated clinically and susceptibility of 292 strains of microorganism isolated from urine to the various antimicrobial agents was tested and compared. Thirty six patients with urinary tract infection were given with 300 to 600mg of Enoxacin daily for 7 to 14 days according to severity of urinary tract infection. The clinical symptoms and urinary findings improved in 30 patients (83.3%) and no clinical response was achieved in 6 patients (16.7%), but revealing 100% response in 9 patients of acute uncomplicated cystitis. In the antimicrobial susceptibility test, Enoxacin was much superior to aminoglycoside, especially against Pseudomonas aeruginosa. Serratia spp., Enterobacter spp. and other Pseudomonas spp.. Enoxacin is a very effective and safe antimicrobial agent in treatment of the urinary tract infection.
Anti-Infective Agents ; Cystitis ; Enoxacin ; Enterobacter ; Humans ; Pseudomonas ; Pseudomonas aeruginosa ; Serratia ; Urinary Tract Infections* ; Urinary Tract*

Despite their existence all around, primary cutaneous infections caused by Serratia marcescens are still fairly rare. In many cases, symptoms caused by S. marcescens usually manifest as opportunistic infections in pulmonary, urinary and digestive organs of immunocompromised patients. It is unusual to find manifestations as "primary" cutaneous infection. A 56-year-old woman presented to our hospital with ulcerative skin lesions. She had a medical history of poorly controlled diabetes mellitus for 5 years. Multiple nodules and ulcerative lesions of various sizes were distributed on the abdomen, both buttocks and thighs. Two biopsy samples revealed deep dermal and subcutaneous suppurative inflammation. Two culture samples from the skin biopsy sites demonstrated S. marcescens. Small-to-medium sized lesions showed improvements with antibiotic treatment for 14 days. However, for large sized lesions, partial-thickness skin grafts were done.
Abdomen ; Biopsy ; Buttocks ; Diabetes Mellitus ; Ecthyma ; Female ; Humans ; Immunocompromised Host ; Inflammation ; Middle Aged ; Opportunistic Infections ; Serratia ; Serratia marcescens ; Skin ; Thigh ; Transplants ; Ulcer

Serratia marcescens is the most important member of the genus Serratia and causes opportunistic infections, particularly pneumonia and septicemia in patients with malignancy, renal failure (acute and chronic), and diabetes mellitus. The most common portals of entry are known to be, in descending order, lung, genitourinary tract, intravenous line, gastrointestinal tract, and skin. S. marcescens rarely causes skin infection because it does not normally colonize human skin. Only six cases of S. marcescens cellulitis were reported. Five of them were immunocompromised patients. We have experienced a case of skin abscess caused by S. marcescens, which was found in a 59-year-old woman. She was undergoing prior antibiotic treatment after insulinoma surgery. S. marcescens was isolated from the skin abscess as a sole organism. She was treated with appropriate antibiotics that exhibited sensitivities for the organism and cured without any complication. The authors report a case of S. marcescens infection on the skin of a 59-year-old woman and review the literature concerning this organism as a causative agent.
Abscess* ; Anti-Bacterial Agents ; Cellulitis ; Colon ; Diabetes Mellitus ; Female ; Gastrointestinal Tract ; Humans ; Immunocompromised Host ; Insulinoma ; Lung ; Middle Aged ; Opportunistic Infections ; Pneumonia ; Renal Insufficiency ; Sepsis ; Serratia marcescens* ; Serratia* ; Skin*

Effect of Cefadroxil monohydrate was evaluated on 37 patients with urinary tract infection in our department during past 6 months periods. Cefadroxil was given Orally at a dose of 1.0 gm - 3.0 gm bid per day for 3 - 15 days and following results were obtained. 1. Excellent or good results was observed in 31 out of 34 patients in whom complete follow up study were done, giving success rate of 91.2%. 2. Therapeutic effects were obtained in 10 out of 11 patients with urethritis and all patients with cystitis and pyelonephritis, but not in 1 with urethritis, 1 with prostatitis and 1 out of 9 urinary tract infections with predisposing factors. 3. In this clinical settings, Cefadroxil was effective against E. coli infection in 10 patients, mixed infection in 2 and Staphylococcus aureus infection in 5. However it was ineffective against Serratia infection in 1 patient and Staphylococcus infection in 1. 4. As to the side effects, only mild dizziness was observed in 2 patient.
Causality ; Cefadroxil* ; Coinfection ; Cystitis ; Dizziness ; Follow-Up Studies ; Humans ; Prostatitis ; Pyelonephritis ; Serratia Infections ; Staphylococcus ; Staphylococcus aureus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Forty five patients with urinary tract infection were treated with 100mg Norfloxacin twice daily for 3 or 7 days according to the seriousness of infection. Of the 19 patients with uncomplicated urinary tract infection including 5 patients with acute bacterial prostatitis or acute epididymitis, none had bacteriuria 7 days after therapy and 1 patient was reinfected 14 days after therapy discontinuation. Of the 26 patients with complicated urinary tract infection, 17 patients(65%) were uninfected 7days after therapy and among them, 3 patients were reinfected I4 days after discontinuation of therapy. Of the 9 patients with persistent infection, 4 patients had resistant bacteriuria and 5 patients had bacteriuria different from that found before therapy. Eradication rate of E. coli, Enterobacter spp., Proteus spp., Pseudomonas spp., and Serratia spp. were 100%,, 100%,, 100%,, 80% and 40%, respectively. Further clinical envaluation seems worthwhile especially in pseudomonas infections since it offers one of the very few alternatives for oral treatment of pseudomonas infections which today may require hospitalization only for the purpose of injectible antibiotics.
Anti-Bacterial Agents ; Bacteriuria ; Enterobacter ; Epididymitis ; Hospitalization ; Humans ; Male ; Norfloxacin ; Prostatitis ; Proteus ; Pseudomonas ; Pseudomonas Infections ; Serratia ; Urinary Tract Infections* ; Urinary Tract*