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A 2-year-old female Bengal cat was referred for acute right forelimb lameness one month after ovariectomy. Physical examination revealed multifocal pain on bone palpation and fever. Radiographs showed mixed lytic-proliferative polyostotic diaphyseal osteopathy of multiple bone segments. Histopathologic evaluation of bone biopsies showed severe chronic pyogranulomatous osteomyelitis and multidrug-resistant Serratia marcescens was cultured. Antibiotic therapy with piperacillin-tazobactam was administered for 60 days, based on susceptibility testing. Lameness and bone pain resolved within 15 days, and radiographs after 30 days showed decreased bone lysis. At a 6-month recheck, the cat recovered completely, and only bone remodelling was evident on radiographs. Multifocal bacterial haematogenous osteomyelitis (HO) caused by Serratia marcescens was diagnosed in an adult immunocompetent cat. HO is infrequently reported in dogs and cats with young and immunocompromised patients being most at risk. Prior ovariectomy and anaesthesia may have predisposed the cat to the development of a hospital-associated infection (HAI), as other aetiologies or predisposing causes for osteomyelitis were reasonably excluded. Serratia marcescens is a gram-negative bacterium recently reported as responsible for human and veterinary HAIs, although it has never been stated for HO in small animals. Early recognition and antibiotic therapy led to good outcome in this case., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Newborns admitted to neonatal intensive care units (NICU) are at increased risk of health care-associated infections. Serratia marcescens represent the third most common pathogen in NICU outbreaks. Here we present an outbreak investigation performed using Whole Genome Sequencing (WGS) analyses and the control measures implemented to limit the spread of S. marcescens in the NICU of an Italian hospital. In February 2023 S. marcescens was isolated from six newborns, when in 2022 this pathogen was isolated only from two samples in the same ward. Measures for infection prevention were adopted. Routinary surveillance screening, performed with rectal swabs collected at admission and weekly thereafter, was implemented to search for S. marcescens presence. Environmental samples were collected. All the isolates, obtained from the conjunctival swab of six newborns, from rectal swab of two newborns who did not develop infections, as well as from the aerators of two faucets, were sequenced. WGS analyses showed no correlation between the isolates from newborns and environmental isolates. The implementation of the measures for infection prevention and control had enabled us to successfully control the outbreak within a short period. WGS analyses proved to be crucial in outbreak investigation to limit the spreading of the pathogens., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Serratia species are not as frequent as with more virulent members of the Enterobacteriaceae. However, when infections do arise, they are largely associated with Serratia marcescens. Presently, about 10 species of Serratia are recognized and infections caused by the remaining Serratia species are seldom recorded in literature, as they are not often isolated from clinical specimens. This is a case report of Serratia rubidaea isolated from ear discharge of a 35-year old female patient with no co-morbidities and with known history of chronic otomastoiditis for which the patient had undergone left modified radical mastoidectomy. Isolation of this bacterium from clinical specimens is rare; however, it can be an etiological agent for infections in patients who have undergone invasive procedures. The patient was managed with antibiotics and on otoendoscopy at follow-up, no discharge was observed., Competing Interests: Conflict of Interest The authors wish to state no conflict of Interest interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Serratia marcescens (S. marcescens) is associated with nosocomial infections with significant morbidity and mortality in the neonatal intensive care units (NICU). We describe the control of a multi-clonal S. marcescens infections outbreak in our tertiary-level NICU and the application of molecular typing using repetitive element palindromic PCR (rep-PCR) and next generation sequencing (NGS) in the investigation., Methods: Outbreak investigation was performed where clinical, spatial and epidemiologic links were established. Screening of all infants in the NICU and the environment was performed. Rep-PCR and NGS methods were used to identify potential environmental sources of infections and clustering among cases., Results: Eleven cases were detected during the outbreak period: mean gestational age 27 weeks (range: 24-32), predominantly male (82%), mean age of infection 24 days (range: 6-51). Six infants were treated for conjunctivitis and one for bacteraemia. Identification of colonized infant via a point prevalence survey and cohorting of all infected/colonized patients were implemented. We performed environmental swabbing of surfaces, water outlets, chlorhexidine hand wash solutions and hand hygiene hand rubs. Both rep-PCR and NGS classified the 11 case isolates into 5 types. No point source was identified except for a single positive environmental isolate from a sink which was clonally distinct from the cases., Conclusion: Identification and cohorting of infected/colonized patient was important in the control of S. marcescens outbreak in the NICU. The utility of rep-PCR was comparable to NGS in providing molecular information to develop S. marcescens outbreak control strategies., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Skin and soft-tissue infections (SSTIs) are common disease presentations to the emergency department (ED), with the majority of the infections attributed to community-acquired methicillin-resistant Staphylococcus aureus. Rapid and accurate identification of potentially serious SSTIs is critical. Clinician-performed ultrasonography (CPUS) is increasingly common in the ED, and assists in rapid and accurate identification of a variety of disease processes., Case Report: A 21-year-old female presented to the ED with chin swelling and "boils." Although her visual examination was benign, CPUS of her facial swelling quickly established a more concerning disease process, which was eventually confirmed by aspiration and bone biopsy to be mandibular osteomyelitis. The causative organism, Serratia odorifera, is rarely associated with infections, and we are aware of no previously reported cases of osteomyelitis due to this species. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In this case of mandibular osteomyelitis, CPUS rapidly and accurately identified abnormal bony cortex of the mandible and an associated fluid collection. CPUS of an otherwise benign presentation of a facial infection led to a maxillofacial computed tomography scan, aspiration and biopsy, and then elective debridement of the bone infection. Emergency physicians should be aware of the utility of CPUS and the need to carefully investigate SSTIs presenting to the ED., (Copyright © 2014 Elsevier Inc. All rights reserved.)

A woman presented for her postpartum examination alarmed about pink stains on her breast pads and on her infant's burp pads and diapers. The stains were also found in her breast pump and the infant's bottles. Out of concern, she stopped breastfeeding. The diagnosis was colonization of mother and infant with Serratia marcescens. They were managed conservatively without antibiotics. The mother was guided to restart breastfeeding. The infant resumed nursing and continued to thrive., (© 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.)

Serratia rubidaea is an opportunist pathogenic bacterium, it is rarely identified in man, and when so, generally found in the respiratory tract, wounds, feces, bile, but also in blood. S. rubidaea can be responsible for infection, particularly in debilitated patients, receiving broad spectrum antibiotics or after undergoing extensive surgery, or invasive procedures. We report the case of a 54-year-old, nicotinic patient, with no previous medical history, admitted for complete arrhythmia due to auricular fibrillation. The patient had been carrying an arterial catheter for two weeks. Two hemocultures were positive in the first 48 hours with identification of Serratia rubidaea. S. rubidaea features inductible chromosomal betalactamase of the cephalosporinase type, resistant to ampicilline and cefalotin. The treatment combined gentamycin 160 mg/d and ciprofloxacin 400 mg/d for 10 days. The evolution was favourable.