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Journal of Clinical Microbiology, July 2004, p. 3108-3116, Vol. 42, No. 7
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.7.3108-3116.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Molecular Epidemiology of Serratia marcescens in Two Hospitals in Danzig, Poland, over a 5-Year Period
ukasz Naumiuk,1,2 Anna Baraniak,3 Marek Gniadkowski,3 Beata Krawczyk,1 Bartosz Rybak,2 Ewa Sadowy,3 Alfred Samet,2 and Józef Kur1*
Department of Microbiology, Gdañsk University of Technology, 80-952 Gdañsk,1 Department of Clinical Microbiology, Public Hospital No. 1, 80-211 Gdañsk,2 National Institute of Public Health, Department of Molecular Microbiology, 00-725 Warsaw, Poland3
Received 23 December 2003/ Returned for modification 14 March 2004/ Accepted 22 March 2004
The history of the Serratia marcescens population in two hospitals in Danzig, Poland, over a 5-year period was analyzed in a study that combined MIC evaluation, typing by randomly amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis, and analysis of extended-spectrum ß-lactamases (ESBLs). We analyzed 354 isolates collected from 341 patients in two teaching hospitals in Danzig, Poland, from 1996 to 2000. The antimicrobial susceptibility profiles varied greatly, and for resistance to newer ß-lactams, probable AmpC cephalosporinase derepression and ESBL production occurred in about 23 and 19% of the isolates, respectively. RAPD typing, by which 69 types were discerned altogether, revealed a high degree of clonal diversity among the populations. However, the four most prevalent types were highly predominant, grouping approximately 71% of the isolates studied. These clones were observed in the two hospitals and were strong contributors to both outbreaks and the background of endemicity of the S. marcescens infections. Some of the strains that were not so widely spread (12 RAPD types; 
14% of the isolates) were responsible for several smaller outbreaks, and the remaining isolates represented unique RAPD types (53 types; 15% of the isolates) and were probably sporadic introductions from other environments. ESBLs were identified in several different clones, and some of these had most likely already been introduced into the hospitals as ESBL producers, whereas the others acquired the ESBL-encoding genes from other enterobacterial strains in these environments. The CTX-M-3 enzyme, which is widely observed in Poland, was the most common ESBL type among the S. marcescens isolates, followed by TEM-47 and SHV-5. The complex epidemiology of ESBLs, especially in 1999 and 2000, must have arisen from the introduction of ESBL producers from other centers, their clonal dissemination, and the constant penetration of the S. marcescens populations with plasmids with ESBL genes. Multiple S. marcescens isolates were obtained from 11 patients, who probably represented both patients with recolonizations and reinfections and patients with recurrences of infections with the evolution of the strain's susceptibility.
* Corresponding author. Mailing address: Department of Microbiology, Gdañsk University of Technology, ul. G. Narutowicza 11/12, 80-952 Gdañsk, Poland. Phone and fax: 48 58 3471822. E-mail: kur{at}altis.chem.pg.gda.pl.
Journal of Clinical Microbiology, July 2004, p. 3108-3116, Vol. 42, No. 7
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.7.3108-3116.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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