Park SY, Kim MJ, Park S, Kim NI, Oh HH, Kim J. Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report. World J Clin Cases 2021; 9(20): 5689-5694 [PMID: 34307626 DOI: 10.12998/wjcc.v9.i20.5689]
Corresponding Author of This Article
Joungmin Kim, MD, Associate Professor, Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 42 Jebong-ro Dong-gu, Gwangju 61469, South Korea. tca77@hanmail.net
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2021; 9(20): 5689-5694 Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5689
Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report
Sue Youn Park, Min Ji Kim, Sanghee Park, Nah Ihm Kim, Hyung Hoon Oh, Joungmin Kim
Sue Youn Park, Min Ji Kim, Sanghee Park, Joungmin Kim, Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju 61469, South Korea
Nah Ihm Kim, Department of Pathology, Chonnam National University Medical School, Gwangju 61469, South Korea
Hyung Hoon Oh, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, South Korea
Author contributions: Park SY and Kim J wrote the manuscript; Kim MJ and Park S performed literature analysis; Kim NI has edited photos and figures; Oh HH revised the manuscript for important intellectual content; and all authors approved the final version of the manuscript to be submitted.
Supported bya grant of Chonnam National University Hwasun Hospital Research Institute of Clinical Medicine, No. HCRI19012.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joungmin Kim, MD, Associate Professor, Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 42 Jebong-ro Dong-gu, Gwangju 61469, South Korea. tca77@hanmail.net
Received: March 5, 2021 Peer-review started: March 5, 2021 First decision: April 4, 2021 Revised: April 7, 2021 Accepted: May 20, 2021 Article in press: May 20, 2021 Published online: July 16, 2021
Abstract
BACKGROUND
Healthcare workers (HCWs) are at an increased risk for exposure to infections. Serratia marcescens (S. marcescens) is a gram-negative, opportunistic and nosocomial pathogen belonging to the Enterobacterieae family. A few case reports have been published of chorioamnionitis caused by S. marcescens infection. Immunological changes during pregnancy can also affect the risk of infection. However, few studies have examined hospital-acquired bacterial infection in pregnant HCWs.
CASE SUMMARY
A 33-year-old woman, a resident in anesthesiology, was admitted at 14 wk gestation for fever with chills. She had no medical history other than contact dermatitis of both hands that started from the beginning of the trainee. There was no obvious infection focus and no bacterial growth in blood cultures. She was discharged after 1 wk of empirical antibiotic treatment. At three weeks before the fever started, she had a blister on the site of contact dermatitis on both hands, she applied antibiotic ointment for three days and the blisters had healed. At 19 wk gestation, she had a high fever and was readmitted. Physical examination and image studies were nonspecific and the patient had no other symptoms. S. marcescens grew in blood cultures at 19 wk gestation. Treatment with intravenous antibiotics was started. However, she suffered a miscarriage at 224/7 wk gestation. Pathologically, the amniotic membrane showed chorioamnionitis with a focal infarct. Subsequently, a placenta tissue culture grew S. marcescens.
CONCLUSION
HCWs can be exposed to pathogens that can cause opportunistic infections such as S. marcescens. Pregnancy affects the immune system, making it susceptible to opportunistic infections. Therefore, pregnant HCWs may require more preventive measures, including hand hygiene and avoid risk factors (ex. wrapping the skin).
Core Tip: In this case, a 33-year-old female patient suffered a miscarriage due to chorioamnionitis caused by Serratia marcescens infection. Although she performed aseptic procedures and hand hygiene during medical practice, it is suspected that the cause of the infection was the weakening of the skin line due to contact dermatitis. In addition, it is thought that changes in the immune system caused by pregnancy may also have an effect. Therefore, it is recommended that pregnant healthcare workers perform more meticulous hand hygiene and avoid infection risk factors (ex. wrapping the skin).
