Evidence map›Paper›PMID 40462178›Full record

ArticleAntimicrobial resistance and infection control2025

Rapid identification of a Serratia marcescens outbreak in a neonatal intensive care unit by third-generation long-read nanopore sequencing.

Desiree Henares, Meritxell Cubero, Irene Martinez-de-Albeniz, Alba Arranz, Muntsa Rocafort, Pedro Brotons, Amaresh Perez-Argüello, Maria Jose Troyano, Amadeu Gene, Aleix Lluansi and 5 more

Abstract read
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Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. International journal of molecular sciences · 2026
    Review
  4. Review
  5. The Fires of Isengard Have Spread:Pathogens (Basel, Switzerland) · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Desiree HenaresDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Meritxell CuberoMicrobiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Irene Martinez-de-AlbenizPediatric Infectious Diseases Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Alba ArranzDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Muntsa RocafortDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Pedro BrotonsDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Amaresh Perez-ArgüelloDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Maria Jose TroyanoNeonatal Intensive Care Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Amadeu GeneMicrobiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Aleix LluansiDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Marti Iriondo-SanzNeonatal Intensive Care Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Iolanda JordanCIBER Center for Epidemiology (CIBER) and Public Health, Carlos III Health Institute (CIBERESP, ISCIII), Madrid, Spain.
Claudia FortunyInfectious Diseases and Microbiome Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain.
Mireia UrreaInfectious Disease Control Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
C Muñoz-AlmagroDepartment of RDI Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. carmen.munoza@sjd.es.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSerratia marcescens is a frequent cause of outbreaks in high-risk hospital settings such as neonatal intensive care units (NICU). This study investigated a potential S. marcescens outbreak in the NICU of a reference children's hospital using Whole Genome Sequencing (WGS). Additionally, it assessed the performance of third-generation sequencing for the rapid and accurate identification and characterization of the outbreak's clonal strain.

methodsA prospective study was conducted from September 8th to November 12th 2021, following a sharp increase in invasive S. marcescens infections in the NICU of University Children's Hospital Sant Joan de Déu (Barcelona, Spain). This study included all patients admitted to NICU and other hospital wards from whom S. marcescens was isolated in any sample type. Nanopore sequencing was performed on S. marcescens isolates. Genomic characterization included phylogenetic analyses and detection of antimicrobial resistance genes.

resultsTwenty-nine patients (16 NICU and 13 non-NICU patients) infected/colonized by S. marcescens were detected during the study period, accounting for a total of 61 isolates. The genomic characterization was performed on 24 isolates from 14 NICU-patients and 10 isolates from eight non-NICU patients. Phylogenetic analyses evidenced three clusters of closely related strains; cluster I (n = 22), II (n = 2) and III (n = 5). The remaining isolates (n = 5) did not cluster. Cluster I contained most isolates from NICU patients (20/24), and most isolates from NICU-patients with confirmed invasive disease (7/8). Cluster II contained two isolates from two NICU-patients, one presenting with invasive disease. The resistance gene blaSRT was found in 97% of S. marcescens isolates (33/34). All isolates exhibited the amikacin-tobramycin aac(6') resistance gene and three multi-drug efflux pumps genes; sdeY, sdeB and smfY. The tetracycline tet(41) resistance gene was found in non-clustered isolates (4/34). The first results were available less than one month after the outbreak's alarm, and complete genomic study after two months.

conclusionTwo clonal strains were co-circulating in the NICU setting, with one being the major strain responsible for the outbreak. Rapid molecular characterization with nanopore sequencing confirmed the outbreak. It revealed the phylogenetic relationships among isolates and their antimicrobial potential. This approach enabled effective contextualization of the outbreak and allowed for monitoring its progression.

Indexed as

Cross InfectionDisease OutbreaksIntensive Care Units, NeonatalNanopore SequencingSerratia InfectionsSerratia marcescensFemaleGenome, BacterialHumansInfant, NewbornMalePhylogenyProspective StudiesSpainWhole Genome Sequencing

Identifiers

PMID40462178
PMCPMC12135216

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.