Morbidity and Mortality of Serratia marcescens Bacteremia During the Substance Use Epidemic

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International journal of antimicrobial agents


BACKGROUND: Serratia marcescens is an Enterobacterales species present throughout the environment causing a range of infections. Historically, Serratia marcescens has been associated with persons who inject drugs (PWID) but literature is scarce. OBJECTIVES: To compare treatment characteristics and clinical outcomes between PWID and Non-PWID with Serratia marcescens bacteremia. METHODS: This was a retrospective cohort study of patients hospitalized with Serratia marcescens bacteremia from January 1, 2013 through December 31, 2019 at a tertiary medical center. Patients were included if they were 18 years and older and had at least one positive blood culture for Serratia marcescens. RESULTS: Of the 67 patients who met inclusion, 14 were identified as PWID (21%) and 53 were non-PWID (79%). PWID were younger (median age in years, PWID = 32; non-PWID = 67) and less likely to have renal disease (PWID 7%; non-PWID 34%). PWID had a higher incidence of infective endocarditis (IE) (PWID 48%; non-PWID 0%) and were more likely to receive combination antimicrobial therapy (PWID 29%; non-PWID 2%). All-cause mortality at 12 months was comparable between groups (PWID 21%; Non-PWID 21%). CONCLUSION: We demonstrate long term outcomes of PWID are comparable to non-PWID despite PWID being a younger cohort with less comorbidities. Clinicians should have high suspicion of IE in PWID with Serratia marcescens bacteremia.

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