Serratia Marcescens

This page is about Serratia marcescens. We examine diagnosis and treatment, how these infections occur, and medical malpractice lawsuits involving this potentially deadly infection.

Serratia marcescens is a dangerous infection that can kill you. This species of bacteria is known to be a highly opportunistic pathogen commonly involved in hospital-acquired infections. Serratia marcescens is commonly found in the environment, particularly in consistently damp conditions where the bacteria proliferate.

S. marcescens can frequently be seen on tile and shower corners or at the water line of a toilet bowl, where it appears as a pink or orange filmy residue. Seldom-used toilets are actually the ideal breeding ground for s. marcescens because of the standing water in the bowl. Aside from shower tiles and toilets, the s. marcescens bacteria can also usually be found in soil and human and animal feces.

History

Serratia marcescens (SM), a Gram-negative bacterium, is part of the Serratia genus within the Yersiniaceae family. Its discovery dates back to 1819 by Bartolomeo Bizio, an Italian pharmacist who later became a professor at the University of Padua, Italy.

Bizio initially observed a blood-like pigment on foodstuffs like polenta and rice, mistaking the bacterium for a fungus. He named it S. marcescens, with ‘Serratia’ honoring Serafino Serrati, a physicist known for operating the first steamboat on the Arno River in 1787, and ‘marcescens’ derived from the Latin for “to decay.”

Serratia Marcescens Symptoms

The symptoms of a Serratia marcescens infection can vary depending on the site of the infection. Here are the potential – and this is a laundry list – symptoms associated with various types of infections caused by Serratia marcescens:

1. Respiratory Infections:
   • Cough
   • Shortness of breath
   • Fever
   • Chest pain
2. Urinary Tract Infections (UTIs):
   • Pain or a burning sensation during urination
   • Frequent urination
   • Cloudy or bloody urine
   • Lower abdominal pain
   • Fever
3. Wound Infections:
   • Redness and swelling around the wound
   • Pain at the wound site
   • Discharge of pus
   • Fever
4. Bloodstream Infections (Bacteremia or Sepsis):
   • Fever and chills
   • Rapid heartbeat
   • Rapid breathing
   • Low blood pressure
   • Confusion or altered mental state
5. Eye Infections (such as Endophthalmitis or Keratitis):
   • Redness of the eye
   • Pain and swelling in the eye
   • Discharge from the eye
   • Blurred vision
6. Meningitis (infection of the membranes surrounding the brain and spinal cord):
   • Severe headache
   • Stiff neck
   • Sensitivity to light
   • Nausea and vomiting
   • Fever
7. Osteomyelitis (bone infection):
   • Pain in the infected bone
   • Swelling, warmth, and redness over the affected area
   • Fever

Of course, the hard part is that these same symptoms are also symptoms of many other ailments. So the key is diagnosing the infection quickly by ruling out S. marcescens.

Serratia Marcescens Infections

At one point, Serratia marcescens was believed to be a completely harmless organism. But scientific research shows that s. marcescens can be a dangerous bacterium that is very dangerous to humans. Serratia marcescens is now a common cause of human infections in the respiratory tract, digestive tract, and wound site infection.

Can serratia marcescens kill you?  It can. Serratia marcescens infections can lead to severe and sometimes life-threatening conditions. For example, the bacterium in neonatal units can cause meningitis, septicemia, and respiratory infections.

Serratia marcescens is a common cause of hospital-acquired infections in patients and healthcare workers. It is believed to be responsible for approximately 2% of all documented cases.

This is because S. marcescens multiples on medical equipment and facilities (e.g., showers, toilets, etc.) found in hospitals. If it can be shown that the infection was due to negligence or lack of proper care, this may lead to a medical malpractice lawsuit.

S. marcescens bacteria is known to cause various types of human infections, including urinary tract infections (UTIs), respiratory tract infections, conjunctivitis, tear duct infections, and keratitis. Although extremely rare, it can also cause pneumonia and meningitis.

Minimizing the Risk of Serratia Marcescens Infection

Once s. marcescens has established itself on a surface; eliminating it can be challenging. The bacteria can be eradicated only with a bleach-based disinfectant or cleaner. The best methods for controlling the development and spread of s. marcescens include:

• Regular Cleaning: thoroughly and regularly cleaning all surfaces with a bleach-based cleaner or disinfectant is the most effective prevention tool. Kitchen and bathroom surfaces and other areas exposed to water are higher-risk areas that require more frequent cleaning.
• Disinfecting & Rinsing: on surfaces where the pink slime associated with s. marcescens has previously developed, complete disinfection and rinsing may be required. Chlorine bleach products are required to disinfect Serratia marcescens properly. Disinfectants should remain on the surface for 20 minutes before thoroughly rinsing away with fresh water.
• Avoid Scratching Surfaces: When cleaning for S. marcescens, take precautions to avoid scratching any surfaces with abrasives. Scratches on a smooth surface can create an ideal breeding ground for S. marcescens.

Treatment for Serratia Marcescens Infections

One reason prevention is often considered so important is the difficulty of treating infections caused by S. marcescens. This is particularly true in a hospital setting where S. marcescens is known to be a problem. Hospitals must ensure proper cleaning and disinfecting of equipment and facilities to prevent S. marcescens from developing and infecting patients.

Serratia marcescens is a bacterium that can be difficult to treat due to its resistance to certain antibiotics. The choice of the best antibiotic to treat an infection caused by Serratia marcescens depends on various factors, including the specific strain of the bacterium, the location and severity of the infection, and the patient’s medical history. There is also a genetic component to all of this that we still do not fully understand. So there is not a one-size-fits-all solution.

Commonly used antibiotics for treating Serratia marcescens infections include:

1. Carbapenems: These are often considered among the most effective antibiotics for Serratia infections. Examples include meropenem and imipenem.
2. Cephalosporins: Some third and fourth-generation cephalosporins, like ceftriaxone or cefepime, may be effective.
3. Aminoglycosides: Antibiotics such as gentamicin and amikacin are sometimes used, especially in combination with other antibiotics to enhance effectiveness.
4. Fluoroquinolones: Drugs like ciprofloxacin or levofloxacin can be effective, but resistance is increasingly a concern.
5. Sulfamethoxazole/Trimethoprim (Bactrim): This combination can be effective against Serratia marcescens, particularly for urinary tract infections.
6. Piperacillin/Tazobactam: This combination antibiotic is often used in hospital settings for serious infections.

Serratia Marcescens Infection and Medical Malpractice

When a hospital-acquired infection is related to Serratia marcescens, it is most likely the result of negligent practices at the hospital, such as failure to properly clean surfaces on a regular basis. Hospital patients who develop infections from s. marcescens at the hospital may be entitled to bring a hospital malpractice lawsuit and get financial compensation for their injuries.

Origins of Malpractice Lawsuits

S. marcescens malpractice lawsuits usually originate less from treatment mistakes – like most infection lawsuits – and more from allowing the infections in the first place:

1. Failure to maintain sterile environments: Sterility in medical environments, especially operation theaters and intensive care units, is paramount. The presence of S. marcescens indicates a failure in maintaining such an environment.
2. Improper sterilization of medical equipment: S. marcescens can thrive in residues left on improperly cleaned or sterilized medical equipment.
3. Contaminated intravenous (IV) fluids or medications: These are directly introduced into the bloodstream, providing a direct route for the bacterium to cause systemic infections.

The outcomes of these malpractice suits depend on various factors, including the severity of the infection, the degree of negligence, and the long-term impact on the patient’s health. Settlements or jury payouts can include compensation for medical expenses, pain and suffering, and possibly punitive damages in some jurisdictions in cases of gross negligence.

Serratia Marcescens Infection Settlement Amounts and Jury Payouts

Below are some sample settlement compensation amounts and jury awards in Serratia marcescens medical malpractice lawsuits. Obviously, you cannot predict the settlement amount in your case by looking at these results because every case is different. But our lawyers think they are helpful both to victims and lawyers handling Serratia marcescens malpractice claims.

• 2019, Virginia: $295,000 Verdict. A 50-something man suffered an ingrown toenail. He underwent a partial nail avulsion. The man suffered wound dehiscence. He experienced lethargy and severe pain. The man presented to the hospital three weeks later. He was diagnosed with septic shock caused by Serratia marcescens. The man alleged negligence against the surgeon who performed the nail avulsion. He claimed he failed to provide adequate care and prescribe antibiotics. The jury awarded $295,000.
• 2018, Minnesota: $2,707,507 Verdict. A 60-something woman underwent a left vitrectomy. Following the procedure, she suffered a left eye infection caused by Pseudomonas aeruginosa and Serratia marcescens. The woman developed left-eye blindness. She underwent an enucleation procedure. The woman now wore a prosthetic implant. She hired a Serratia marcescens lawyer and filed a lawsuit against the hospital. The woman claimed the surgical team failed to sterilize surgical equipment and provide adequate care. She received a $2,707,507 verdict.
• 2007, New York: $5,000,000 Settlement. A one-month-old premature baby suffered leukocytosis. He experienced decreased appetite, apnea, and bradycardia. The boy received antibiotics. His symptoms improved after two days. The hospital staff discontinued antibiotics. Two days later, the boy suffered abdominal distension, bradycardia, and paleness. His paleness worsened hours later. The boy received antibiotics, including vancomycin and cefotaxime. He was diagnosed with an infection caused by Serratia marcescens one day later. The boy suffered meningitis and a cerebral abscess. He developed cerebral palsy. The boy’s parents filed a Serratia marcescens lawsuit against the hospital. They claimed its staff failed to treat an infection and order extensive tests promptly. This case settled for $5,000,000.
• 2000, North Carolina: $9,000,000 Settlement. A baby was placed on top of overheated liquid-filled plastic bags within minutes of her birth. She suffered severe first-, second-, and third-degree buttock and back burns. The developed hydrocephalus, Grade IV intraventricular hemorrhaging, and meningitis. She required shunting. The girl’s burn wound culture tested positive for Serratia marcescens. She was left with permanent neurological injuries. The girl’s family alleged negligence against the hospital. They claimed its staff provided substandard care and failed to address her injuries timely. This case settled for $9,000,000.

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