An outbreak of Serratia marcescens on the neonatal unit:a tale of two clones

Serratia spp. are an important cause of hospital-acquired infections and outbreaks in high-risk settings. Twenty-one patients were infected or colonized over a nine-month period during 2001-2002 on a neonatal unit. Twenty-two isolates collected were examined for antibiotic susceptibility, β-lactamase production and genotype. Random-amplified polymorphic DNA polymerase chain reaction and pulsed-field gel electrophoresis revealed that two clones were present. The first clone caused invasive clinical infection in four babies, and was subsequently replaced by a non-invasive clone that affected 14 babies. Phenotypically, the two strains also differed in their prodigiosin production; the first strain was non-pigmented whereas the second strain displayed pink-red pigmentation. Clinical features suggested a difference in their pathogenicity. No environmental source was found. The outbreak terminated following enhanced compliance with infection control measures and a change of antibiotic policy. Although S. marcescens continued to be isolated occasionally for another five months of follow-up, these were sporadic isolates with distinct molecular typing patterns. © 2005 The Hospital Infection Society.

Policy on the hoof:the handling of the foot and mouth disease outbreak in 2001

The foot and mouth disease (FMD) epidemic of 2001 was a disaster for sections of the agricultural industry, a number of businesses and for the Ministry of Agriculture, Fisheries and Food (MAFF), which met its demise as a government department during the crisis, being replaced by the Department of the Environment, Food and Rural Affairs (DEFRA). There were some 2,030 confirmed cases and over four million animals slaughtered. It caused the postponement of local elections and of a general election. From a public policy perspective it raised questions about contingency planning, the adjustment of policy to take account of change and how to manage a crisis. This article focuses on the background to the crisis and how it was handled.