From the Research
For a 2-week-old neonate with Morganella isolated from a tracheal aspirate, isolation precautions should be maintained for the duration of hospitalization or until two consecutive negative cultures are obtained at least 24-48 hours apart. This recommendation is based on the fact that Morganella morganii is a gram-negative bacterium that can cause healthcare-associated infections, particularly in neonates with immature immune systems 1. The most recent and highest quality study, published in 2021, highlights the importance of considering Morganella morganii as a potential cause of invasive infections, especially in hospital settings, due to its high degree of mortality and potential to develop multidrug resistance 1. Key considerations for isolation precautions include:
- Contact isolation with use of gowns and gloves when entering the room and proper hand hygiene
- Placing the neonate in a single room if possible, or cohorted with other infants with the same organism if necessary
- Vigilant equipment cleaning and disinfection, as Morganella can persist on environmental surfaces
- Decision to discontinue isolation should be made in consultation with infection control specialists based on the infant's clinical status and local protocols It is also important to note that the 2022 study published in Microbiology spectrum, highlights the increasing incidence of Morganella morganii bloodstream infections, particularly in elderly male subjects and individuals with comorbidities, but this does not directly impact the isolation precautions for a 2-week-old neonate 2. Additionally, the 2017 study published in the American journal of perinatology, found that Gram-negative rods, such as Morganella morganii, in the airways of preterm infants receiving mechanical ventilation at 36 weeks postmenstrual age, are associated with increased risk for prolonged supplemental oxygen use 3. However, the primary concern for a 2-week-old neonate with Morganella isolated from a tracheal aspirate is preventing the spread of the infection to other vulnerable infants in the NICU, and the recommended isolation precautions should be followed to minimize this risk.