From the FDA Drug Label
- 3 Hospital-acquired Bacterial Pneumonia and Ventilator-associated Bacterial Pneumonia (HABP/VABP) AVYCAZ (ceftazidime and avibactam) is indicated for the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) in adult and pediatric patients (at least 31 weeks gestational age) caused by the following susceptible gram-negative microorganisms: Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli, Serratia marcescens, Proteus mirabilis, Pseudomonas aeruginosa, and Haemophilus influenzae.
Serratia marcescens is a type of gram-negative bacteria that can cause hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP).
- A person can get Serratia marcescens through:
- Hospital-acquired infections
- Ventilator-associated infections
- Serratia marcescens sputum cultures positive indicates that the bacteria is present in the sputum, which can be a sign of infection.
- The recommendations for treatment include using AVYCAZ (ceftazidime and avibactam), which is effective against Serratia marcescens 1.
From the Research
Serratia marcescens positive sputum cultures indicate the presence of this gram-negative bacterium in the respiratory tract, which can cause respiratory infections, particularly in hospitalized or immunocompromised individuals, and treatment should be guided by the most recent and highest quality study, which recommends carbapenems or aminoglycosides in combination with third-generation cephalosporin 2.
Causes and Risk Factors
People acquire Serratia marcescens infection through:
- Contact with contaminated medical equipment, respiratory devices, or through person-to-person transmission in healthcare settings
- Contaminated soil, water, and food
Prevention and Treatment
Prevention includes:
- Proper hand hygiene
- Sterilization of medical equipment
- Isolation precautions for infected patients Treatment typically involves antibiotics such as:
- Carbapenems (e.g., meropenem 1g every 8 hours intravenously)
- Aminoglycosides
- Third-generation cephalosporins (e.g., ceftriaxone 1-2g daily)
- Cotrimoxazole for uncomplicated urinary infections It is essential to complete the full course of antibiotics even if symptoms improve to prevent recurrence and antibiotic resistance.
Key Considerations
- Serratia marcescens can be resistant to multiple antibiotics, so treatment should be guided by susceptibility testing 3
- Identifying and addressing underlying risk factors such as immunosuppression, chronic lung disease, or prolonged hospitalization is crucial for those with recurrent infections
- Recent studies suggest that ceftazidime-avibactam can be effective for persistent carbapenem-resistant Serratia marcescens infection, highlighting the importance of antimicrobial stewardship 4
- A combination of antibiotics should be used empirically as early as possible, and the antibiotic regimen should be adjusted according to drug sensitivity results 5