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''Serratia marcescens'' () is a species of rod-shaped, Gram-negative bacteria in the family Yersiniaceae. It is a facultative anaerobe and an opportunistic pathogen in humans. It was discovered in 1819 by Bartolomeo Bizio in Padua, Italy.Serratia marcescens. (2011, April). Retrieved from https://microbewiki.kenyon.edu/index.php/Serratia_marcescens ''S. marcescens'' is commonly involved in hospital-acquired infections (HAIs), also called nosocomial infections, particularly catheter-associated
bacteremia Bloodstream infections (BSIs), which include bacteremias when the infections are bacterial and fungemias when the infections are fungal, are infections present in the blood. Blood is normally a sterile environment, so the detection of microb ...
, urinary tract infections, and wound infections, and is responsible for 1.4% of HAI cases in the United States. It is commonly found in the respiratory and urinary tracts of hospitalized adults and in the gastrointestinal systems of children. Due to its abundant presence in the environment, and its preference for damp conditions, ''S. marcescens'' is commonly found growing in bathrooms (especially on tile grout, shower corners, toilet water lines, and basins), where it manifests as a pink, pink-orange, or orange discoloration and slimy film feeding off phosphorus-containing materials or fatty substances such as soap and shampoo residue. Once established, complete eradication of the organism is often difficult, but can be accomplished by application of a
bleach Bleach is the generic name for any chemical product that is used industrially or domestically to remove color (whitening) from a fabric or fiber or to clean or to remove stains in a process called bleaching. It often refers specifically, to ...
-based disinfectant. Rinsing and drying surfaces after use can also prevent the establishment of the bacterium by removing its food source and making the environment less hospitable. ''S. marcescens'' may also be found in environments such as dirt and the subgingival biofilm of teeth. Due to this, and because ''S. marcescens'' produces a reddish-orange tripyrrole dye called prodigiosin, it may cause staining of the teeth. The biochemical pathway for the production of prodigiosin by ''S. marcescens'' has been characterized by analyzing what intermediates become accumulated in specific mutants.


Identification

''S. marcescens'' is a motile organism and can grow in temperatures ranging from 5–40 °C and in pH levels ranging from 5 to 9. It is differentiated from other Gram-negative bacteria by its ability to perform casein hydrolysis, which allows it to produce extracellular metalloproteinases which are believed to function in cell-to-extracellular matrix interactions. Since this bacterium is a facultative anaerobe, meaning that it can grow in either the presence of oxygen (aerobic) or in the absence of oxygen (anaerobic), it is capable of nitrate reduction under anaerobic conditions. Therefore, nitrate tests are positive since nitrate is generally used as the final electron acceptor rather than oxygen. ''S. marcescens'' also exhibits tyrosine hydrolysis and citrate degradation. Citrate is used by ''S. marcescens'' to produce
pyruvic acid Pyruvic acid (CH3COCOOH) is the simplest of the alpha-keto acids, with a carboxylic acid and a ketone functional group. Pyruvate, the conjugate base, CH3COCOO−, is an intermediate in several metabolic pathways throughout the cell. Pyruvic aci ...
, thus it can rely on citrate as a carbon source and test positive for citrate utilization. In identifying the organism, one may also perform a methyl red test, which determines if a microorganism performs mixed-acid fermentation. ''S. marcescens'' results in a negative test. Another determination of ''S. marcescens'' is its capability to produce lactic acid by oxidative and fermentative metabolism. Therefore, ''S. marcescens'' is lactic acid O/F+.


Pathogenicity

In humans, ''S. marcescens'' can cause an
opportunistic infection An opportunistic infection is an infection caused by pathogens (bacteria, fungi, parasites or viruses) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune ...
in several sites, including the urinary tract,
respiratory tract The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to th ...
, wounds, and the eye, where it may cause conjunctivitis, keratitis, endophthalmitis, and tear duct infections. It is also a rare cause of endocarditis and osteomyelitis (particularly in people who use intravenous drugs recreationally), pneumonia, and
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...
. Most ''S. marcescens'' strains are resistant to several
antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...
s because of the presence of R-factors, which are a type of
plasmid A plasmid is a small, extrachromosomal DNA molecule within a cell that is physically separated from chromosomal DNA and can replicate independently. They are most commonly found as small circular, double-stranded DNA molecules in bacteria; how ...
that carry one or more genes that encode
resistance Resistance may refer to: Arts, entertainment, and media Comics * Either of two similarly named but otherwise unrelated comic book series, both published by Wildstorm: ** ''Resistance'' (comics), based on the video game of the same title ** ''T ...
; all are considered intrinsically resistant to ampicillin, macrolides, and first-generation cephalosporins (such as cephalexin). In elkhorn coral, ''S. marcescens'' is the cause of the disease known as white pox disease. In
silkworm The domestic silk moth (''Bombyx mori''), is an insect from the moth family Bombycidae. It is the closest relative of ''Bombyx mandarina'', the wild silk moth. The silkworm is the larva or caterpillar of a silk moth. It is an economically imp ...
s, it can also cause a lethal disease, especially in association with other pathogens. In research laboratories employing '' Drosophila'' fruit flies, infection of them with ''S. marcescens'' is common. It manifests as a pink discoloration or plaque in or on larvae, pupae, or the usually starch and sugar-based food (especially when improperly prepared). A rare clinical form of gastroenteritis occurring in early infancy caused by infection with'' S. marcescens''. The red color of the diaper can be mistaken for hematuria (blood in the urine), which may cause unnecessary investigations by the physicians. ''S. marcescens'' causes cucurbit yellow vine disease, leading to sometimes serious losses in melon fields. Professor Jim Burritt and his students at the University of Wisconsin-Stout have discovered a new strain of ''S. marcescens'' in bee blood (haemolymph) from hives decimated by winterkill. His research findings have been published and the new strain was named sicaria, which means assassin in Latin. The professor states that ''S. marcescens sicaria'' "may contribute to the wintertime failure of honey bee colonies".


History


Possible role in medieval miracles

Because of its red pigmentation, caused by expression of the
dye A dye is a colored substance that chemically bonds to the substrate to which it is being applied. This distinguishes dyes from pigments which do not chemically bind to the material they color. Dye is generally applied in an aqueous solution an ...
prodigiosin, and its ability to grow on bread, ''S. marcescens'' has been evoked as a naturalistic explanation of medieval accounts of the "miraculous" appearance of blood on the Corporal of Bolsena. This followed celebration of a mass at Bolsena in 1263, led by a
Bohemia Bohemia ( ; cs, Čechy ; ; hsb, Čěska; szl, Czechy) is the westernmost and largest historical region of the Czech Republic. Bohemia can also refer to a wider area consisting of the historical Lands of the Bohemian Crown ruled by the Bohem ...
n priest who had doubts concerning transubstantiation, or the turning of bread and wine into the Body and Blood of Christ during the mass. During the mass, the Eucharist appeared to bleed and each time the priest wiped away the blood, more would appear. This event is celebrated in a
fresco Fresco (plural ''frescos'' or ''frescoes'') is a technique of mural painting executed upon freshly laid ("wet") lime plaster. Water is used as the vehicle for the dry-powder pigment to merge with the plaster, and with the setting of the plaste ...
in the Apostolic Palace in the Vatican City, painted by Raphael.


Discovery

''S. marcescens'' was discovered in 1819 by
Venetian Venetian often means from or related to: * Venice, a city in Italy * Veneto, a region of Italy * Republic of Venice (697–1797), a historical nation in that area Venetian and the like may also refer to: * Venetian language, a Romance language s ...
pharmacist Bartolomeo Bizio, as the cause of an episode of blood-red discoloration of
polenta Polenta (, ) is a dish of boiled cornmeal that was historically made from other grains. The dish comes from Italy. It may be served as a hot porridge, or it may be allowed to cool and solidify into a loaf that can be baked, fried, or grilled. ...
in the city of Padua. Bizio named the organism four years later in honor of Serafino Serrati, a physicist who developed an early
steamboat A steamboat is a boat that is marine propulsion, propelled primarily by marine steam engine, steam power, typically driving propellers or Paddle steamer, paddlewheels. Steamboats sometimes use the ship prefix, prefix designation SS, S.S. or S/S ...
; the epithet ''marcescens'' (Latin for 'decaying') was chosen because of the dyestuff's rapid deterioration (Bizio's observations led him to believe that the organism decayed into a mucilage-like substance upon reaching maturity). ''Serratia'' was later renamed ''Monas prodigiosus'' and ''Bacillus prodigiosus'' before Bizio's original name was restored in the 1920s.


Uses and misuse


Role in biowarfare testing

Until the 1950s, ''S. marcescens'' was erroneously believed to be a nonpathogenic " saprophyte", and its reddish coloration was used in school experiments to track infections. During the
Cold War The Cold War is a term commonly used to refer to a period of geopolitical tension between the United States and the Soviet Union and their respective allies, the Western Bloc and the Eastern Bloc. The term '' cold war'' is used because the ...
, it was used as a simulant in biological warfare testing by the
U.S. military The United States Armed Forces are the military forces of the United States. The armed forces consists of six service branches: the Army, Marine Corps, Navy, Air Force, Space Force, and Coast Guard. The president of the United States is the ...
, which studied it in field tests as a substitute for the tularemia bacterium, which was being weaponized at the time. On 26 and 27 September 1950, the U.S. Navy conducted a secret experiment named " Operation Sea-Spray" in which balloons filled with ''S. marcescens'' were released and burst over urban areas of the San Francisco Bay Area in California. Although the Navy later claimed the bacteria were harmless, beginning on September 29, 11 patients at a local hospital developed very rare, serious urinary tract infections. One of the afflicted patients, Edward J. Nevin, died. Cases of pneumonia in San Francisco also increased after ''S. marcescens'' was released. (That the simulant bacteria caused these infections and death has never been conclusively established.) Nevin's son and grandson lost a lawsuit they brought against the government between 1981 and 1983, on the grounds that the government is immune, and that the chance that the sprayed bacteria caused Nevin's death was minute. The bacterium was also combined with phenol and an anthrax simulant and sprayed across south Dorset by US and UK military scientists as part of the DICE trials which ran from 1971 to 1975. Since 1950, ''S. marcescens'' has steadily increased as a cause of human infection, with many strains resistant to multiple antibiotics. The first indications of problems with the
influenza vaccine Influenza vaccines, also known as flu shots, are vaccines that protect against infection by influenza viruses. New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes. While their effectiveness varies fr ...
produced by Chiron Corporation in 2004 involved ''S. marcescens'' contamination.


Contaminated injectables

In early 2008, the U.S. Food and Drug Administration issued a nationwide recall of one lot of Pre-Filled
Heparin Heparin, also known as unfractionated heparin (UFH), is a medication and naturally occurring glycosaminoglycan. Since heparins depend on the activity of antithrombin, they are considered anticoagulants. Specifically it is also used in the treatm ...
Lock Flush Solution USP. The heparin IV flush syringes had been found to be contaminated with ''S. marcescens'', which resulted in patient infections. The Centers for Disease Control and Prevention confirmed growth of ''S. marcescens'' from several unopened syringes of this product. ''S. marcescens'' has also been linked to 19 cases in Alabama hospitals in 2011, including 10 deaths. All of the patients involved were receiving total parenteral nutrition at the time, and this is being investigated as a possible source of the outbreak.


Ground-water flow tracing

Because of its ability to be grown on
agar Agar ( or ), or agar-agar, is a jelly-like substance consisting of polysaccharides obtained from the cell walls of some species of red algae, primarily from ogonori (''Gracilaria'') and "tengusa" (''Gelidiaceae''). As found in nature, agar is ...
plates into even, well coloured lawns, and the existence of a phage specific to ''S. marscecens'', it has been used to trace water flows in
Karst Karst is a topography formed from the dissolution of soluble rocks such as limestone, dolomite, and gypsum. It is characterized by underground drainage systems with sinkholes and caves. It has also been documented for more weathering-resistant ro ...
limestone systems. Known quantities of phage are injected into a fixed point in the Karst water system and the outflow of interest are monitored by conventional small-volume sampling at fixed time intervals. In the laboratory, the samples are poured onto grown ''S. marscecens'' lawns and incubated. Colourless plaques in the lawns indicate the presence of phage. The method was claimed to be sensitive at very high dilutions because of the ability to detect single phage particles.


See also

* Eucharistic miracle


References


Further reading

*


External links

*
Type strain of ''Serratia marcescens'' at Bac''Dive'' - the Bacterial Diversity Metadatabase
{{Taxonbar, from=Q140004 Enterobacterales Gram-negative bacteria Bacteria described in 1823