The goal of this New Emergency
Clearance is to request approval for an investigation is to
identify potential risk factors leading to an outbreak of Serratia
maraescens infections among US healthcare patients. Data will be
used to identify a cause of the infections and prevent additional
events from occurring. On March 27, 2018, the Colorado Department
of Public Health and Environment (CDPHE) notified CDC of 4 cases of
Serratia marcescens bacteremia among pediatric patients with
central lines in an acute care hospital between January 20 and
March 23, 2018. This cluster of cases was above the normal baseline
of 1–3 cases per year at that facility. The facility examined
exposures including common staff and medications and identified
commonalities related to the maintenance and care of central lines
as well as several medical products including prefilled normal
saline syringes and prefilled heparin flushes. On March 28, CDPHE
issued a call for cases to other state and local health departments
through the Epidemic Information Exchange (Epi-X) system. On March
29, the Tennessee Department of Health (TDH) notified CDC of 3
cases of Serratia marcescens bacteremia in pediatric patients with
central lines in a pediatric hospital between March 6 and March 21,
2018; initial examination of medications and common products
identified central venous catheter line products as a possible
source of infections, including prefilled heparin and normal saline
syringes. CDC is currently conducting a multistate investigation to
support state health departments. Currently, eight state health
departments have reported a total of 26 cases to CDC.
Serratia marcescens is a
Gram-negative bacillus that can be found in the environment and
thrives in moist environments. In healthcare settings, it can be
found on the hands of healthcare workers and as a contaminant of
medical products and devices, particularly aqueous products. It is
a known cause of healthcare-associated infections, particularly
urinary tract infection, wound infections, and bloodstream
infections, and it is an important opportunistic pathogen in
neonatal and pediatric intensive care units. Serratia marcescens
has been implicated previously in multistate outbreaks of
bloodstream infections caused by intrinsic contamination of
prefilled syringes of heparin and isotonic sodium chloride
solution.
Submission of 0920-18ACN is a
New Emergency ICR designed to collect information on the
undetermined cause of Serratia marcescens infections in multiple
States.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.