• Tracy M Macdonald, Joanne M Langley, Tim Mailman, Kimberley Allain, George Nelson, Lydia Hatton, Timothy Sanford, Ken George, David Hancock, Dora Stinson, and Michael R Mulvey.
• Department of Infection Prevention and Control Services, IWK Health Center, Halifax, Canada.
• Pediatr Crit Care Me. 2011 Nov 1;12(6):e282-6.

ObjectiveTo interrupt transmission of Serratia marcescens colonization in a neonatal intensive care unit and determine the source of ongoing transmission.DesignMultidisciplinary outbreak investigation and simulation of droplet generation by a high-frequency oscillator using fluorescent dye.SettingLevel III neonatal intensive care unit.PatientsVery low birth weight premature infants with respiratory failure.InterventionsInfection control interventions, pulsed-field gel electrophoresis of isolates to determine relatedness, and construction of a scavenging system to capture the circuitry condensate expelled by the oscillator exit port.Measurements And Main ResultsAffected infants were housed in the same geographic site. Serratia marcescens isolates were indistinguishable or closely related using pulsed-field gel electrophoresis. Fluorescent droplet splatter from the circuitry, generated when no containment device covered the exit valve, was visible up to 49 in (107.8 cm) from the source.ConclusionsImplementation and adherence to infection control measures is essential to prevent transmission of opportunistic pathogens among ventilated infants. Oscillators can generate droplets that travel farther than 1 m from the source.

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