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Abstract

Initially identified as a low-virulence opportunistic bacterium, Serratia marcescens has emerged as a significant pathogen, particularly in high-risk settings. Increasing reports of multidrug-resistant (MDR) and carbapenem-resistant (CR) isolates emphasise its role in healthcare-associated infections. Outbreaks have been documented, often linked to invasive devices, contaminated solutions, and lapses in infection prevention and control (IPC). While data from Southeast Asia remains limited, evidence suggests an upward trend. This narrative review summarises developments in S.marcescens resistance and therapeutic options. A PRISMA-informed search was conducted in ScienceDirect, PubMed and Google Scholar for English-language articles published between 2019 and 2025. Eligible studies included original research, surveillance reports, and case reports. Data were synthesised qualitatively. Published literature describes a global rise in resistant isolates. S.marcescens demonstrates intrinsic resistance to colistin, ampicillin, and first-generation cephalosporins, while also harbouring inducible AmpC β-lactamase. Acquisition of extended-spectrum β-lactamases (ESBLs) and carbapenemases further limits therapeutic options. Ceftazidime-avibactam (CZA) alone or in combination with aztreonam demonstrates efficacy against KPC-producing strains and metallo-β-lactamase producers. Cefiderocol, despite limited availability, has shown promising activity. In conclusion, the rising resistance of S.marcescens underscores the need for strengthened microbiological surveillance and antimicrobial stewardship. Future research should prioritise local resistance mechanisms and the optimisation of therapeutic strategies.

Keywords

Serratia marcescens Antimicrobial Resistance Carbapenem-resistant Therapeutic Options

Article Details

References

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