Surgical Site Infection Caused by Serratia Marcescens Following Adult Spinal Deformity Surgery: A Case Report

Background: Surgical site infections (SSIs) are severe complications of spinal surgeries. Serratia marcescens, an increasingly recognized pathogen causing nosocomial infections, presents unique challenges in managing SSIs, particularly in spinal instrumentation cases. Case Presentation: A 68-year-old female with a history of osteoporosis developed a Serratia marcescens infection following staged adult spinal deformity (ASD) surgery. The infection persisted despite seven aggressive debridement procedures and systemic antibiotic therapies. In the final debridement, antibiotic-impregnated calcium phosphate bone cement paste (CPC) was applied to the surgical site to augment all the pedicle screws and infectious disc spaces. This approach helped successfully manage the infection without resorting to spinal implant removal. The patient has remained symptom-free for five years since this treatment. Conclusion: SSIs caused by Serratia marcescens present a significant challenge in ASD surgery. Antibiotic-impregnated CPC enabled sustained local antibiotic release, maintaining a high concentration in the long term and contributing to infection resolution without requiring implant removal.