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An outbreak of Streptococcus pyogenes surgical site infections in a cardiovascular surgery department

Yasemin Tezer Tekçe1, Ayşe Erbay, Özlem Ünaldı

  • 11 Department of Infectious Diseases and Clinical Microbiology, Türkiye Yüksek İhtisas Education and Research Hospital , Ankara, Turkey .

Surgical Infections
|June 5, 2014
PubMed
Abstract

Insights

A Streptococcus pyogenes outbreak caused surgical site infections in cardiovascular surgery patients. Inadequate hand hygiene and cross-contamination were likely causes, though the exact source remained unidentified.

Area of Science:

  • Infectious Disease Epidemiology
  • Microbiology
  • Public Health

Background:

  • An outbreak of surgical site infections (SSIs) occurred in a cardiovascular surgery department.
  • The infections were caused by genetically related strains of Streptococcus pyogenes.

Purpose of the Study:

  • To investigate an outbreak of Streptococcus pyogenes-related surgical site infections.
  • To identify potential sources and contributing factors for the outbreak.

Main Methods:

  • Direct observation and staff interviews were conducted by an infection control team.
  • Surveillance sampling of patients, healthcare workers, and the environment was performed.
  • Pulsed-field gel electrophoresis (PFGE) was used for molecular typing of Streptococcus pyogenes isolates.

Main Results:

  • Four patients developed SSIs due to Streptococcus pyogenes following cardiovascular surgery.
  • PFGE analysis confirmed that all S. pyogenes isolates were of the same genetic strain.

Conclusions:

  • While a definitive source was not identified, poor adherence to hand hygiene during surgical dressing was suspected.
  • Contamination and cross-contamination were identified as probable factors contributing to the outbreak.

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