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A report on the first outbreak of emm89 group A streptococcus invasive infections in a burns unit in Tunisia

Basma Mnif1, Nesrine Sallem1, Zied Triki2

  • 1Laboratory of Microbiology, Research Laboratory for Microorganisms and Human Disease, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Journal of Medical Microbiology
|September 5, 2019
PubMed

Insights

A nurse transmitted an invasive group A streptococcus (GAS) emm89 clone in a burn unit. Eradication treatment of the nurse controlled the outbreak, highlighting the emm89 clone

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Group A Streptococcus (GAS) can cause severe invasive infections.
  • Burn units are susceptible to healthcare-associated infections.
  • The emergence of specific GAS clones can lead to outbreaks.

Purpose of the Study:

  • To investigate a cluster of GAS bacteraemia cases in a burn unit.
  • To identify the source and transmission dynamics of the GAS outbreak.
  • To characterize the emm type and genetic relatedness of the outbreak strains.

Main Methods:

  • Epidemiological investigation including patient and staff contact tracing.
  • Microbiological characterization of GAS isolates using emm typing and pulsed-field gel electrophoresis (PFGE).
  • Identification of GAS carriage in healthcare workers.

Main Results:

  • Four cases of GAS bacteraemia occurred within two weeks in a burn unit.
  • Patient isolates were identified as emm89 and genetically related to strains isolated later.
  • A nurse carrying the outbreak strain was identified as the likely source of transmission.
  • The outbreak involved six patients in total.

Conclusions:

  • The emm89 GAS clone has the potential to cause invasive outbreaks in healthcare settings.
  • Healthcare workers can act as reservoirs for GAS transmission.
  • Prompt identification and intervention, such as eradication therapy, are crucial for outbreak control.
Keywords:
Group A Streptococcusemm89invasive infectionsoutbreak

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