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An outbreak of group A streptococcal bacteremia in an intensive care unit
Abstract:
Admission of a patient with group A streptococcal cellulitis and bacteremia to the intensive care unit of a tertiary care teaching hospital was followed by two subsequent cases of group A streptococcal bacteremia with pneumonia in the unit. All streptococcal isolates were the same M- and T-type. Endotracheal intubation with respiratory ventilation was a risk factor for disease acquisition. The characteristics of onset of the two nosocomially acquired cases suggested that a staff member may have been, at least transiently, a streptococcal carrier, but no such carrier was identified. No further cases occurred subsequent to a period when all patients in the unit received antibiotics effective for group A streptococcal therapy.
Insights
Group A Streptococcus can spread in intensive care units, posing a risk to intubated patients. Prompt antibiotic therapy can effectively prevent further nosocomial infections.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Group A Streptococcus (GAS) can cause severe invasive infections.
- Intensive care units (ICUs) are vulnerable settings for nosocomial pathogen transmission.
Observation:
- Three cases of GAS bacteremia, including pneumonia, occurred in an ICU within a short period.
- All isolates were identical M- and T-types, suggesting a common source.
- Endotracheal intubation and mechanical ventilation were identified as risk factors.
Findings:
- Nosocomial transmission of GAS occurred in the ICU.
- A transient carrier, possibly a staff member, was suspected but not identified.
- Widespread antibiotic administration effective against GAS halted further cases.
Implications:
- Highlights the potential for GAS outbreaks in ICUs, particularly among ventilated patients.
- Emphasizes the importance of vigilant infection control and prompt therapeutic interventions.
- Suggests considering targeted antibiotic prophylaxis in outbreak situations.