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Group C streptococcal surgical wound infections transmitted by an anorectal and nasal carrier
Abstract:
Streptococcus equisimilis (Lancefield group C), an unusual cause of nosocomial surgical infection, was isolated from two orthopedic postoperative wound infections. Both operations had been performed by the same surgeon within a three-day period. Examination of the surgeon revealed perianal dermatitis from which S. equisimilis was isolated. The organism was also recovered from the surgeon's nose and rectum. The wound infections responded to treatment with penicillin derivatives. The surgeon was successfully treated with topical bacitracin and oral penicillin and vancomycin. This report documents the pathogenicity of the C Streptococcus in postoperative infection and suggests a possible nosocomial source of the organism.
Insights
Streptococcus equisimilis caused rare surgical infections in two patients. The source was traced to a surgeon with dermatitis, highlighting a potential nosocomial transmission route.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Site Infections
Background:
- Nosocomial infections pose significant challenges in healthcare settings.
- Streptococcus equisimilis (Lancefield group C) is an uncommon pathogen in surgical site infections.
- Identifying the source of nosocomial pathogens is crucial for prevention.
Observation:
- Two patients developed orthopedic postoperative wound infections caused by Streptococcus equisimilis.
- Both surgical procedures were performed by the same surgeon within a short timeframe.
- The surgeon presented with perianal dermatitis from which Streptococcus equisimilis was isolated.
Findings:
- Streptococcus equisimilis was identified as the causative agent in both surgical wound infections.
- The organism was also found to colonize the surgeon's nose and rectum, indicating the surgeon as the likely reservoir.
- The wound infections and the surgeon's dermatitis responded to appropriate antibiotic treatments.
Implications:
- This case highlights Streptococcus equisimilis as a potential cause of nosocomial surgical infections.
- Healthcare providers, especially surgeons, should be screened for infections or colonization if outbreaks occur.
- Implementing strict hygiene protocols can prevent the transmission of pathogens like Streptococcus equisimilis in surgical settings.