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Clustering of group A streptococcal infections on a burns unit: important lessons in outbreak management
1Department of Microbiology, Whiston Hospital, Prescot, Merseyside, UK.
Insights
A Streptococcus pyogenes (Group A streptococcus) outbreak infected 37 patients and 4 staff on a burns unit. Strict infection control measures, including screening and prophylactic antibiotics, were implemented to manage the outbreak.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Streptococcus pyogenes (Group A streptococcus) poses a significant risk in healthcare settings, particularly in vulnerable populations like burn patients.
- Nosocomial infections can lead to severe complications, including sepsis and mortality.
Purpose of the Study:
- To investigate an outbreak of Streptococcus pyogenes on a specialized burns unit.
- To identify the sources and transmission dynamics of the infection.
- To evaluate the effectiveness of implemented infection control strategies.
Main Methods:
- Retrospective analysis of infection data over a 12-month period.
- Microbiological screening of patients, staff, and the environment.
- Serotyping of Streptococcus pyogenes isolates to identify distinct clusters.
- Implementation and review of infection control measures, including isolation and prophylactic antibiotics.
Main Results:
- 37 patients and 4 staff members were infected or colonized by Streptococcus pyogenes.
- One patient developed fatal sepsis.
- Serotyping identified five distinct clusters of infection, indicating multiple transmission events.
- Implemented infection control measures aimed to curb further spread.
Conclusions:
- Staff and patient carriers, along with the environment, played a role in the persistent transmission of Streptococcus pyogenes.
- Serotyping is a crucial tool for understanding outbreak epidemiology and guiding control measures.
- Effective infection control protocols are essential in preventing and managing streptococcal outbreaks in high-risk units.
Abstract:
In a 12-month period 37 patients and four members of staff on a burns unit were infected or colonized by Streptococcus pyogenes (Group A streptococcus). One patient became septicaemic and died. Serotyping revealed five distinct clusters against a low background level of infection. Infection control measures included isolation, screening of patients, staff and environment and the use of prophylactic antibiotics for uninfected patients. We discuss the role of staff and patient carriers and the environment as a continuing source of infection, and the importance of serotyping in outbreak epidemiology.