Nosocomial Transmission of Invasive Group A Streptococcus from Patient to Health Care Worker

Autor: Kim Horn, Mark D. Lacy
Rok vydání: 2009
Předmět:
Adult
DNA
Bacterial
Male
Microbiology (medical)
medicine.medical_specialty
Infectious Disease Transmission
Patient-to-Professional
Genotype
Isolation (health care)
Streptococcus pyogenes
Health Personnel
medicine.medical_treatment
Fulminant
Respiratory therapist
Necrotising fasciitis
medicine.disease_cause
Occupational Exposure
Streptococcal Infections
Internal medicine
Pneumonia
Bacterial
medicine
Cluster Analysis
Humans
Fasciitis
Necrotizing
Intensive care medicine
Antigens
Bacterial
Cross Infection
Molecular Epidemiology
business.industry
Streptococcus
Toxic shock syndrome
Middle Aged
medicine.disease
DNA Fingerprinting
Shock
Septic
Bacterial Typing Techniques
Electrophoresis
Gel
Pulsed-Field
Transmission-based precautions
Pneumonia
Infectious Diseases
Female
Carrier Proteins
business
Bacterial Outer Membrane Proteins
Zdroj: Clinical Infectious Diseases. 49:354-357
ISSN: 1537-6591
1058-4838
DOI: 10.1086/599832
Popis: Background. Nosocomial transmission of group A streptococcus (GAS) has been well described. Instances resulting in fulminant disease among health care workers have not been described. Contact and droplet precautions have been advised to minimize the risk of nosocomial transmission. We aimed to determine whether a case of invasive GAS pneumonia and streptococcal toxic shock syndrome in a respiratory therapist was acquired as a result of caring for a patient with GAS necrotizing fasciitis. Contacts of these patients were screened to determine if they were the reservoir of the GAS. Genetic testing to confirm clonal transmission was conducted. Methods. Contacts of the patients with GAS infection were screened using questionnaires and testing of pharyngeal specimens. Specimens from patients and carriers of GAS who were identified during screening were subjected to pulsed-field gel electrophoresis and emm gene typing. Results. We identified 705 contacts of the 2 patients; all contacts had oropharyngeal specimens collected for culture. Only the index patient and the respiratory therapist yielded identical pulse-field gel electrophoresis GAS isolates, with clonality indicated by emm typing. Conclusions. Nosocomial transmission of GAS from a patient to a health care worker who developed streptococcal toxic shock syndrome may have occurred after the index patient had received 48 h of antibiotic therapy and despite placement in contact isolation. Isolation guidelines for patients with severe GAS infection may need to be reviewed.
Databáze: OpenAIRE
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