Description of the epidemiology of multiple clusters of Streptococcus pyogenes infection in a rehabilitation hospital
Abstract number: p899
Dave J., Bell J., Fraser C., Venkatesh H., Olson E., Emery M., Efstratiou A.
Description of the epidemiology and management of multiple clusters of Streptococcus pyogenes in a rehabilitation hospital
Multiple clusters of infected and colonised patients with Streptococcus pyogenes including one staff were identified on two wards over six months. In February a cluster of five patients and a member of staff were identified with Streptococcus pyogenes isolated from hand lesion, ear and eye swabs and wounds. The ward was closed, deep cleaned, appropriate antibiotic treatment administered and symptomatic staff were screened. Subsequently two further patients with the organism were identified on the same ward despite implementing an education programme and reinforcing standard infection control measures. A further cluster of three patients was identified on another ward in May. One of these patients continued to be positive for the organism when a third cluster of five patients was identified two months later.
The wards were closed, patients isolated or cohorted, screening throat and skin lesion swabs were obtained from staff and patients, environmental cleaning implemented and standard infection control precautions and education was reinforced. The strains were typed and the three major types detected were emm1, emm87 and emm28. These also reflected the major types found in the local community. The strains isolated from patients differed from the staff member. All strains from one ward had the emm28 type whilst the other ward had emm87 type, suggesting spread within the same ward but not between the two wards. In two patients, the organism was isolated despite at least 48 hours of previous penicillin treatment.
Control of the incident required communication of all stakeholders including infection control, public health, ward staff and managers. Characterisation of the strains confirmed the epidemiology of these infections. Azithromycin was successful in eradicating Streptococcus pyogenes especially in the patients with persistent infection despite penicillin therapy.
|Session name:||XXIst ISTH Congress|
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