Minimum amount of penicillin prophylaxis required to control Streptococcus pyogenes epidemic in closed community

Clustering of group A streptococcal infections on a burns unit: important lessons in outbreak management

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.

An outbreak of group A streptococcal bacteremia in an intensive care unit

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.