Postoperative Streptococcal Wound Infection

Gryska, Paul F.

doi:10.1001/jama.1970.03170330069015

Cited by 38 publications

(7 citation statements)

References 5 publications

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“…Perhaps surprisingly, in most published accounts of hospital outbreaks, anal or vaginal carriers have been the source of infection [36][37][38][39][40][41][42][43][44]. Anal and vaginal swabs were not collected from theatre staff in this investigation.…”

Section: Discussionmentioning

confidence: 95%

A cluster of cases of streptococcal necrotizing fasciitis in Gloucestershire

et al. 1995

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SUMMARYWe describe the first cluster of cases of necrotizing fasciitis (NF) in this century in the United Kingdom (UK). Between 1 January and 30 June 1994 there were six cases (five confirmed, one probable) of Streptococcus pyogenes NF in west Gloucestershire, population 320000. Two cases died. The first two patients probably acquired their infections during the course of elective surgery performed in the same operating theatre, possibly from a nasopharyngeal carrier amongst the theatre staff. The remaining infections were community-acquired. Of 5 S. pyogenes isolates there were 2 MI strains, 1 M3, 1 M5 and 1 M non-typeable strain. S. pyogenes NF had not been recorded in west Gloucestershire in the preceding 10 years and the incidence of S. pyogenes bacteraemia in England and Wales had not risen in the past 5 years.The two presumably theatre-acquired infections raised several issues. The need for detailed bacteriological investigation of all cases of post-surgical NF was confirmed. Clusters of S. pyogene8 infection following surgery should be managed by closure of the operating theatre until all staff have been screened for carriage. Closure of an operating theatre and screening of staff following a sporadic case is probably not justified because of the infrequency of surgical cross-infection with S. pyogenes. Regular. routine screening of theatre staff is neither practical nor necessary.

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Section: Discussionmentioning

confidence: 95%

A cluster of cases of streptococcal necrotizing fasciitis in Gloucestershire

et al. 1995

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“…Multiple nosocomial outbreaks of group A ␤hemolytic streptococcus have been described ( Typically, personnel who served as the index case were asymptomatic. 35,37,[39][40][41]46,49,70,80 During outbreaks, active surveillance has revealed additional personnel colonized by the epidemic strain ( Table 2). Hospital personnel have developed clinical infections as secondary cases ( Table 2).…”

Section: Lessons From Nosocomial Outbreaksmentioning

confidence: 99%

“…The possibility of true airborne transmission has been suggested by several investigators. 33,36,40,41,47,50,52,54 Investigators have demonstrated that rectal or vaginal carriage by healthcare personnel can lead to airborne contamination when changing clothes or exercising. 35,40,41,52 Rectal or vaginal carriage also can lead to transient scalp contamination, which in turn may lead to contamination of wound sites during surger y.…”

Section: Lessons From Nosocomial Outbreaksmentioning

confidence: 99%

“…62,75,81 However, several investigators have failed to document environmental contamination. 35,37,41,51,58,68,73,88 One outbreak of nosocomial streptococcal infection was due to ingestion of contaminated food. 59 Nosocomial outbreaks of streptococcal infections also have been caused by group C, 90,91 and group G 92 streptococcus.…”

Section: Lessons From Nosocomial Outbreaksmentioning

confidence: 99%

“…†References 33,36,37,39,44,46,47,49,52,58,65,67,70,78. ‡References 36,37,[39][40][41]44,46,47,49,52,67,70,[78][79][80]86. November 1996…”

Section: Evaluation and Management Of Healthcare Workers With Pharyngmentioning

confidence: 99%

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Management of Healthcare Workers with Pharyngitis or Suspected Streptococcal Infections

Weber

Rutala²,

Denny³

1996

Infection Control and Hospital Epidemiology

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The group A streptococcus may cause pharyngitis, rheumatic fever, streptococcal toxic shock syndrome, and serious skin and soft-tissue infections. More than 50 nosocomial outbreaks have been reported since 1966. For this reason, healthcare facilities should develop policies for the diagnosis and treatment of symptomatic hospital employees, and for the recognition and management of potential outbreaks. The clinical diagnosis of streptococcal pharyngitis is unreliable. Rapid streptococcal tests may be used for initial screening, but a negative rapid test should be confirmed with a properly obtained culture. Penicillin remains the treatment of choice, but new alternatives now include a 5-day course of either azithromycin or cefpodoxime.

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The Airborne Component of Wound Contamination and Infection

Walter¹

1973

Arch Surg

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Postoperative Streptococcal Wound Infection

Cited by 38 publications

References 5 publications

A cluster of cases of streptococcal necrotizing fasciitis in Gloucestershire

A cluster of cases of streptococcal necrotizing fasciitis in Gloucestershire

Management of Healthcare Workers with Pharyngitis or Suspected Streptococcal Infections

The Airborne Component of Wound Contamination and Infection

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