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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Outbreak of Invasive Group A Streptococcal Infections in a Nursing Home: Lessons on Prevention and Control
Archives of Internal Medicine, Volume 152, No. 5, Year 1992
Notification
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Description
Objective.—Nine outbreaks of group A streptococcal (GAS) infections in nursing homes were reported to the Centers for Disease Control (Atlanta, Ga) during the past two winters. We conducted an intensive epidemiologic and laboratory investigation of one of these outbreaks to determine clinical characteristics, risk factors for transmission and infection, and methods of control and prevention. Methods.—Cases were detected using cultures and serologic tests. Matched case-control and retrospective cohort studies were performed to determine risk factors for infection. Results.—Between December 13, 1989, and January 31, 1990,16 (20%) of 80 residents, and three (7%) of 45 staff, were infected with GAS. Eleven of the residents had invasive disease and four died. Isolates were available from four persons; all were serotype M-1, T-1. There was strong spatial clustering of cases within the nursing home; having a roommate with prior infection was the most important risk factor. Residents with preexisting decubiti had a reduced risk of infection, perhaps because of stricter infection control practices in their care. No evidence was found for common-source transmission of infection. No further cases occurred after improvement of infection control practices and administration of prophylactic antimicrobials to all residents and staff. Conclusions.—Invasive GAS disease is increasing nationwide, and is a potentially serious problem in the growing and high-risk setting of nursing homes. These data suggest that, in this outbreak, a virulent GAS strain was introduced, with subsequent person-to-person transmission. Adherence to infection control practices can prevent or control GAS outbreaks. Prophylactic antimicrobials may be an effective adjunct to control severe or ongoing outbreaks. © 1992, American Medical Association. All rights reserved.
Authors & Co-Authors
Schwartz, Benjamin J.
United States, Atlanta
National Center for Infectious Diseases
Adimora, Adaora A.
United States, Rockville
Us Public Health Service
Breiman, Robert F.
United States, Atlanta
National Center for Infectious Diseases
Jarvis, William Robert
United States, Atlanta
National Center for Infectious Diseases
Statistics
Citations: 69
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.1001/archinte.1992.00400170099019
ISSN:
00039926
Study Design
Cohort Study
Case-Control Study