Microbiological investigation of a hospital outbreak of invasive group A streptococcal disease in Krakow, Poland

• Published in: Clinical microbiology and infection Vol. 16; no. 9; pp. 1442 - 1447
• Main Authors: Strus, M., Drzewiecki, A., Chmielarczyk, A., Tomusiak, A., Romanek, P., Kosowski, K., Kochan, P., van der Linden, M., Lütticken, R., Heczko, P.B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01-09-2010; Blackwell Publishing Ltd; Wiley-Blackwell; Elsevier Limited
• Subjects: Antigens, Bacterial - genetics; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Bacterial Outer Membrane Proteins - genetics; Bacterial Typing Techniques; Biological and medical sciences; C-section; Carrier Proteins - genetics; Carrier State - epidemiology; Carrier State - microbiology; Cluster Analysis; Cross Infection - epidemiology; Cross Infection - microbiology; Disease Outbreaks; Disease transmission; Female; FISH; Fluorescence in situ hybridization; General aspects; Genotype; group A streptococcus; Hospitals; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; In Situ Hybridization, Fluorescence; Infection; Infectious diseases; invasive infections; Medical personnel; Medical sciences; Molecular Typing; necrotizing fasciitis; Poland - epidemiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcus pyogenes; Streptococcus pyogenes - classification; Streptococcus pyogenes - genetics; Streptococcus pyogenes - isolation & purification; Superantigens; Surgery; Poland; Europe; C-section; necrotizing fasciitis; FISH; group A streptococcus; Streptococcus pyogenes; invasive infections; surgery; Connective tissue disease; Nosocomial infection; Skin disease; Infection; Streptococcaceae; Microbiological investigation; Treatment; Surgery; Necrotizing fasciitis; Streptococcal infection; Streptococcus A; Bacteriosis; Bacteria; Micrococcales
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/j.1469-0691.2010.03139.x

The present study reports the epidemiological investigations undertaken in one of Krakow’s city hospitals regarding the source of infection and the routes of transmission of a group A streptococcus (Streptococcus pyogenes), using fluorescent in situ hybridization as a rapid method for detecting S. pyogenes carriage in the medical personnel involved. Four patients from the gynaecology department and two patients from the surgery department presented with clinical signs of infection. Characteristics of the S. pyogenes strains isolated from patients and from one medical staff member, including the emm gene and superantigens encoding genes, are described. All patients (four confirmed and two probable cases) survived; the operating theatre aid was identified as an S. pyogenes carrier and the source of the infections.