Group A Streptococcus Toxic Shock Syndrome: An outbreak report and review of the literature

Abstract

Group A Streptococcal (GAS) Toxic Shock Syndrome (TSS) is an acute, rapidly progressive, and often fatal illness. Outbreaks can occur in hospitals. However, early infection control measures may interrupt transmissions and prevent morbidity and mortality. Two cases of invasive GAS TSS were diagnosed within 48h after two uncomplicated laparoscopic surgeries that were performed in the same operating room of a women's hospital. Investigations conducted by the infection prevention and control department of the hospital identified 46 obstetrical staff members who were involved in the surgeries and/or had contact with either of the patients. All of the staff members were interviewed regarding any recent history of upper respiratory tract infections, the presence of skin lesions and vaginal or rectal symptoms. Throat, rectal, and vaginal cultures were obtained two times from all of the involved staff members. Throat colonization with GAS was detected in the cultures from one obstetrical intern who attended the 1st surgery and from one nurse who had formerly worked in the postnatal ward. These two strains were epidemiologically different from each other and from the outbreak strain. Both carriers were suspended from direct patient care and were treated with a ten-day course of oral clindamycin. The success of their decolonization status was assessed at the end of therapy and at three, six, nine and twelve months thereafter before reassigning them to routine work. Unfortunately, in spite of the extensive investigation of all involved personnel and of the environment, the mode of transmission to the second patient could not be established. However, droplet or airborne transmission could not be ruled out. Early and meticulous implementation of infection control measures was crucial and instrumental in the successful management and control of this outbreak. Furthermore, there were no subsequent GAS cases detected during the 24 months following the outbreak.

Toxic Shock Syndrome after Surgery: Case Presentation and Systematic Review of the Literature

“…Two papers describe TSS in patients following the removal of skin lesions. 8 , 9 Suction-assisted lipectomy, 10 , 11 pilonidal cyst excision, 12 , 13 surgical biopsy, 13 , 14 arthroscopy, 15 and elective tubal ligation 16 represent just some of the procedures in our review. Furthermore, our review of the literature demonstrates that patients affected by postoperative TSS are often young and in otherwise good health.…”

Life‐threatening necrotizing myometritis, due to Group A streptococcus – still a life‐threatening condition

“…Since 1980, only small epidemics were reported 6. During the past decade, a more virulent and aggressive group of GAS has been seen and has now posed a global public health problem.…”

“…As sterile techniques and antibiotic treatment became standard, the morbidity and mortality from streptococcal puerperal infections declined. Since 1980, only small epidemics were reported [6]. During the past decade, a more virulent and aggressive group of GAS has been seen and has now posed a global public health problem.…”

Necrotizing fasciitis after Caesarean section. Can this complication be avoided?

“…Objawy ogólne są konsekwencją procesu toksycznego i posocznicy. Zaburzenia świadomości korelują z ciężkością procesu chorobowego, w który jest zaangażowanych wiele narządów [20]. Obrzęk tkanek poprzez zmniejszenie objętości łożyska naczyniowego sprzyja zagęszczeniu krwi.…”