Outbreak of group A Streptococcus infections in an outpatient wound clinic—Colorado, 2014

A Review of Streptococcus pyogenes: Public Health Risk Factors, Prevention and Control

“…Prevention and control measures/strategies Early/improved diagnosis and treatment [15,19,69,[79][80][81][82][83][84][85][86][87] Infection control in hospitals/aged care settings [31,32,39,42,[88][89][90][91][92][93] Epidemiological investigations/improved surveillance systems [94][95][96][97][98][99] Improved quality of housing [15,20] Health education for healthcare providers and patients/community [15,45,85,[100][101][102][103][104] Screening of healthcare workers, asymptomatic cases and post-exposure prophylaxis for vulnerable groups [32] Hand hygiene [15,42] Avoid overcrowding [15] Reduced malnutrition and HIV infection [17] Improved GAS detection methods [105,106] Capacity building of healthcare workers [29] Suggested future preventio...…”

“…Other factors identified as promoting the spread of GAS infections, especially in hospitals and care homes, included poor infection control practices resulting in cross-infection by healthcare workers, other patients or residents, and the cross-contamination of hospital equipment and devices [31,32,39,[88][89][90][91][92][93]. Poor personal and hand hygiene [15,42] and exposure to asymptomatic persons [77] were also highlighted as risk factors for GAS infections.…”

“…Several studies have suggested that early diagnosis and treatment is an effective way to prevent and control iGAS infections and complications from mild infections [15,19,69,[79][80][81][82][83][84][85][86][87]. In hospitals and care facilities, effective infection control procedures were identified as being crucial for the prevention of GAS infections [31,32,39,[88][89][90][91][92][93]. This could also include the screening of asymptomatic cases, including healthcare workers, and the post-exposure prophylaxis of vulnerable groups [32].…”

“…Appropriate infection control practice was also identified as critical to preventing GAS infections in hospital and healthcare settings. This includes the proper use of personal protective equipment, aseptic management of wounds and proper disposal of medical waste [31,32,39,[88][89][90][91][92][93]. Patients or residents infected with GAS in hospitals or care homes should also be isolated as a prevention measure to stop further GAS transmission [93,104].…”

Outpatient Infection Prevention: A Practical Primer

“…In fact, ambulatory clinics are an extension of hospitals in the continuum of care as patients are typically managed in the outpatient setting, including pre-admission and after discharge. A potential downfall of perceiving the clinic environment as safer than the hospital is illustrated by an outbreak of group A Streptococcus among patients in an outpatient clinic due to ignoring numerous infection prevention practices [ 12 ]. The clinic was noted to have lapses in disinfection of multi-use items between patients, glove use, hand hygiene, and in implementing contact precautions.…”