title: An outbreak of group A Streptococcal infection among health care workers.
abstract: We describe the nosocomial transmission of group A Streptococcus species (GAS) from a single source patient to 24 health care workers (HCWs). DNA typing revealed that all of the isolates were identical to that of the source patient. The isolates were M type 1, positive for production of nicotine adenine dinucleotidase, and negative for opacity factor, all of which are factors reported to have a higher correlation with invasive disease. The 24 HCWs developed symptoms of pharyngitis < or =4 days after exposure to the source patient. Nosocomial transmission occurred < or =25 h after exposure to the source patient, before the institution of outbreak-control measures. A questionnaire was distributed to HCWs to help identify the factors responsible for the high attack rate among those who were exposed. Invasive GAS disease in a nosocomial setting can be highly transmissible. Rapid identification, early treatment, and adherence to infection-control practices may prevent or control outbreaks of infection.
authors.affiliation: Department of Hospital Epidemiology and Infection Control, University of California San Francisco Medical Center, San Francisco, CA 94117, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kakis
authors.forename: Laurel
authors.initials: L
authors.lastname: Gibbs
authors.forename: Jose
authors.initials: J
authors.lastname: Eguia
authors.forename: Joe
authors.initials: J
authors.lastname: Kimura
authors.forename: Diane
authors.initials: D
authors.lastname: Vogelei
authors.forename: Nancy
authors.initials: N
authors.lastname: Troup
authors.forename: Dennis
authors.initials: D
authors.lastname: Stevens
authors.forename: Edward L
authors.initials: EL
authors.lastname: Kaplan
authors.forename: Dwight R
authors.initials: DR
authors.lastname: Johnson
authors.forename: John E
authors.initials: JE
authors.lastname: Conte
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000235:genetics / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents