A foodborne outbreak of a group A streptococcal infection in a Japanese university hospital.
We describe an outbreak of foodborne tonsillopharyngitis caused by group A streptococcus (GAS), a rarely reported event that occurred during a campus orientation meeting in Japan. Of 461 students and staff members who had eaten boxed lunches during a meeting at Kitasato University, 298 developed sore throat and/or fever, and 285 underwent medical examination. Amoxicillin was prescribed when throat culture specimens yielded GAS. The attack rate was 64.6%. T-25 GAS was isolated from 150 examined persons. Of 65 patients who received amoxicillin for 3 days, GAS was eradicated before the first follow-up throat culture in 46 (70.8%) cases. Susceptibility was demonstrated to penicillins, cephalosporins, and macrolides in 86 GAS isolates obtained more than once from a given patient. GAS strains isolated at various time points were indistinguishable by pulsed-field gel electrophoresis (PFGE), and prtF1 was present. GAS strains were often difficult to eradicate because of a short initial treatment period, patient compliance problems, and the presence of prtF1.
Takayama
Y
Y
Department of Laboratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. yoko@med.kitasato-u.ac.jp
Hikawa
S
S
Okada
J
J
Sunakawa
K
K
Akahoshi
T
T
D018829:Adhesins, Bacterial / Q000235:genetics; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D010612:Pharyngitis / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D014069:Tonsillitis / Q000453:epidemiology / Q000382:microbiology
D018829:Adhesins, Bacterial; D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; C078635:fibronectin-binding proteins, bacterial; D000658:Amoxicillin