title: Group A streptococcal endometritis: Report of an outbreak and review of the literature.
abstract: Two cases of group A streptococcus (gas) postpartum endometritis were diagnosed within 24 h following uncomplicated vaginal delivery. Investigation by the infection control service identified all 10 obstetric personnel who performed any invasive procedure on both cases. These personnel were questioned about a recent history of sore throat, skin lesions, vaginal or rectal symptoms. Throat and rectal cultures were obtained for gas from all 10 personnel. A carrier was identified among the personnel screened. This nurse was removed from direct patient care and treated with a two-week course of oral clindamycin and rifampin with documentation of carrier eradication of gas at the end of therapy, 30 days, 60 days and six months post-treatment. All three isolated strains were identical by restriction endonuclease analysis and by M and T typing. Rapid implementation of infection control measures were successful in arresting this outbreak, with no further cases of gas occurring in the subsequent year.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Ottawa General Hospital and the University of Ottawa; Occupational Health and Safety and Infection Control, Ottawa General Hospital; and Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Memish
authors.forename: D
authors.initials: D
authors.lastname: Gravel-Tropper
authors.forename: C
authors.initials: C
authors.lastname: Oxley
authors.forename: B
authors.initials: B
authors.lastname: Toye
authors.forename: G E
authors.initials: GE
authors.lastname: Garber