title: Outbreak of infections caused by Group A Streptococcus after modified radical mastectomy.
abstract: BACKGROUND
  Eight infections occurred after modified radical mastectomies in a tertiary-care hospital. Group A streptococci (GAS) were isolated from three of the eight patients.
  
  
  METHODS
  To control the outbreak, an epidemiologic investigation was conducted, and healthcare workers were screened for pathogens. Strains isolated from healthcare workers were compared with patient strains by emm typing.
  
  
  RESULTS
  One surgeon attended one of the eight operations and observed the other seven. Streptococcus strains from the hands of this surgeon were identical to the patient strains. After the surgeon was suspended from duty and underwent eradication treatment, the outbreak was controlled.
  
  
  CONCLUSIONS
  This outbreak of GAS infection is believed to have occurred by airborne transmission. Suspending patient care by healthcare workers who carry the causative GAS in a site(s) other than the respiratory tract for only the first 24 h they are receiving chemoprophylaxis may not be long enough. Sampling of the hands of healthcare workers during an investigation of nosocomial GAS infection is valuable.
authors.affiliation: Infectious Disease Office, Qingdao University, Qingdao City, Shandong Province, China, 26003. chenqingzeng2002@yahoo.com
authors.forename: Chen
authors.initials: C
authors.lastname: Qing-Zeng
authors.forename: Sun
authors.initials: S
authors.lastname: Yun-Bo
authors.forename: Liu
authors.initials: L
authors.lastname: Shi-Hai
authors.forename: Lun
authors.initials: L
authors.lastname: Li-Min
authors.forename: Ren
authors.initials: R
authors.lastname: Li-Juan
authors.forename: Sun
authors.initials: S
authors.lastname: Ying-Juan
authors.forename: Pan
authors.initials: P
authors.lastname: Pi-Chun
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D017757:Infectious Disease Transmission, Professional-to-Patient; D015411:Mastectomy, Modified Radical / Q000009:adverse effects / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D013297:Streptococcus pyogenes / Q000302:isolation & purification*