title: Group A streptococcus: is there a genital carrier state in women following infection?
abstract: Group A streptococcus (GAS) is a rare but serious cause of postpartum and gynecological infections. There are no follow-up or prophylaxis guidelines for women with previous GAS genital infection. We aimed to evaluate the incidence of long-term gynecological carrier state in patients with a history of genital GAS infection. This is a prospective study of women who had a genital GAS infection and were followed for 1 year from the date of isolation. Cultures were obtained every 3-4 months. As a control group, women with no previously documented GAS infection were screened for GAS. Twenty-five women with a previous GAS infection participated in the study. Two of the 25 patients had positive vaginal GAS cultures during follow-up, giving a carrier rate of 8 %. Four hundred and thirty-six women participated in the control group; none was a carrier of GAS (p < 0.003). We found that common gynecological procedures were occasionally associated with invasive GAS infection. A significant rate of carriers was found among women with previous GAS genital infection. Common office procedures can be related to severe GAS infection. Consideration should be given to screening women with previous GAS infection prior to invasive as well as semi-invasive gynecological or obstetric procedures.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. levsagie@netvision.net.il.
authors.forename: A
authors.initials: A
authors.lastname: Lev-Sagie
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Hochner-Celnikier
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Stroumsa
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Khalaileh
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: H
authors.initials: H
authors.lastname: Daum
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: A E
authors.initials: AE
authors.lastname: Moses
mesh_terms: D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D049590:Postpartum Period; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D014621:Vagina / Q000382:microbiology*; D055815:Young Adult