Health Care Workers May
Spread 'Flesh-Eating' Bacteria
By Alex Kirby
Environment Correspondent
BBC News
NEW YORK - In rare cases, outbreaks of potentially life-threatening group A streptococcal infections - the "flesh-eating" bacteria that is also the cause of strep throat - can be traced to healthcare workers who act as silent carriers of infection, according to a report from the Centers for Disease Control and Prevention.
The bacterium is commonly found on the skin or in the throat, and may cause no illness or only mild illness.
If introduced into the blood or a wound, however, these bacteria can cause necrotizing fasciitis, which features destruction of fat and muscle (hence the name "flesh-eating"), or cause streptococcal toxic shock syndrome, which injures internal organs, such as the kidneys, liver, and lungs.
CDC figures show that between 500 and 1,500 cases of necrotizing fasciitis and 2,000 to 3,000 cases of streptococcal toxic shock syndrome occur each year in the US. About 20% of the necrotizing fasciitis patients and 60% of those with the shock syndrome die.
According to the report released Thursday, nine women came down with group A streptococcal infections after giving birth at a single hospital in Maryland between July 1996 and August 1997.
Some women developed infections of the endometrium (uterine lining), two developed blood-borne infections, one a urinary tract infection, and one an infection of a cesarean section wound. None of the women died, although one was admitted to the intensive care unit with dangerously low blood pressure.
One healthcare worker was determined to be the most likely carrier of the strep A bacteria. After testing of samples from the throat, rectum, vagina, and skin of 198 hospital employees, the suspected individual was indeed found to be a carrier of identical bacteria to that infecting one of the patients.
In a second outbreak in California, two patients died and a third nearly died after a surgical wound became infected with group A streptococcus.
One surgeon was found to have been in contact with all three patients, but it was not clear if the surgeon was carrying group A streptococcus. As a precaution, two surgeons took 10 days of antibiotics before being allowed to return to the operating room.
Surgical patients and new mothers are particularly vulnerable to group A streptococcal infections, according to the CDC report in the March 5th issue of the Morbidity and Mortality Weekly Report.
To prevent such outbreaks, healthcare workers should be tested for strep A if any patient comes down with such an infection after surgery or giving birth, CDC officials advise.
"The spread of all types of group A streptococcus infections may be reduced by good handwashing, especially after coughing and sneezing, before preparing foods and before eating," write CDC officials. "Persons with sore throats should be seen by a doctor who can perform tests to find out whether it is 'strep throat'; if so, the person should stay home from work, school, or day care until 24 hours or more after taking an antibiotic."
The health officials also recommend that people with infected wounds, especially those with fever, seek medical care.