- 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.
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- The bacterium is commonly found on the
skin or in the throat, and may cause no illness or only mild illness.
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- 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.
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- 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.
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- 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.
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- 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.
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- 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.
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- In a second outbreak in California, two
patients died and a third nearly died after a surgical wound became infected
with group A streptococcus.
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- 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.
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- 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.
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- 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.
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- "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."
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- The health officials also recommend that
people with infected wounds, especially those with fever, seek medical
care.
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