Successive outbreaks of Group A streptococcus (GAS) in care of the elderly settings; lessons learned

2011 ◽  
Vol 13 (2) ◽  
pp. 38-43 ◽  
Author(s):  
T Inkster ◽  
P Wright ◽  
H Kane ◽  
E Paterson ◽  
S Dodd ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Infection Control ◽  
Healthcare Workers ◽  
Group A Streptococcus ◽  
The Elderly ◽  
Rapid Identification ◽  
Lessons Learned ◽  
Control Measures ◽  
Infection Control Measures ◽  
Group A

Group A streptococcal (GAS) outbreaks in care of the elderly settings are rare. We describe two successive outbreaks involving care of the elderly patients. The first outbreak involved 18 patients and the second involved six patients and two healthcare workers. We describe the difficulties encountered controlling GAS outbreaks in care of the elderly settings and how the lessons learned from the first outbreak influenced management of the second incident. Stringent infection control measures including isolation until completion of treatment and re-screening for evidence of eradication were required to bring outbreak one under control. These measures were adopted early in outbreak two and we suspect that these measures and the rapid identification of carriers brought this second outbreak under control quickly.

Nursing Home Outbreak of Invasive Group A Streptococcal Infections Caused by 2 Distinct Strains

2007 ◽  
Vol 28 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Michael C. Thigpen ◽  
D. Michael Thomas ◽  
David Gloss ◽  
Sarah Y. Park ◽  
Amy J. Khan ◽  
...  
Keyword(s):  
Nursing Home ◽  
Infection Control ◽  
Group A Streptococcus ◽  
Respiratory Illness ◽  
Control Measures ◽  
Unknown Etiology ◽  
Susceptible Population ◽  
Invasive Group ◽  
Infection Control Measures ◽  
Group A

Objective.To identify factors contributing to a cluster of deaths from invasive group A streptococcus (GAS) infection in a nursing home facility and to prevent additional cases.Design.Outbreak investigation.Setting.A 146-bed nursing home facility in northern Nevada.Methods.We defined a case as the isolation of GAS from a normally sterile site in a resident of nursing home A. To identify case patients, we reviewed resident records from nursing home A, the local hospital, and the hospital laboratory. We obtained oropharyngeal and skin lesion swabs from staff and residents to assess GAS colonization and performed emm typing on available isolates. To identify potential risk factors for transmission, we performed a cohort study and investigated concurrent illness among residents and surveyed staff regarding infection control practices.Results.Six residents met the case patient definition; 3 (50%) of them died. Among invasive GAS isolates available for analysis, 2 distinct strains were identified: emm11 (3 isolates) and emm89 (2 isolates). The rate of GAS carriage was 6% among residents and 4% among staff; carriage isolates were emm89 (8 isolates), emm11 (2 isolates), and emm1 (1 isolate). Concurrently, 35 (24%) of the residents developed a respiratory illness of unknown etiology; 41% of these persons died. Twenty-one (30%) of the surveyed employees did not always wash their hands before patient contacts, and 27 (38%) did not always wash their hands between patient contacts.Conclusions.Concurrent respiratory illness likely contributed to an outbreak of invasive GAS infection from 2 strains in a highly susceptible population. This outbreak highlights the importance of appropriate infection control measures, including respiratory hygiene practices, in nursing home facilities.

scholarly journals Group A Streptococcal Endometritis: Report of an Outbreak and Review of the Literature

1994 ◽  
Vol 5 (6) ◽  
pp. 276-281 ◽  
Author(s):  
Ziad A Memish ◽  
Denise Gravel-Tropper ◽  
Catherine Oxley ◽  
Baldwin Toye ◽  
Gary E Garber
Keyword(s):  
Infection Control ◽  
Group A Streptococcus ◽  
Invasive Procedure ◽  
Restriction Endonuclease Analysis ◽  
Skin Lesions ◽  
Control Measures ◽  
Direct Patient Care ◽  
Infection Control Measures ◽  
History Of ◽  
Group A

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 forgasfrom 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 ofgasat 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 ofgasoccurring in the subsequent year.

scholarly journals Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned

2019 ◽  
Vol 41 ◽  
pp. e2019033
Author(s):  
Zayid K. Al Mayahi ◽  
Nasser Al-Shaqsi ◽  
Hamid A. Elmutashi ◽  
Ali Al-Dhoyani ◽  
Azza Al Hattali ◽  
...  
Keyword(s):  
Infection Control ◽  
Low Income ◽  
Lessons Learned ◽  
Control Measures ◽  
Care Level ◽  
Middle Income ◽  
Primary Care Level ◽  
Middle Income Countries ◽  
Infection Control Measures ◽  
Detection Point

Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.

scholarly journals Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e76272 ◽  
Author(s):  
Mareli M. Claassens ◽  
Cari van Schalkwyk ◽  
Elizabeth du Toit ◽  
Eline Roest ◽  
Carl J. Lombard ◽  
...  
Keyword(s):  
South Africa ◽  
Infection Control ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Control Measures ◽  
Healthcare Facilities ◽  
Infection Control Measures

scholarly journals COVID-19 Critical Care Simulations: An International Cross-sectional Survey

2020 ◽  
Author(s):  
Mohamad-Hani Temsah ◽  
Abdulkarim Alrabiaah ◽  
Ayman Al-Eyadhy ◽  
Fahad Al-Sohime ◽  
Abdullah Al Huzaimi ◽  
...  
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Primary Outcome ◽  
Control Measures ◽  
Team Leaders ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Transport ◽  
Infection Control Measures ◽  
Better Than

Abstract Background: Many healthcare systems initiated rapid training with COVID-19 simulations for their healthcare workers (HCWs) to build surge capacity and optimize infection control measures. This study aimed to describe COVID-19 simulation drills in international healthcare centers. Methods: This is a cross-sectional survey among simulation team leaders and HCWs, based on each center's debriefing reports from simulation centers from 30 countries in all WHO regions where COVID-19 simulation drills were conducted. The primary outcome measures were the COVID-19 simulations' characteristics, outcomes, facilitators, obstacles, and challenges encountered during the simulation sessions. Results: Invitation was sent to 500 simulation team leaders and HCWs, and 343 responded. Those who completed the study comprised 121 participants: 62.8% females; 56.2% physicians; 41.3% from East Mediterranean (EMRO) countries; 25.6% from Southeast Asian countries (SERO); and 12.4% from Europe. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30–60 minutes. The most commonly reported debriefing leaders were ICU staff, simulation lab staff, and E.R. facilitators, and the least common were infection control staff. A total of 80% reported "a lot" to "a great improvement" in terms of clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 simulation sessions and thought they were better than expected. Most of the perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues. Conclusion: Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions. The presence of multiprofessional personnel during drills is warranted. These drills are a valuable tool for rehearsing safe dynamics of HCWs on the frontline of COVID-19.Trial registration: Not applicable.

scholarly journals Management of a Hospital-Wide COVID-19 Outbreak Affecting Patients and Healthcare Workers

2020 ◽  
Vol 2 (12) ◽  
pp. 2540-2545
Author(s):  
Steffen Höring ◽  
René Fussen ◽  
Johannes Neusser ◽  
Michael Kleines ◽  
Thea Laurentius ◽  
...  
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Spatial Separation ◽  
Control Measures ◽  
Medical Conditions ◽  
Hospital Workers ◽  
Infection Control Team ◽  
Healthcare Facilities ◽  
Infection Control Measures ◽  
Control Team

AbstractTo the best of our knowledge, here, we describe the first hospital-wide outbreak of SARS-CoV-2 that occurred in Germany in April 2020. We aim to share our experience in order to facilitate the management of nosocomial COVID-19 outbreaks in healthcare facilities. All patients and hospital workers were screened for SARS-CoV-2 repeatedly. An infection control team on the side was installed. Strict spatial separation of patients and intensified hygiene training of healthcare workers (HCW) were initiated. By the time of reporting, 26 patients and 21 hospital workers were infected with a cluster of cases in the geriatric department. Fourteen patients developed COVID-19 consistent symptoms and five patients with severe pre-existing medical conditions died. The outbreak was successfully contained after intensified infection control measures were implemented and no further cases among patients were detected over a period of 14 days. Strict application of standard infection control measures proved to be successful in the management of nosocomial SARS-CoV-2 outbreaks.

scholarly journals Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

2019 ◽  
Vol 53 (4) ◽  
pp. 1801789 ◽  
Author(s):  
Lika Apriani ◽  
Susan McAllister ◽  
Katrina Sharples ◽  
Bachti Alisjahbana ◽  
Rovina Ruslami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infection Control ◽  
Healthcare Workers ◽  
Latent Tuberculosis ◽  
Annual Incidence ◽  
Control Measures ◽  
Middle Income ◽  
Middle Income Countries ◽  
Infection Control Measures ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of latent tuberculosis (TB) infection (LTBI) and TB disease.We conducted an updated systematic review of the prevalence and incidence of LTBI in HCWs in low- and middle-income countries (LMICs), associated factors, and infection control practices. We searched MEDLINE, Embase and Web of Science (January 1, 2005–June 20, 2017) for studies published in any language. We obtained pooled estimates using random effects methods and investigated heterogeneity using meta-regression.85 studies (32 630 subjects) were included from 26 LMICs. Prevalence of a positive tuberculin skin test (TST) was 14–98% (mean 49%); prevalence of a positive interferon-γ release assay (IGRA) was 9–86% (mean 39%). Countries with TB incidence ≥300 per 100 000 had the highest prevalence (TST: pooled estimate 55%, 95% CI 41–69%; IGRA: pooled estimate 56%, 95% CI 39–73%). Annual incidence estimated from the TST was 1–38% (mean 17%); annual incidence estimated from the IGRA was 10–30% (mean 18%). The prevalence and incidence of a positive test was associated with years of work, work location, TB contact and job category. Only 15 studies reported on infection control measures in healthcare facilities, with limited implementation.HCWs in LMICs in high TB incidence settings remain at increased risk of acquiring LTBI. There is an urgent need for robust implementation of infection control measures.

A review of nosocomial norovirus outbreaks: infection control interventions found effective

2012 ◽  
Vol 140 (7) ◽  
pp. 1151-1160 ◽  
Author(s):  
J. D. GREIG ◽  
M. B. LEE
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Population Studies ◽  
Rapid Identification ◽  
Control Measures ◽  
Federal State ◽  
Environmental Cleaning ◽  
Modes Of Transmission ◽  
Infection Control Measures ◽  
Government Websites

SUMMARYThe purpose of this study was to review documented outbreaks of enteric illness associated with nosocomial norovirus infections and to identify modes of transmission, morbidity and mortality patterns, and recommendations for control. Searches of electronic databases, public health publications, and federal, state/provincial public health websites were completed for 1 January 2000 to 31 December 2010. Computer-aided searches of literature databases and systematic searches of government websites identified 54 relevant outbreak reports. Transmission routes included person-to-person (18·5%), foodborne (3·7%) and in the majority (77·8%) the route was unknown. Actions taken during the outbreak to control infection included restricting the movements of patients and staff (22·5%), enhanced environmental cleaning (13·6%) and hand hygiene (10·3%). Rapid identification of norovirus outbreaks in hospitals is vital for the immediate implementation of infection control measures and isolation of infected individuals in this mainly immunocompromised population. Studies that statistically evaluate infection control measures are needed.

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