Streptococcal toxic shock syndrome in two patients infected by a colonized surgeon
- PMID: 10885838
- DOI: 10.1007/s150100050024
Streptococcal toxic shock syndrome in two patients infected by a colonized surgeon
Abstract
The incidence of severe invasive infections caused by Streptococcus pyogenes, a group A streptococcus (GAS), has increased in the past 10 years. Most cases occur outside of the hospital setting. We report on two patients with nosocomial streptococcal toxic shock syndrome (StrepTSS). In patient 1 the syndrome was associated with the development of necrotizing fasciitis following inguinal hernia repair. Patient 2 suffered from StrepTSS shortly after receiving a tetanus vaccine in her left deltoid. Epidemiologic investigations of these cases, which were noted within 48 hours of each other, showed that the same surgeon performed the vaccination on patient 2 after assisting a colleague during the hernia repair procedure on patient 1. He was found to be a nasal carrier of GAS. All GAS isolates from the patients and the surgeon were indistinguishable by pulsed field gel electrophoresis. PCR analysis demonstrated the presence of streptococcal pyogenic exotoxins A and F. All strains were of the T-1 serotype and possessed the gene for M-protein 1. This report demonstrates that a virulent strain of GAS may be spread by asymptomatically colonized medical personnel via the air route.
Similar articles
-
Nosocomial transmission of invasive group a streptococcus from patient to health care worker.Clin Infect Dis. 2009 Aug 1;49(3):354-7. doi: 10.1086/599832. Clin Infect Dis. 2009. PMID: 19580415
-
A household cluster of fulminant group A streptococcus pneumonia associated with toxic shock syndrome-Quebec.Can Commun Dis Rep. 1996 Mar 15;22(6):41-3. Can Commun Dis Rep. 1996. PMID: 8935389 Review. No abstract available.
-
Invasive group A streptococcal infections in North Carolina: epidemiology, clinical features, and genetic and serotype analysis of causative organisms.J Infect Dis. 1997 Oct;176(4):992-1000. doi: 10.1086/516540. J Infect Dis. 1997. PMID: 9333158
-
The flesh-eating bacterium: what's next?J Infect Dis. 1999 Mar;179 Suppl 2:S366-74. doi: 10.1086/513851. J Infect Dis. 1999. PMID: 10081509 Review.
-
Streptococcal toxic shock syndrome in a postpartum woman. Case report and review of the literature.Infection. 1996 Mar-Apr;24(2):164-7. doi: 10.1007/BF01713330. Infection. 1996. PMID: 8740114 Review.
Cited by
-
Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018-2019.Emerg Infect Dis. 2022 May;28(5):915-23. doi: 10.3201/eid2805.211497. Emerg Infect Dis. 2022. PMID: 35451366 Free PMC article. Review.
-
Toxic Shock Syndrome after Surgery: Case Presentation and Systematic Review of the Literature.Plast Reconstr Surg Glob Open. 2020 May 29;8(5):e2499. doi: 10.1097/GOX.0000000000002499. eCollection 2020 May. Plast Reconstr Surg Glob Open. 2020. PMID: 33133879 Free PMC article.
-
Sepsis, parenteral vaccination and skin disinfection.Hum Vaccin Immunother. 2016 Oct 2;12(10):2546-2559. doi: 10.1080/21645515.2016.1190489. Epub 2016 Jun 13. Hum Vaccin Immunother. 2016. PMID: 27295449 Free PMC article. Review.
-
Fatal necrotizing fasciitis following elective inguinal hernia repair.Hernia. 2011 Feb;15(1):75-7. doi: 10.1007/s10029-009-0601-3. Epub 2009 Dec 10. Hernia. 2011. PMID: 20012332
-
An outbreak of severe infections with community-acquired MRSA carrying the Panton-Valentine leukocidin following vaccination.PLoS One. 2007 Sep 5;2(9):e822. doi: 10.1371/journal.pone.0000822. PLoS One. 2007. PMID: 17786194 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous