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Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Abstract Text
Character count for abstract text: 2495
Background: Streptococcus pyogenes is beta-hemolytic bacterium , also known as group A streptococci (GAS). GAS can relatively cause mild human illness, such as pharyngitis and cellulitis. However, this pathogen can cause invasive and even life-threatening illnesses such as necrotizing fasciitis, meningitis or streptococcal toxic shock syndrome.
Post surgical invasive GAS disease occurred in two patients who had surgery in women OB/GYN operating Theatre #3 on the dates of April 5 and April 6 2009
The first case was a 39 Yr old women under-went a left salpingectomy laproscopy on April 52009 for a ruptured ectopic pregnancy, 6 Hrs from surgery she became symptomatic with fever ,shortness of breath and expired 2 days laters The second patient was a 31 Year-old under-went elective tubal ligation on April6 2009, discharged home on same day of surgery re-admitted 19Hr post-operative with fever ,abdominal pain ,diarrhea and vomiting ,under-went intubation and continues to receive care in ICU, within few days patient improved and discharged on April22,2009
Objective: To trace the source of infection and to improve provision of postpartum and post surgical care by being adequately educating staff about signs and symptoms of this disease, thereby enhancing their ability to recognize it and obtain the appropriate collaborative medical care.
Methods: verifying the diagnosis was based on working group on sever streptococcal ,and by review clinical presentation and lab results for the patients,An outbreak team was conducted on daily basis to discuss updated issues of the two post-surgical cases of nosocomial invasive GAS disease,An investigation was conducted on April 9, 2009, stared with closure of OR3 ,line listing of staff involved in 2 cases , environmental screening for 25samples were done and 46 staff were screened from throat,rectal,nasal,skin and high vaginal site ,GAS isolates from the two patients and positive staff were send to UK for PFGE and EMM typing to identify the strains
Results: . Two staff were found to be positive of GAS one medical intern and one from East 6 Gyne unit staff. There was no GAS isolated from the 25 environmental samples ,Case two husband and kids were screened and they were all negative. However, the first case family was not screened Conclusions: The results of Emm gene typing of isolates from the two patients were identical, however the isolates from the two healthcare workers were different from each other and patients strain. Unfortunately, the infection control team could not identify the source of GAS infections in the two patients. Many studies have shown the same results. Control measures were strictly implemented,. . Operating theater was closed since April 7, 2009 and re-opened on May 5, 2009. No cases were reported since then, prospective and retrospective surveillance for 6 months were started to identify any possible cases of invasive GAS
Character count for abstract text: 2495
Background: Streptococcus pyogenes is beta-hemolytic bacterium , also known as group A streptococci (GAS). GAS can relatively cause mild human illness, such as pharyngitis and cellulitis. However, this pathogen can cause invasive and even life-threatening illnesses such as necrotizing fasciitis, meningitis or streptococcal toxic shock syndrome.
Post surgical invasive GAS disease occurred in two patients who had surgery in women OB/GYN operating Theatre #3 on the dates of April 5 and April 6 2009
The first case was a 39 Yr old women under-went a left salpingectomy laproscopy on April 52009 for a ruptured ectopic pregnancy, 6 Hrs from surgery she became symptomatic with fever ,shortness of breath and expired 2 days laters The second patient was a 31 Year-old under-went elective tubal ligation on April6 2009, discharged home on same day of surgery re-admitted 19Hr post-operative with fever ,abdominal pain ,diarrhea and vomiting ,under-went intubation and continues to receive care in ICU, within few days patient improved and discharged on April22,2009
Objective: To trace the source of infection and to improve provision of postpartum and post surgical care by being adequately educating staff about signs and symptoms of this disease, thereby enhancing their ability to recognize it and obtain the appropriate collaborative medical care.
Methods: verifying the diagnosis was based on working group on sever streptococcal ,and by review clinical presentation and lab results for the patients,An outbreak team was conducted on daily basis to discuss updated issues of the two post-surgical cases of nosocomial invasive GAS disease,An investigation was conducted on April 9, 2009, stared with closure of OR3 ,line listing of staff involved in 2 cases , environmental screening for 25samples were done and 46 staff were screened from throat,rectal,nasal,skin and high vaginal site ,GAS isolates from the two patients and positive staff were send to UK for PFGE and EMM typing to identify the strains
Results: . Two staff were found to be positive of GAS one medical intern and one from East 6 Gyne unit staff. There was no GAS isolated from the 25 environmental samples ,Case two husband and kids were screened and they were all negative. However, the first case family was not screened Conclusions: The results of Emm gene typing of isolates from the two patients were identical, however the isolates from the two healthcare workers were different from each other and patients strain. Unfortunately, the infection control team could not identify the source of GAS infections in the two patients. Many studies have shown the same results. Control measures were strictly implemented,. . Operating theater was closed since April 7, 2009 and re-opened on May 5, 2009. No cases were reported since then, prospective and retrospective surveillance for 6 months were started to identify any possible cases of invasive GAS