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Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019

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Title: Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019
Authors: Laura E. Nabarro, Colin S. Brown, Sooria Balasegaram, Valérie Decraene, James Elston, Smita Kapadia, Pauline Harrington, Peter Hoffman, Rachel Mearkle, Bharat Patel, Derren Ready, Esther Robinson, Theresa Lamagni
Source: Emerging Infectious Diseases, Vol 28, Iss 5, Pp 915-923 (2022)
Publisher Information: Centers for Disease Control and Prevention, 2022.
Publication Year: 2022
Collection: LCC:Medicine
LCC:Infectious and parasitic diseases
Subject Terms: Group A Streptococcus, Bacteria, Streptococci, Streptococcus pyogenes, public health, long-term care, Medicine, Infectious and parasitic diseases, RC109-216
More Details: Healthcare-associated invasive group A Streptococcus (iGAS) outbreaks are common worldwide, but only England has reported outbreaks associated with home healthcare (HHC). We describe 10 outbreaks during 2018–2019 in England. A total of 96 iGAS cases (range 2–39 per outbreak) and 28 deaths (case-fatality rate 29%) occurred. Outbreak duration ranged from 3–517 days; median time between sequential cases was 20.5 days (range 1–225 days). Outbreak identification was difficult, but emm typing and whole-genome sequencing improved detection. Network analyses indicated multiple potential transmission routes. Screening of 366 HHC workers from 9 outbreaks identified group A Streptococcus carriage in just 1 worker. Outbreak control required multiple interventions, including improved infection control, equipment decontamination, and antimicrobial prophylaxis for staff. Transmission routes and effective interventions are not yet clear, and iGAS outbreaks likely are underrecognized. To improve patient safety and reduce deaths, public health agencies should be aware of HHC-associated iGAS.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1080-6040
1080-6059
Relation: https://wwwnc.cdc.gov/eid/article/28/5/21-1497_article; https://doaj.org/toc/1080-6040; https://doaj.org/toc/1080-6059
DOI: 10.3201/eid2805.211497
Access URL: https://doaj.org/article/ccd73da7003c40fd90553aca59e2bef2
Accession Number: edsdoj.73da7003c40fd90553aca59e2bef2
Database: Directory of Open Access Journals
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  Data: Emerging Infectious Diseases, Vol 28, Iss 5, Pp 915-923 (2022)
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  Data: Healthcare-associated invasive group A Streptococcus (iGAS) outbreaks are common worldwide, but only England has reported outbreaks associated with home healthcare (HHC). We describe 10 outbreaks during 2018–2019 in England. A total of 96 iGAS cases (range 2–39 per outbreak) and 28 deaths (case-fatality rate 29%) occurred. Outbreak duration ranged from 3–517 days; median time between sequential cases was 20.5 days (range 1–225 days). Outbreak identification was difficult, but emm typing and whole-genome sequencing improved detection. Network analyses indicated multiple potential transmission routes. Screening of 366 HHC workers from 9 outbreaks identified group A Streptococcus carriage in just 1 worker. Outbreak control required multiple interventions, including improved infection control, equipment decontamination, and antimicrobial prophylaxis for staff. Transmission routes and effective interventions are not yet clear, and iGAS outbreaks likely are underrecognized. To improve patient safety and reduce deaths, public health agencies should be aware of HHC-associated iGAS.
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  Data: https://wwwnc.cdc.gov/eid/article/28/5/21-1497_article; https://doaj.org/toc/1080-6040; https://doaj.org/toc/1080-6059
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