Nursing home outbreaks of invasive group A streptococcal infections - Illinois, Kansas, North Carolina and Texas

Three outbreaks of streptococcal infections in nursing homes were reported to the United States Centers for Disease Control during the past winter. A total of 18 residents with invasive (systemic) disease and 10 deaths (56 percent) were reported. The patients suffered from severe, changed mental state, and other symptoms. Eight of the patients developed pneumonia, seven had skin infections, two had sinusitis. In three patients the site of the original infection could not be identified. Severe infections of the connective tissue around muscles (fasciitis) required surgical intervention including amputation, and kidney failure and adult respiratory distress syndrome were reported complications. Few staff members were found to have streptococcal infections. Evaluation of throat cultures showed that approximately four percent of patients and one percent of staff had streptococcal organisms in the throat or pharynx, but were free of symptoms. In two nursing homes, full antimicrobial therapy was given to residents and staff, and in a third, therapy was discontinued when all cultures were found to be negative for the organism. Following this therapy no further cases were reported. (Consumer Summary produced by Reliance Medical Information, Inc.)