An outbreak of surgical-wound infections due to group A Streptococcus carried on the scalp

An outbreak of surgical wound infections as a result of infection by the beta-hemolytic streptococcal bacteria led to an epidemiologic investigation. In 10 of the previously reported outbreaks of this serious infection of wounds, a hospital worker directly involved with patient-care in the operating room was identified as the source. Twenty cases were identified during this outbreak, which represented an attack rate of 1 surgical wound infection for each 1,097 surgical procedures, which is about 5 to 10 times the expected frequency. Operating room staff were examined to see if they were carriers of beta-hemolytic strep, but none could be detected. Sterile plates were placed at strategic locations in the operating suites and a log of individuals entering various areas was kept. As a result of these detection methods, one individual was identified. The subject had a history of intermittent eczema since childhood. Although on her four previous examinations, no source of the organism could be found, close examination revealed areas of scaling on her scalp, ears, under her breasts and at skin folds. Her condition was diagnosed as psoriasis (a chronic skin condition resulting in a redness of the affected skin and scaling) and seborrhea (scalp infection of oil glands). She was treated with topical medications and systemic antibiotics, and was transferred away from the operating suite and other patient-care areas. Tests of other family members of this individual also revealed infections, which were similarly treated. Following the isolation of this individual, no further cases of surgical wound infection related to this subgroup of organism occurred at the hospital. In other cases of wound infection, the organism was usually located in the rectum or vagina of the infected worker. The present report identifies another possible source of infection the scalp. (Consumer Summary produced by Reliance Medical Information, Inc.)