Outbreak of Streptococcus pyogenes emm type 58 in a high dependency unit of a level-1 trauma center of India

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Vibhor Tak
2. Parul Punia
3. Manesh C. Misra
4. Nibu Varghese John
ISSN
0972-5229
DOI
10.4103/0972-5229.126076
Volume
18
Issue
2
Publishing Year
2014
Pages
6
Author Affiliations
    1. Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
    1. Department of Laboratory Medicine, Microbiology Section, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
    1. Department of Hospital Infection Control, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
    1. Department of Surgery, Jai Prakash Narain Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
  • Article keywords
    Beta-hemolytic Streptococci , group A Streptococcus, outbreak, Streptococcus pyrogenic exotoxins emm types, trauma patients

    Abstract

    Background and Aims: Group A Streptococcus (GAS) can cause illnesses ranging from self-limited to severe, life-threatening, invasive infections. The objective of the following study was to investigate a suspected Streptococcus pyogenes outbreak in a high dependency unit (HDU) of our trauma center. Materials and Methods: All the isolates of beta hemolytic Streptococci were identified by standard microbiological methods, Vitek 2 system and latex agglutination tests. Antimicrobial susceptibility testing was performed as recommended by Clinical Laboratory Standards Institute. Exotoxin genes, including speA, speB, speC, speF, smeZ, ssa, speG, speH, speJ, speL, speM and speI were detected by polymerase chain reaction (PCR). The emm types of isolates of S. pyogenes were determined by sequencing the variable 5′ end of emm gene after amplification by PCR. Results: In a 28 bedded poly-trauma ward with a four bedded HDU three out of four patients developed S. pyogenes emm type 58 infection. The strain was macrolide and tetracycline resistant and produced the Streptococcal pyrogenic exotoxins speB, speC, speG, speF and smeZ. Surveillance sampling was done for investigation from patients, health-care workers and environmental samples. Conclusion: An outbreak of GAS infections was established caused by the uncommonly reported emm type 58. The outbreak was controlled by prompt treatment, intensive surveillance, feedback and training.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved