scholarly journals Invasive group A streptococcal infection outbreaks of type emm118 in a long-term care facility, and of type emm74 in the homeless population, Montréal, Quebec

2019 ◽  
Vol 45 (1) ◽  
pp. 26-31 ◽  
Author(s):  
PA Pilon ◽  
N Savard ◽  
J Aho ◽  
J Caron ◽  
A Urbanek ◽  
...  
Keyword(s):  
Long Term Care ◽  
Streptococcal Infection ◽  
Care Facility ◽  
Homeless Population ◽  
Term Care ◽  
Invasive Group ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

scholarly journals Investigation of a Prolonged Group A Streptococcus Outbreak Among Residents and Outpatients Receiving Wound Care at a Long-Term Care Facility (LTCF)

2020 ◽  
Vol 41 (S1) ◽  
pp. s305-s306
Author(s):  
Alana Cilwick ◽  
April Burdorf ◽  
Wendy Bamberg ◽  
Christopher Czaja ◽  
Alexis Burakoff ◽  
...  
Keyword(s):  
Infection Control ◽  
Staff Member ◽  
Long Term Care ◽  
Wound Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

Background: In February 2019, the Colorado Department of Public Health and Environment (CDPHE) identified a cluster of 3 invasive group A Streptococcus (GAS) infections in residents receiving wound care in a long-term care facility (LTCF). An investigation revealed a larger outbreak that extended to nonresidents receiving outpatient wound care at the LTCF. Methods: A case was defined as a positive culture for GAS emm type 82 from an individual with exposure to the LTCF between January and June 2019. Cases were categorized as clinical (symptoms of GAS disease or GAS isolated from a wound or sterile site) or carriage (no symptoms). Carriers were identified via samples collected from throat and skin lesions. Screening occurred in 2 rounds and included residents of affected units followed by screening of all wound-care staff and residents facility-wide. Available isolates were sent for emm type testing and whole-genome sequencing (WGS) at the CDC. CDPHE staff performed infection control observations. Results: We identified 14 cases: 8 clinical and 6 carriage (from 5 residents and 1 staff member). Two patients with invasive GAS died. Of 8 patients with clinical GAS, 6 resided in the facility on or 1 day prior to symptom onset; 2 were not residents but received outpatient therapy at the LTCF. All 8 patients with clinical GAS (100%) and 3 carriers had received wound care. The staff member with emm 82 carriage had provided wound care and occupational therapy to the affected residents and the 2 outpatients. Two additional cases were detected with onset dates following staff member decolonization. Moreover, 13 of the 14 emm 82 isolates were found to be identical by WGS. Infection control observations identified lapses in staff wound care and hand hygiene practices in the residential and outpatient settings of the facility. Conclusions: This investigation details a large GAS outbreak in an LTCF associated with asymptomatic carriage in residents and staff that included patients who had only received care in the outpatient portion of the facility. The outbreak was halted following decolonization of a staff member and improvements in infection control, including in the outpatient setting. Outpatient services, particularly wound care, provided by LTCFs should be considered when investigating LTCF-related GAS cases and outbreaks.Funding: NoneDisclosures: None

Outbreak of Group A Streptococcus at a Pediatric Long Term Care Facility

2014 ◽  
Vol 42 (6) ◽  
pp. S158
Author(s):  
Mary M. Keenan ◽  
Meghan Murray ◽  
Linda Mosiello ◽  
Joseph Savitt
Keyword(s):  
Long Term Care ◽  
Group A Streptococcus ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

Tightly Clustered Outbreak of Group A Streptococcal Disease at a Long-Term Care Facility

2006 ◽  
Vol 27 (12) ◽  
pp. 1377-1384 ◽  
Author(s):  
Kathryn E. Arnold ◽  
Jody L. Schweitzer ◽  
Barbara Wallace ◽  
Monique Salter ◽  
Ruth Neeman ◽  
...  
Keyword(s):  
Infection Control ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Infection Control Measures ◽  
Group A

Objective.To describe investigation of a tightly clustered outbreak of invasive group A streptococcal (GAS) disease associated with a high mortality rate in a long-term care facility (LTCF).Design.Cross-sectional carriage survey and epidemiologic investigation of LTCF resident and employee cohorts.Setting.A 104-bed community LTCF between March 1 and April 7, 2004.Patients.A cohort of LTCF residents with assigned beds at the time of the outbreak.Interventions.Reinforcement of standard infection control measures and receipt of chemoprophylaxis by GAS carriers.Results.Four confirmed and 2 probable GAS cases occurred between March 16 and April 1, 2004. Four case patients died. The final case occurred during the investigation, before the patient was determined to be a GAS carrier. No case occurred during the 6 months after the intervention. Disease was caused by typeemm3GAS; 16.5% of residents and 2.4% of employees carried the outbreak strain. Disease was clustered in 1 quadrant of the LTCF and associated with nonintact skin. GAS disease or carriage was associated with having frequent personal visitors.Conclusions.Widespread carriage of a virulent GAS strain likely resulted from inadequate infection control measures. Enhanced infection control and targeted prophylaxis for GAS carriers appeared to end the outbreak. In addition to employees, regular visitors to LTCFs should be trained in hand hygiene and infection control because of the potential for extended relationships over time, leading to interaction with multiple residents, and disease transmission in such residential settings. Specific attention to prevention of skin breaks and proper wound care may prevent disease. The occurrence of a sixth case during the investigation suggests urgency in addressing severe, large, or tightly clustered outbreaks of GAS infection in LTCFs.

Cluster of deaths from group A streptococcus in a long-term care facility?Georgia, 2001

2005 ◽  
Vol 33 (2) ◽  
pp. 108-113 ◽  
Author(s):  
C GREENE ◽  
C VANBENEDEN ◽  
M JAVADI ◽  
T SKOFF ◽  
B BEALL ◽  
...  
Keyword(s):  
Long Term Care ◽  
Group A Streptococcus ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Group A

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

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