An Outbreak of Surgical-Wound Infections Due to Group A Streptococcus Carried on the Scalp

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Abstract
GROUP A β-hemolytic streptococcus is an uncommon but serious cause of postoperative wound infection. Group A streptococcus is isolated from less than 1 percent of all surgical-wound infections and causes less than 1 incisional-wound infection per 10,000 operations (National Nosocomial Infections Surveillance System, Centers for Disease Control: unpublished data). Clusters of group A streptococcal postoperative wound infections can usually he associated with a carrier who has direct patient-care responsibilities in the operating room. A carrier was identified in 10 of the 12 outbreaks reported since 1965.1 2 3 4 5 6 7 8 9 10 11 12 13 Eight carriers were operating-room personnel with group A streptococcus in their rectums or vaginas.3 , 6 7 8 9 10 11 12 13 Two small outbreaks (five and two cases) were associated with surgeons who carried the organism in the upper airways.1 , 4 Aerosolization of group A streptococcus from an identified carrier has been demonstrated and suggested as the mode of dissemination in some outbreaks.3 , 7 , 8 , 11 , 13