Streptococcal wound infections caused by a vaginal carrier

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Abstract
During a 4 mo. period, 10 cases of group A streptococcal (GAS) postoperative wound infection occurred among patients in a community hospital. Bacteremia developed in 2 patients; 1 patient died. Group A streptococcal surgical wound infections were associated with exposure to a circulating nurse and duration of surgery. Prophylactic antibiotics reduced the risk of infection. Vaginal, perineal and anal cultures from nurse A yielded GAS, serotype M-4, T-4, as did the blood of 2 infected patients. Penicillin eradicated GAS colonization of nurse A; she returned to work. Five mo. later, 2 additional cases of GAS postoperative wound infections occurred and were associated with recolonization of the same nurse with GAS, serotype M-nontypeable, T-12. She was relieved of patient-care duties; no further cases have occurred.

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