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Canadian Journal of Infectious Diseases
Volume 5 (1994), Issue 6, Pages 276-281
http://dx.doi.org/10.1155/1994/834746
Case Report

Group A Streptococcal Endometritis: Report of an Outbreak and Review of the Literature

Ziad A Memish,1,2 Denise Gravel-Tropper,2 Catherine Oxley,1,2 Baldwin Toye,1,2,3 and Gary E Garber1,2

1Division of Infectious Diseases, Department of Medicine, Ottawa General Hospital and the University of Ottawa, Ottawa, Ontario, Canada
2Occupational Health and Safety and Infection Control, Ottawa General Hospital, University of Ottawa, Ottawa, Ontario, Canada
3Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada

Received 17 November 1993; Accepted 9 May 1994

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Two cases of group A streptococcus (gas) postpartum endometritis were diagnosed within 24 h following uncomplicated vaginal delivery. Investigation by the infection control service identified all 10 obstetric personnel who performed any invasive procedure on both cases. These personnel were questioned about a recent history of sore throat, skin lesions, vaginal or rectal symptoms. Throat and rectal cultures were obtained for gas from all 10 personnel. A carrier was identified among the personnel screened. This nurse was removed from direct patient care and treated with a two-week course of oral clindamycin and rifampin with documentation of carrier eradication of gas at the end of therapy, 30 days, 60 days and six months post-treatment. All three isolated strains were identical by restriction endonuclease analysis and by M and T typing. Rapid implementation of infection control measures were successful in arresting this outbreak, with no further cases of gas occurring in the subsequent year.