The Health Protection Agency (HPA) together with the Group A streptococcal (GAS) Working Group has produced new guidelines for the investigation, control and prevention of GAS infection in acute healthcare settings, including maternity units.
The bacterium is occasionally found in the throat and on the skin and can be carried for long periods without causing illness. It is spread by direct contact with an infected or colonised person and can cause a range of infections, from mild sore throats and skin infections to rare but life-threatening invasive disease. Most severe infections are acquired in the community, with around 10% being acquired in the hospital environment. General guidelines for controlling infections in healthcare settings do already exist, but it is hoped that the new guidelines will give clearer, evidence-based advice on how to minimise the risk of spread of GAS infections in hospitals and maternity settings. Commenting on the new guidelines, Dr Joe Kearney, chair of the GAS Working Group said: “These new recommendations are specifically aimed at assisting healthcare workers in controlling the spread of these infections. They have been drawn up with expert colleagues from a wide range of organisations, including a patient support group, to ensure that we have developed comprehensive advice for managing GAS infections in hospitals and other acute healthcare settings. Although cases of hospital-acquired GAS infection are rare, it is important that appropriate control measures are implemented quickly if a case is identified to reduce the risk of further spread to other patients.” The guidance provides recommendations for hospital staff in carrying out investigations of all inpatients with GAS infection to determine how the infection was probably acquired. GAS infections diagnosed in women who have recently given birth or patients discharged within the last seven days should also be investigated. Where the infection was acquired in hospital or as result of contact with healthcare services further investigations are recommended to find the source of the infection. The guidance also gives clear recommendations on how hospital staff should manage and investigate outbreaks, such as identifying healthcare workers linked to cases, identifying any signs or symptoms of possible GAS infections in close contacts and recommending appropriate antibiotic treatment, if necessary.
