1/12. Invasive group a streptococcus associated with an intrauterine device and oral sex.BACKGROUND: peritonitis due to group A Streptococcus (GAS) and toxic shock syndrome occurred in a previously healthy 45-year-old woman with an intrauterine device. The intrauterine device was believed to be the portal of entry. In addition, her husband was found to be an asymptomatic carrier of GAS in his oropharynx. GOAL: The goal was to increase physicians' awareness of oral sex as a risk factor for transmission of invasive GAS disease. STUDY DESIGN: This is a case report of the development of GAS peritonitis and toxic shock syndrome in a woman after acquisition of the organism through oral sex. RESULTS: The GAS strains isolated from the patient and her husband were identical in their M-type, T-type, and exotoxin gene pattern. CONCLUSION: Because the couple practices oral sex, it was postulated that this was the mode of transmission of the GAS.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
2/12. Streptococcal toxic shock syndrome by an iMLS resistant M type 77 streptococcus pyogenes in the netherlands.An increasing number of group A streptococci (GAS) with constitutive or inducible resistance to macrolide-lincosamide-streptogramin b antibiotics (cMLS or iMLS phenotype) is observed in europe, but MLS resistant GAS associated with streptococcal toxic shock syndrome (STSS) has not been reported. We describe a patient admitted with STSS caused by an iMLS resistant T28 M77 streptococcus pyogenes carrying the ermA [subclass TR] gene. A 2-y retrospective analysis among 701 nationwide collected GAS strains revealed an incidence of 3.1% of this M type 77 GAS. Analysis of 17 available M77 strains (12 T28 and 5 T13) indicated that 2 (12%) were MLS resistant due to the ermA [TR] gene. Both MLS resistant strains were cultured from blood and belonged to T28 serotype. multilocus sequence typing (MLST) showed that all M77 isolates belonged to sequence type 63. We conclude that 17 M77 GAS collected in the netherlands in a 2-y period were associated with invasive disease and belonged to the same clonal complex. Since only 12% carried the ermA [TR] resistance gene, it is very likely that the gene has been acquired by horizontal transmission rather than from spread of a resistant circulating clone.- - - - - - - - - - ranking = 0.5keywords = transmission (Clic here for more details about this article) |
3/12. Transmission of 'toxic strep' syndrome from an infected child to a firefighter during CPR.Several cases of a toxic shocklike syndrome have been reported in the united states during the past five years in association with streptococcus pyogenes infection. We report a case of a firefighter exposed during attempted CPR to the secretions of an S pyogenes-infected child. The firefighter developed an infection of the hand and subsequent febrile illness with hypotension, erythematous rash, renal failure, and hypocalcemia. Bacterial isolates of blood and cerebrospinal fluid from the deceased child were identical in type and exotoxin production with isolates grown from the hand wound of the firefighter. This is the first reported case of documented transmission of S pyogenes, causing a toxic shocklike syndrome in an emergency medical technician.- - - - - - - - - - ranking = 0.5keywords = transmission (Clic here for more details about this article) |
4/12. Nosocomial transmission of a strain of staphylococcus aureus causing toxic shock syndrome.A strain of staphylococcus aureus producing toxic shock syndrome toxin-1 was repeatedly isolated from the nares of a neurosurgeon. This strain was identical to strains cultured from two of his patients who developed toxic shock syndrome after laminectomy. The relatedness of the isolates was shown by Southern blot hybridization analyses using chromosomal transposons as probes. This approach should be considered, in addition to standard bacteriologic techniques, as an effective method to analyze the relatedness of nosocomial isolates.- - - - - - - - - - ranking = 2keywords = transmission (Clic here for more details about this article) |
5/12. Variant postpartum toxic shock syndrome with probable intrapartum transmission to the neonate.We report a unique mother-infant pair with variant staphylococcal toxic shock syndrome and probable intrapartum transmission to the neonate. diagnosis of probable toxic shock was supported by the finding of fever, desquamative skin rash, multi-organ system involvement, and pronounced mucocutaneous manifestations, including strawberry tongue, dermal swelling, pharyngitis, and vulvar edema, although hypotension was absent. staphylococcus aureus was isolated from the vagina, placenta, chorioamnion, and surface swabs and gastric aspirates of the infant. The isolates produced enterotoxin C but not enterotoxin F, and illness developed in both mother and infant despite preexisting high antibody titers to enterotoxin F and enterotoxin C. This unique mother-infant pair highlights our present lack of knowledge of the precise etiology and pathogenesis of toxic shock syndrome and illustrates the consequent difficulty in clinical diagnosis and laboratory confirmation of this disease in certain patients with atypical presentations.- - - - - - - - - - ranking = 2.5keywords = transmission (Clic here for more details about this article) |
6/12. dengue fever in the united states. A report of a cluster of imported cases and review of the clinical, epidemiologic, and public health aspects of the disease.In the united states during 1981, fourteen state health departments reported a total of 44 imported cases of dengue fever. Most originated in the Caribbean, where dengue type 4 has reached pandemic proportions. Because the mosquito vector for dengue is abundant throughout the southeast and imported cases continue to occur, the possibility exists for indigenous dengue transmission. We report a cluster of imported dengue type 1 cases in florida, discuss the clinical, epidemiologic, and public health aspects of the disease, and make recommendations as to how clinicians can assist public health officials in minimizing the risk of indigenous dengue transmission in the united states.- - - - - - - - - - ranking = 1keywords = transmission (Clic here for more details about this article) |
7/12. Evidence for postpartum toxic-shock syndrome in a mother-infant pair.Toxic-shock syndrome occurred in a mother and possibly in her infant in the immediate postpartum period. staphylococcus aureus of identical phage type and antibiogram was recovered from mucous membranes in both patients. Staphylococci were transmitted from mother to infant during parturition. These cases represent the first postpartum clinical description and possible vertical transmission of this disease.- - - - - - - - - - ranking = 0.5keywords = transmission (Clic here for more details about this article) |
8/12. hemorrhage and shock associated with invasive pneumococcal infection in healthy infants and children--new mexico, 1993-1994.From December 1993 through May 1994, four previously healthy children (including two infants) in new mexico developed a severe illness characterized by septic shock and hemorrhage into the skin or internal organs. An investigation subsequently implicated streptococcus pneumoniae as the cause of illness. The two infants attended the same child care center (CCC) and died 6 weeks apart. This report describes the syndrome, an investigation of potential transmission in the CCC, and prevention measures.- - - - - - - - - - ranking = 0.5keywords = transmission (Clic here for more details about this article) |
9/12. yersinia enterocolitica transmission from a red cell unit 34 days old.In 1993 the North london blood transfusion Centre received its first report of yersinia enterocolitica transmission from a unit of red cells supplied to a local hospital. The recipient was a 23-year-old male who was neutropenic following a third cycle of chemotherapy for treatment of acute myeloblastic leukaemia (FAB type M6) and received a 34-day-old red cell unit. During transfusion the patient developed septicaemia and endotoxin-mediated shock. The transfusion was stopped immediately and broad spectrum antibiotics administered immediately on suspicion of bacteraemia from the transfused unit. This prompt action undoubtedly prevented a fatal outcome. Y. enterocolitica was isolated from the blood bag. Antibody was also detected in the bag and in a sample taken from the donor 39 days post-donation. Antibody to serotype 03 was identified, the commonest serotype reported in transfusion-transmitted Y. enterocolitica. The donor reported no gastrointestinal upset or illness prior to donation. This transfusion reaction might not have occurred had the red cells been transfused earlier in their storage period, but would not have been prevented by the exclusion of donors with a history of gastrointestinal illness as the donor was asymptomatic. Nor would it have been prevented by inspecting the blood for a change in colour, as no such change was observed. Y. enterocolitica is a significant problem in transfusion medicine and transmission is generally associated with a high mortality rate. hospitals should be urged to investigate bacteriologically all appropriate transfusion reactions so that the true extent of the problem in the United Kingdom can be assessed.- - - - - - - - - - ranking = 3keywords = transmission (Clic here for more details about this article) |
10/12. Transmission of streptococcus pyogenes causing toxic shock-like syndrome among family members and confirmation by dna macrorestriction analysis.streptococcus pyogenes can cause severe infections, such as toxic shock-like syndrome (TSLS). The transmission and pathogenesis of TSLS are poorly understood, and information is needed to develop prevention strategies. Four cases were identified in which the organism was transmitted among patients with TSLS and their family members. dna macrorestriction endonuclease analysis using pulsed-field gel electrophoresis demonstrated the spread of S. pyogenes clones that caused TSLS among the family members. Although 14 persons related to the case-patients experienced only colonization or self-limited disease, 3 developed invasive infections (pneumonia, severe pharyngitis requiring hospitalization, and puerperal sepsis). These findings indicate that antimicrobial prophylaxis for close contacts of patients with TSLS should be considered and reinforce the need for further studies on epidemic control of TSLS.- - - - - - - - - - ranking = 0.5keywords = transmission (Clic here for more details about this article) |
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