Guidelines for the prevention and control of group A streptococcal infection in acute healthcare and maternity settings in the UK (external link - abstract only))

The Health Protection Agency (HPA) together with the group A streptococcal (GAS) Working Group has today launched new guidelines for the investigation, control and prevention of GAS infection in acute healthcare settings, including maternity units, in the UK. The Working Group comprised of a wide range of healthcare specialists from across the UK involved in the identification, treatment and control of infectious diseases. Group A streptococcus is a bacterium occasionally found in the throat and on the skin and may be carried for long periods of time without causing any illness (also known as colonised). It is spread by direct person-to-person contact with an infected or colonised person and can cause a range of infections, from relatively mild sore throats and skin infections to rare but life-threatening invasive disease. Most severe infections are acquired in the community with around one in ten acquired in hospital settings. GAS infection can be treated with penicillin and many other antibiotics. Although general guidelines for controlling infections in healthcare settings exist, these new guidelines will give hospitals clear, evidence-based advice on how to minimise the risk of spread of GAS infections in hospitals and maternity settings such as midwife-led units. The guidance provides recommendations for hospital staff in carrying out investigations of every inpatient 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 be similarly investigated. Where the infection was acquired in hospital or as result of contact with healthcare services (e.g. following a home birth), further investigations are recommended to find the source of the infection. There are three main routes of transmission of GAS infections in healthcare settings: patient-to-patient, from healthcare worker to patient (and vice-versa) and through the immediate hospital environment. Implementing a targeted investigation to locate the source of the infection will help hospital staff to eliminate it and safeguard patient care. 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.