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Investigate all 'GAS' infections, says HPA

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Nurses who have come into contact with hospital cases of Group A Streptococcal (GAS) infections should be screened as possible sources, according to guidance from the Health Protection Agency.

The new recommendations, published in the Journal of Infection, cover the investigation, control and prevention of GAS infections in acute healthcare settings.

They recommend hospital staff carry out a “targeted investigation” of every inpatient with GAS infection to determine how the infection was probably acquired in order to reduce the spread.

This includes identifying healthcare workers linked to cases, looking out for signs and symptoms of infection in those who have had close contact and appropriate antibiotic treatment.

The HPA joined forces with a GAS Working Group to develop the guidelines using evidence gathered from a range of organisations from across the UK.

Although general guidelines for controlling infections in healthcare settings exist, the HPA said the 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. 

The guidance stated that screening of epidemiologically linked healthcare workers should be considered for healthcare associated cases of GAS infection, where no alternative source is readily identified.

It also said communal facilities, such as baths, bidets and showers, should be cleaned and decontaminated between all patients, especially on delivery suites, post-natal wards and other high risk areas.

Continuous surveillance is required to identify outbreaks which arise over long periods of time, it added, and GAS isolates from in-patients, peri-partum patients, neonates, and post-operative wounds should be saved for six months to facilitate outbreak investigation.

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.”

GAS, a bacterium occasionally found in the throat and on the skin, can cause infections which vary in severity, from sore throats to potentially life-threatening infectious diseases.

Often, it is carried without causing any illness and can be spread through direct person-to-person contact and indirectly when the bacterium is present in the environment.

“Although cases of hospital-acquired GAS infection are rare, it’s important that appropriate control measures are implemented quickly if a case is identified to reduce the risk of further spread to other patients,” Dr Kearney added.

While most severe infections are acquired in the community, one in 10 occurs in hospital settings.

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