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An outbreak of Streptococcus pyogenes surgical site infections in a cardiovascular surgery department.

BACKGROUND
We report an outbreak of surgical site infections due to genetically related strains of Streptococcus pyogenes in a cardiovascular surgery department.


METHODS
The practices that were possibly related to the outbreak were investigated through direct observation and interviews with staff by an infection control team. Surveillance sampling from patients, health-care workers, and environment were done for the investigation of the source. Pulsed-field gel electrophoresis was used to investigate a clonal relationship among the S. pyogenes isolates.


RESULTS
Four patients operated on in the cardiovascular surgery department developed surgical site infection due to S. pyogenes. Molecular characterization of S. pyogenes done by pulsed-field gel electrophoresis revealed the same strain.


CONCLUSIONS
Although a definite source for the outbreak could not be identified, probably lack of adherence to hand hygiene practices during surgical dressings, contamination, and cross contamination led to this outbreak.