Control measures for invasive group A streptococci (iGAS) outbreaks in care homes

A. Cummins, S. Millership*, Theresa Lamagni, K. Foster

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objectives: The incidence of invasive group A streptococcal infections (iGAS) is increasing in Europe, with a particularly high morbidity and mortality in the elderly. Control of outbreaks in care homes is therefore important; but is unclear how best to manage these incidents. We attempted to identify which control measures are most likely to be effective. Methods: We undertook literature searches using PubMed and Google Scholar and contacted colleagues in Health Protection Units in England for unpublished outbreaks. Results: We identified 31 outbreaks; of which 20 had sufficient detail for further analysis. Overall carriage rates of GAS in care home residents identified in outbreak investigations were 4.7%, and in staff 3.2%. In 8 outbreaks mass antibiotic prophylaxis was offered, in 9 selective prophylaxis only and in 3 none at all. Surveillance swabbing had limited influence on decisions regarding prophylaxis. A few papers mentioned the role of environmental contamination and the risk from an affected roommate. Conclusions: Pooling of results from these outbreaks failed to suggest any clear advantage to either a selective or mass antibiotic prophylaxis strategy in controlling spread. Systematic investigation and data collection from future outbreaks could be of benefit in informing future policy.

Original languageEnglish
Pages (from-to)156-161
Number of pages6
JournalJournal of Infection
Issue number2
Publication statusPublished - Feb 2012


  • Care homes
  • Control measures
  • Invasive group A streptococcus
  • Outbreak


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