CDC report says Montco nursing home had strep outbreak

A weekly report published by the U.S. Centers for Disease Control and Prevention said this week that a Montgomery County nursing home had an outbreak of invasive group A streptococcus, a life-threatening bacterial infection, that it termed "one of the largest and most prolonged" such outbreaks in a nursing facility.

The center's Morbidity and Mortality Weekly Report said that between Oct. 12, 2009, and Sept. 22, 2010, 13 residents of the facility had the invasive strep, and two died. Ten residents had noninvasive strep infections.

The report, written by public health authorities including representatives of the state and Montgomery County health departments, concluded that long-term care facilities should investigate single cases of invasive strep infection and make sure good infection-control practices are in place.

It said the facility involved had "multiple infection prevention deficiencies" that included ineffective staff "hand-hygiene practices." That, combined with vulnerable patients and the likely introduction of strep through more than one source, contributed to the extended outbreak.

Group A strep is a common bacterium that usually causes relatively mild illnesses such as strep throat or impetigo, a skin infection. The invasive form goes beyond the normal surface infections and spreads to blood, muscles, or the lungs. It can cause toxic shock syndrome and necrotizing fasciitis, the so-called flesh-eating disease.

The report did not name the nursing facility involved, but said it had 150 beds and specialized in ventilator weaning, spinal-cord injury care, and short-term rehabilitation. The state and Montgomery County health departments refused to identify the facility.

Rhea Goodwin, administrator of AristaCare at Meadow Springs in Plymouth Meeting, the only nursing facility in Montgomery County that matches the report's description, confirmed that her facility had an outbreak of strep. She said AristaCare was one of only seven "specialized rehabilitation nursing facilities" in Pennsylvania and cares for "some of the most acute and medically complex nursing-home patients in the state."She said there was no "direct link" between the bacteria and the deaths of the two patients.

She said the facility, which offers "unparalleled levels of medical excellence," embraced the investigation by the health departments and accepted their recommendations. She said she suspected that some patients became infected during trips to hospitals or through contact with visitors.

"I'm very proud of the care that we provide at the facility," she said.

After the outbreak, AristaCare installed disinfectant gel dispensers in every room and began testing all new patients for strep. "There's so much that we do as a result of this for the betterment of all our patients," she said.

Holli Senior, deputy press secretary for the state health department, said "the facility took those recommendations seriously and did what they needed to do, and no one has gotten sick since December 2010."

The state health department inspected AristaCare at Meadow Springs 50 times between 2009 and the present and found a variety of deficiencies. A report from December 2010 focused on infection control. It faulted the facility for not having gloves in every room and several instances of sloppy housekeeping.

Goodwin said those problems had been corrected. AristaCare hired a full-time infection prevention worker in August 2010.

Admissions at the facility were suspended for 13 days in October 2010 while five strep carriers, including four staff members, were treated with antibiotics.

Source: Philly.com Health News , By Stacey Burling "Inquirer Staff Writer"