Group A Strep in Long-term Care Facilities: Identifying and Managing Outbreaks (Toolkit)

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

This toolkit is intended for use by personnel in state, tribal, local, and territorial public health departments and LTCFs, including skilled nursing and rehabilitation facilities.

Targeted to public health departments and LTCFs, including skilled nursing and rehabilitation facilities, the toolkit encourages an investigation into even a single case of invasive GAS infection. The 6-page toolkit also offers strategies to ramp up the response if additional cases occur.

GAS bacteria cause many different types of infections, with cellulitis and wound infections being the most common among older adults and LTCF residents. Early recognition is important as GAS infections can rapidly progress and result in death in these populations. Approximately 14% of people aged 65 years or older die from their invasive GAS infection. Increasing resistance in GAS bacteria complicates treatment and makes it a concerning threat in CDC’s AR Threats Report (2-page infographic: Erythromycin-Resistant Group A Streptococcus).

Strong infection prevention and control practices are critical to stopping GAS transmission and preventing outbreaks in LTCFs. The toolkit includes detailed strategies for three potential scenarios, including how to:

  • Identify any additional symptomatic cases among residents and staff
  • Identify and treat asymptomatic carriers                        
  • Assess and improve current infection control practices in the facility  
  • Identify potential transmission routes

LTCF staff should work with their local public health departments when investigating suspected GAS outbreaks. Local public health departments can seek further assistance from their state, tribal, or territorial health departments. If needed, CDC is available for additional assistance.

Additional information on GAS infection can be found here.