Advertisement

Invasive Group A Streptococcus Infections Linked to Outpatient Liposuction

Summary and Comment |
July 11, 2014

Invasive Group A Streptococcus Infections Linked to Outpatient Liposuction

  1. Larry M. Baddour, MD

An outbreak of infection involved 13 medical spa clients and resulted in 1 death.

  1. Larry M. Baddour, MD

Group A Streptococcus (GAS) is a well-recognized cause of surgical-site infections and other, more-serious complications such as toxic shock syndrome and necrotizing fasciitis. Cosmetic surgery, including that performed in the outpatient setting, carries the risk for such complications. In 2012, an outbreak occurred involving patients who had undergone tumescent liposuction at medical spas. Researchers now report the results of the ensuing investigation.

The researchers identified 13 cases of GAS infection (4 confirmed, 9 suspected) among 66 patients who had undergone liposuction procedures at either of two affiliated outpatient surgery facilities between July 1 and September 14, 2012 (attack rate, 20%). The four patients with confirmed invasive GAS infections developed necrotizing fasciitis; three of them also had signs of possible toxic shock syndrome, and one died. Healthcare workers noted routine prescription of cephalexin or azithromycin for all patients undergoing liposuction.

All procedures linked to illness were performed by a single surgical team. Two of the team members were colonized with GAS. The genotypes of their isolates and the isolates available for molecular typing from patients with confirmed infection were identical. Multiple deficiencies in infection-control practices were identified at the two facilities. Neither the facilities nor the procedures conducted were covered by state or federal regulation.

Comment

This is the first reported outbreak of invasive GAS infections associated with liposuction. It highlights the potential harm to individuals who undergo cosmetic procedures — even seemingly minor ones performed in an outpatient setting without any type of anesthesia. The experience should prompt a renewed interest in establishing minimal infection prevention and control standards in all cosmetic surgery facilities.

  • Disclosures for Larry M. Baddour, MD at time of publication Editorial boards UpToDate Leadership positions in professional societies American Heart Association (Chairman, Rheumatic Fever, Endocarditis, Kawasaki Disease Committee)

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

Advertisement
Advertisement
Advertisement