Kaan J A, van Dijk Y, Mascini E M, van Kessel R P M, Schellekens J F P
Ned Tijdschr Geneeskd. 2008 Oct 11;152(41):2245-8.
In three hospitals three women aged 34, 33 and 25 years respectively, developed fever following delivery; in two of them a beta-haemolytic streptococcus of Lancefield group A (GAS) was cultured. Between the time of transmission of the infective agent of the first and the third patients there was a period of ten days. Because the intervals between the emergence of cases were relatively long, the suspicion of a common vector, i.e. the midwife, was raised only after some time. The midwife who had been present at all three deliveries turned out to be negative for GAS carriership on three occasions. However, cultures taken from her son and partner were positive for GAS carriership. A number of typing systems were unable to distinguish the GAS-isolates from the first two patients and from the son. After the midwife and her family members had been treated, no new cases occurred. This case illustrates the importance of keeping midwives as well as the department of public health informed of a rise in the number of cases of puerperal fever, whether the cases involve more than one hospital or not, in order to prevent a potential epidemic. Only then can a common source be looked for and the epidemic contained.
在三家医院，分别有三名年龄为34岁、33岁和25岁的女性在分娩后出现发热症状；其中两名患者培养出了A群β溶血性链球菌（GAS）。从第一名患者到第三名患者感染源传播的时间间隔为十天。由于病例出现的间隔时间相对较长，一段时间后才怀疑存在共同传播媒介，即助产士。在这三例分娩过程中均在场的助产士，三次检测结果均显示其不是GAS携带者。然而，从她儿子和伴侣身上采集的培养样本检测结果显示为GAS携带者。一些分型系统无法区分前两名患者以及助产士儿子身上分离出的GAS菌株。助产士及其家庭成员接受治疗后，未再出现新的病例。该案例说明了，无论产褥热病例是否涉及多家医院，都要及时向助产士以及公共卫生部门通报产褥热病例数量的增加，以防止潜在的疫情爆发。只有这样，才能找到共同传染源并控制疫情。
