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Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone

Published online by Cambridge University Press:  25 March 2010

M. Barnham
Affiliation:
Department of Microbiology, Harrogate General Hospital, Knaresborough Road, Harrogate, North Yorkshire HG2 7ND
J. Kerby
Affiliation:
Department of Microbiology, Harrogate General Hospital, Knaresborough Road, Harrogate, North Yorkshire HG2 7ND
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Outbreaks of wound infection with Streptococcus pyogenes and Staphylococcus aureus occurred in an abattoir and a pork-processing factory in Autumn 1980. Investigations showed that staff handling the meat before de-boning were particularly affected and that bone was the cause of 48 % of the wounds which became clinicially infected. Of the total isolates of Strep. pyogenes and Staph. aureus from wounds of known cause 75% were from lesions caused by bone. In one outbreak streptococcal infection was seen principally in newly-employed staff. Group L streptococci were found in several sites in the pork factory and were isolated from infected lesions in two workers. Strep. pyogenes and Staph. aureus were cultured from tap handles in the lavatories.

Sixty-six workers were examined in a non-epidemic period and 59 % were found to have current wounds on the hand or wrist; 13% of wounds were infected but Strep. pyogenes was not isolated. Bone was the commonest of the many causes of injury, accounting for 31 % of all wounds. Butchers had the highest rates of wounding and most bone-inflicted injury was seen in this group. Packers were the only group to wear protective gloves regularly. Damaged fingernails were found in 50% of workers, including a high proportion of nail-biters (33% of all workers). The epidemic strain of Staph. aureus was cultured from bitten fingernails. Three of four infected workers carrying epidemic organisms in the throat were examined and all were nail-biters. Sharp-edged bone was produced by rotary saws early in the production line and bone dust contaminated the carcasses and adjacent surfaces. It is suggested that bone fragments could contaminate wounds and that this might have implications for the initiation of infection and the development of outbreaks.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1981

References

Barber, M. (1948). Discussion on swine erysipelas infection (Erysipelothrix rhusiopathiae) in man and animals. Proceedings of the Royal Society of Medicine 41, 328330.Google Scholar
Barnham, M., Kerby, J. & Skillin, J.(1980 a). An outbreak of streptococcal infection in a chicken factory. Journal of Hygiene 84, 7175.CrossRefGoogle Scholar
Barnham, M., Kerby, J. & Skillin, J. (1980 b). Communicable Disease Surveillance Centre, Public Health Laboratory Service (unpublished).Google Scholar
Bisno, A. L. & Nelson, K. E. (1974). Type-specific opsonic antibodies in streptococcal pyoderma. Infection and Immunity 10, 13561361.Google Scholar
Boisvert, P. L. & Powers, G. F. (1944). Eczema and haemolytic streptococcal disease in children. Yale Journal of Biological Medicine 16, 595612.Google ScholarPubMed
Brachman, P. S. (1977). In Infectious Diseases (ed. Hoeprich, P. D.), 2nd ed., pp. 807812. Hagerstown: Harper and Row.Google Scholar
Burwell, R. G. (1964). Biological mechanisms in foreign bone transplantation. In Modern Trends in Orthopaedics 4. Science of Fractures (ed. Clark, J. M. P.), pp. 138190. London: Butterworths.Google Scholar
Council on Drugs (1966). A new implant material for use in reconstructive surgical procedures. Journal of the American Medical Association 195, 951952.CrossRefGoogle Scholar
Dajani, A. S. & Wannamaker, L. W. (1970). Experimental infection of the skin in the hamster simulating human impetigo. 1. Natural history of the infection. Journal of Infectious Diseases 122, 196204.Google Scholar
Dillon, H. C. (1972). Streptococcal infections of the skin and their complications: impetigo and nephritis. In Streptococci and Streptococcal Diseases; Recognition, Understanding and Management (ed. Wannamaker, L. W. and Matsen, J. M.), pp. 571–87. New York and London: Academic Press.Google Scholar
Duma, R. J., Weinberg, A. N., Medrek, T. F.& Kunz, L. J. (1969). Streptococcal Infections – a bacteriologic and clinical study of streptococcal bacteraemia. Medicine (Baltimore) 48, 87127.Google Scholar
Fraser, C. A. M., Ball, L. C., Maxted, W. R. & Parker, M. T. (1979). Streptococcal skin sepsis among meat handlers. In Pathogenic Streptococci (ed. Parker, M. T.). Chertsey, Surrey: Reedbooks.Google Scholar
Fraser, C. A. M., Ball, L. C., Morris, C. A. & Noah, N. D. (1977). Serological characterization of Group-A streptococci associated with skin sepsis in meat handlers. Journal of Hygiene 78, 283296.Google Scholar
Fleming, A. & Porteous, A. B. (1919). Streptococcal infections of septic wounds at a base hospital. Lancet ii, 4951.Google Scholar
Green, D. M. & Jamieson, W. M. (1958). Anthrax and bone-meal fertiliser. Lancet vii, 153155.CrossRefGoogle Scholar
Hallen, L. G. (1966). Heterologous transplantation with Kiel bone. Acta Orthopaedica Scandinavica 37, 119.Google Scholar
Hamburger, M. Jnr & Green, M. J. (1946). The problem of the dangerous carrier of haemolytic streptococci. Journal of Infectious Disease 79, 3344.Google Scholar
Hunter, D. (1978). The Diseases of Occupations, 6th ed., pp. 687743. London: Hodder and Stoughton.Google Scholar
Jamieson, W. M. & Green, D. M. (1955). Anthrax and bone-meal fertiliser. Lancet i, 560561.Google Scholar
Klauder, J. V., Kramer, D. W. & Nicholas, L. (1943). Erysipelothrix rhusiopathiae septicaemia: diagnosis and treatment. Journal of the American Medical Association 122, 938943.CrossRefGoogle Scholar
Lancefield, R. C. (1972). Group A streptococcal infections in animals–natural and experimental. In Streptococci and Streptococcal Diseases; Recognition, Understanding and Management (ed. Wannamaker, L. W. and Matsen, J. M.), pp. 313326. New York and London: Academic Press.Google Scholar
Lawson, G. B. & Stinnett, M. S. (1933). Erysipeloid occurring among workers in a bone button factory. Southern Medical Journal 26, 10681070.CrossRefGoogle Scholar
McGinnes, G. F. & Spindle, F. (1934). Erysipeloid condition among workers in a bone button factory due to the bacillus of swine erysipelas. American Journal of Public Health 24, 3235.CrossRefGoogle Scholar
Morris, C. A. (1980). Communicable Disease Surveillance Centre, Public Health Laboratory Service (unpublished).Google Scholar
Noble, W. C. (1965). The production of subcutaneous staphylococcal skin lesions in mice. British Journal of Experimental Pathology 46, 254262.Google Scholar
Ross, R. F. (1972). Streptococcal infections in swine. In Streptococci and Streptococcal Diseases; Recognition, Understanding and Management (ed. Wannamaker, L. W. and Matsen, J. M.), pp. 339353. New York and London: Academic Press.Google Scholar
Samman, P. D. (1972). The nails. In Textbook of Dermatology, 2nd ed., (ed. Rook, A.Wilkinson, D. S. and Ebling, F. J. G.), pp. 16421671. Oxford: Blackwell Scientific Publications.Google Scholar
Stokes, E. J. (1975). Clinical Bacteriology, 4th ed., pp. 208225. London: Edward Arnold.Google Scholar
Tsai, T. F., Watson, W. N., Hayes, P. S., Facklam, R. R. & Fraser, D. W. (1979). Mode of spread of group A streptococci in an abattoir outbreak of wound sepsis. In Pathogenic Streptococci (ed. Parker, M. T.). Chertsey, Surrey: Reedbooks.Google Scholar
Widdowson, J. P., Maxted, W. R., Notley, C. M. & Pinney, A. M. (1974). The antibody responses in man to infection with different serotypes of group A streptococci. Journal of Medical Microbiology 7, 483496.Google Scholar
Williams, R. E. O., Blowers, R., Garrod, L. P. & Shooter, R. A. (1966). Hospital Infection; Causes and Prevention, 2nd ed., pp. 2935. London: Lloyd-Luke.Google Scholar
Williams, R. E. O. & Miles, A. A. (1949). Infection and sepsis in industrial wounds of the hand: a bacteriological study of aetiology and prophylaxis. Medical Research Council Special Report Series, no. 266. London: His Majesty's Stationery Office.Google Scholar
Wilson, G. S. & Miles, A. A. (1975). Topley and Wilson's Principles of Bacteriology, Virology and Immunity, 6th ed., pp. 740. London: Edward Arnold.Google Scholar
Working Group on Streptococcal Infection in Meat Handlers (1979). A survey of streptococcal skin sepsis among meat handlers and other workers. In Pathogenic Streptococci (ed. Parker, M. T.). Chertsey, Surrey: Reedbooks.Google Scholar