CME ACTIVITY : Invasive Group A Streptococcal Disease in Nursing Homes, Minnesota, 1995–2006

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eid; (4) view/print certificate.

Learning Objectives

Upon completion of this activity, participants will be able to:

• Identify the risk factors for invasive group A streptococcal (GAS) disease

• Compare the incidence of invasive GAS disease among persons older than 65 years with that of the general population in the United States

• Identify factors most likely to contribute to GAS outbreaks in nursing homes

• Describe the case-fatality ratio of GAS disease among older patients

• Describe the pattern of invasive GAS disease in nursing homes

Editor

D. Peter Drotman, MD, Editor-in-Chief, Emerging Infectious Diseases. Disclosure: D. Peter Drotman, MD, has disclosed no relevant financial relationships.

CME Author

Désirée Lie, MD, MSEd, Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California. Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.

Authors

Disclosures: Jean Rainbow, RN, MPH; Brenda Jewell; Richard N. Danila, PhD; David Boxrud, MS; Bernard Beall, PhD; Chris Van Beneden, MD, MPH; and Ruth Lynfield, MD, have disclosed no relevant financial relationships.

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions and earn continuing medical education (CME) credit, please go to http://www.medscape.com/cme/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.com. If you are not registered on Medscape.com, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

CME Questions

1. Which one of the following is least likely to be a risk factor for invasive group A streptococcal (GAS) disease?

   • A. Diabetes mellitus

   • B. Cancer

   • C. Chronic obstructive pulmonary disease

   • D. Depression

2. The incidence of invasive GAS disease among persons older than 65 years compared with the general population is best described by which one of the following?

   • A. Similar

   • B. Two times higher

   • C. Three times higher

   • D. Four times higher

3. Which one of the following is least likely to be a cause of outbreaks of invasive GAS disease among nursing home residents in the United States?

   • A. Frequent invasive procedures

   • B. Resident-to-resident spread

   • C. Inadequate infection control

   • D. Chronically infected resident

4. Which one of the following best describes the case-fatality ratio of invasive GAS disease in nursing home residents over 65 years under the surveillance program described for Minnesota?

   • A. 12%

   • B. 20%

   • C. 35%

   • D. 50%

5. The pattern of invasive GAS disease in nursing homes is best described by which one of the following?

   • A. Sporadic

   • B. Chronic

   • C. Epidemic

   • D. Staff-transmitted

     Table. Activity Evaluation.

     1. The activity supported the learning objectives.
     Strongly Disagree				Strongly Agree
     1	2	3	4	5
     2. The material was organized clearly for learning to occur.
     Strongly Disagree				Strongly Agree
     1	2	3	4	5
     3. The content learned from this activity will impact my practice.
     Strongly Disagree				Strongly Agree
     1	2	3	4	5
     4. The activity was presented objectively and free of commercial bias.
     Strongly Disagree				Strongly Agree
     1	2	3	4	5