The most common causative bacteria in maternal sepsis-related deaths in Japan were group A Streptococcus: A nationwide survey

J Infect Chemother. 2019 Jan;25(1):41-44. doi: 10.1016/j.jiac.2018.10.004. Epub 2018 Oct 28.

Abstract

The present retrospective study provides an in-depth analysis of the maternal sepsis-related deaths reported in Japan, and aims to guide future care regarding maternal sepsis. This is a nationwide, retrospective, descriptive cohort study. Data were retrospectively analyzed on all maternal death cases related to sepsis reported in Japan from 2010 through 2016. A total of 7,347,727 births and 317 maternal deaths were reported during the study period. The cause of maternal death was sepsis in 24 women (7.5%). Causative bacteria were Streptococcus pyogenes (54.2%), Chlamydia psittaci (8.3%), Mycobacterium tuberculosis (8.3%), Escherichia coli (4.2%), Neisseria meningitidis (4.2%), Epstein-Barr virus (4.2%), and unknown (16.6%). In maternal death due to S. pyogenes (13 women), onset periods ware antepartum in 10 women (76.9%) and postpartum in 3 (23.1%); death within 24 h after hospital admission occurred in 7 women (53.8%); and the median time from hospital admission to death was 12 h (6-744 h). The most common causative bacteria in to maternal sepsis-related death were GAS. When encountering severe sepsis during the peripartum period, we recommend considering severe GAS infection and early intervention.

Keywords: Group A Streptococcus; Maternal death; Sepsis.

MeSH terms

  • Adult
  • Chlamydophila psittaci / genetics
  • Chlamydophila psittaci / isolation & purification
  • Cohort Studies
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Female
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Maternal Mortality*
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification
  • Neisseria meningitidis / genetics
  • Neisseria meningitidis / isolation & purification
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications, Infectious / blood
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy Complications, Infectious / mortality*
  • Retrospective Studies
  • Streptococcal Infections / blood
  • Streptococcal Infections / complications
  • Streptococcal Infections / microbiology*
  • Streptococcal Infections / mortality*
  • Streptococcus pyogenes / genetics
  • Streptococcus pyogenes / isolation & purification*
  • Surveys and Questionnaires
  • Young Adult