Abstract：
OBJECTIVE: To clarify the infection route in maternal death due to invasive group A streptococcal (GAS) infection and toxic shock syndrome (TSS).
METHODS: A retrospective study was conducted on maternal deaths due to GAS-TSS in Japan between January 2010 and March 2024. The final causal diagnosis of maternal death and the infection routes of GAS were analysed using medical records, laboratory data and autopsy findings.
RESULTS: Among the 616 maternal deaths during the study period, 48 (8%) involved infectious diseases. The most common infection was invasive GAS (56%, n = 27), 21 (78%) and six cases occurred during the antepartum and puerperium periods, respectively. In the GAS-TSS group, 71% (15/21) infections were originated the upper respiratory tract. However, in the puerperium cases, 67% (4/6) were infected from the genital tract. In addition, no maternal deaths due to GAS-TSS were reported during the COVID-19 pandemic period in Japan from 2020 to 2023.
CONCLUSIONS: Most antepartum GAS infections were from the upper respiratory tract. They may be reduced by preventive measures, including frequent disinfection, wearing masks and isolation from persons at high risk of carrying GAS, such as symptomatic children. On the other hand, GAS-TSS during puerperium infection via the genital tract.
METHODS: A retrospective study was conducted on maternal deaths due to GAS-TSS in Japan between January 2010 and March 2024. The final causal diagnosis of maternal death and the infection routes of GAS were analysed using medical records, laboratory data and autopsy findings.
RESULTS: Among the 616 maternal deaths during the study period, 48 (8%) involved infectious diseases. The most common infection was invasive GAS (56%, n = 27), 21 (78%) and six cases occurred during the antepartum and puerperium periods, respectively. In the GAS-TSS group, 71% (15/21) infections were originated the upper respiratory tract. However, in the puerperium cases, 67% (4/6) were infected from the genital tract. In addition, no maternal deaths due to GAS-TSS were reported during the COVID-19 pandemic period in Japan from 2020 to 2023.
CONCLUSIONS: Most antepartum GAS infections were from the upper respiratory tract. They may be reduced by preventive measures, including frequent disinfection, wearing masks and isolation from persons at high risk of carrying GAS, such as symptomatic children. On the other hand, GAS-TSS during puerperium infection via the genital tract.
摘要：
目的：明确侵袭性A组链球菌（GAS）感染和中毒性休克综合征（TSS）导致孕产妇死亡的感染途径。
方法：在2010年1月至2024年3月期间，对日本因GAS-TSS导致的孕产妇死亡进行了回顾性研究。使用医疗记录分析孕产妇死亡的最终因果诊断和GAS的感染途径。实验室数据,和尸检结果。
结果：在研究期间的616例孕产妇死亡中，48(8%)涉及传染病。最常见的感染是侵袭性GAS（56%，n=27),21例（78%）和6例发生在产前和产褥期，分别。在GAS-TSS组中，71％（15/21）的感染起源于上呼吸道。然而,在产褥期，67%(4/6)来自生殖道感染。此外,在2020-2023年日本的COVID-19大流行期间，没有因GAS-TSS导致的孕产妇死亡报告。
结论：大多数产前GAS感染来自上呼吸道。它们可以通过预防措施减少，包括频繁的消毒，戴着面具,与高风险携带气体的人隔离，比如有症状的孩子。另一方面,产褥期经生殖道感染的GAS-TSS。
方法：在2010年1月至2024年3月期间，对日本因GAS-TSS导致的孕产妇死亡进行了回顾性研究。使用医疗记录分析孕产妇死亡的最终因果诊断和GAS的感染途径。实验室数据,和尸检结果。
结果：在研究期间的616例孕产妇死亡中，48(8%)涉及传染病。最常见的感染是侵袭性GAS（56%，n=27),21例（78%）和6例发生在产前和产褥期，分别。在GAS-TSS组中，71％（15/21）的感染起源于上呼吸道。然而,在产褥期，67%(4/6)来自生殖道感染。此外,在2020-2023年日本的COVID-19大流行期间，没有因GAS-TSS导致的孕产妇死亡报告。
结论：大多数产前GAS感染来自上呼吸道。它们可以通过预防措施减少，包括频繁的消毒，戴着面具,与高风险携带气体的人隔离，比如有症状的孩子。另一方面,产褥期经生殖道感染的GAS-TSS。
