Postpartum Group A Streptococcus Sepsis and Maternal Immunology

Authors

  • Katie L. Mason,

    1. Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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  • David M. Aronoff

    1. Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
    2. Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
    3. Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, USA
    4. Reproductive Sciences Program, University of Michigan Medical School, Ann Arbor, MI, USA
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David M. Aronoff, University of Michigan Medical School, Internal Medicine – Infectious Diseases, 5510-E MSRB I, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-5680, USA.
E-mail: daronoff@umich.edu

Abstract

Citation Mason KL, Aronoff DM. Postpartum group A Streptococcus sepsis and maternal immunology. Am J Reprod Immunol 2012; 67: 91–100

Group A Streptococcus (GAS) is an historically important agent of puerperal infections and sepsis. The inception of hand-washing and improved hospital hygiene drastically reduced the incidence of puerperal sepsis, but recently the incidence and severity of postpartum GAS infections has been rising for uncertain reasons. Several epidemiological, host, and microbial factors contribute to the risk for GAS infection and mortality in postpartum women. These include the mode of delivery (vaginal versus cesarean section), the location where labor and delivery occurred, exposure to GAS carriers, the altered immune status associated with pregnancy, the genetic background of the host, the virulence of the infecting GAS strain, and highly specialized immune responses associated with female reproductive tract tissues and organs. This review will discuss the complicated factors that contribute to the increased susceptibility to GAS after delivery and potential reasons for the recent increase observed in morbidity and mortality.

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