title: Deaths of early-onset, invasive sepsis in full-term infants in Miyazaki: nine cases from a regional population-based analysis from 1998-2006.
abstract: In a population-based study we investigated the early-onset, invasive sepsis caused by group B streptococcus (GBS) and non-GBS in the era of intrapartum antimicrobial prophylaxis. From 1998 to 2006, we had 387 perinatal deaths in 98,495 deliveries, and 9 full-term infants met the criteria of early-onset, invasive sepsis, in which microorganisms were proven from blood sampling. Of these cases, 4 involved GBS, 2 ampicillin-resistant Escherichia coli, 2 methicillin-resistant Staphylococcus aureus, and 1 was unidentified. All 4 cases of GBS related death underwent improper procedures contrary to the prophylaxis recommendation. Eighty percent of non-GBS related deaths had septicemia of antibiotic-resistant pathogens. We found in our population-based study that early-onset, fatal sepsis in full-term infants is associated with insufficient adherence to the prophylaxis strategy for GBS and with the emergence of antimicrobial resistant non-GBS bacteria.
authors.affiliation: Department of Obstetrics and Gynecology and Perinatal Center, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan. hsameshima@fc.miyazaki-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sameshima
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kodama
authors.forename: Masatoki
authors.initials: M
authors.lastname: Kaneko
authors.forename: Tsuyomu
authors.initials: T
authors.lastname: Ikenoue
mesh_terms: D017668:Age of Onset; D000668:Ampicillin Resistance; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000382:microbiology / Q000401:mortality*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D016106:Methicillin Resistance; D011159:Population Surveillance; D018805:Sepsis / Q000382:microbiology / Q000401:mortality*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality*; D013211:Staphylococcus aureus / Q000187:drug effects; D013290:Streptococcal Infections / Q000382:microbiology / Q000401:mortality*; D013292:Streptococcus agalactiae / Q000302:isolation & purification