Main findings
This study sought to report the clinical consequences of women diagnosed with pregnancy-associated GAS. Its main findings were:
  1. Women who received antibiotic prophylaxis during labor for various reasons had less severe infectious characteristics, such as STSS. This observation was supported by a longer interval between delivery to the first infectious presentation in those who received antibiotics.
  2. Predictors ICU admission were a tardive empirical antibiotic administration of more than 24 h after presentation postpartum and tachycardia.
  3. In contrast to other reports on a 30% mortality rate, there were no incidences of maternal death among the women who had sustained SSTS in the current study.
  4. Hospital staff transmission was relatively uncommon throughout the study period. There was a seasonal distribution of GAS infection in a multi-year analysis, with most cases having been identified between October and April.
In spite of the advances in medical care, pregnancy-associated GAS infection contributes significantly to maternal morbidity and mortality worldwide. Since the recognition of healthcare personnel-related puerperal sepsis by Semmelweis (13), extensive and costly efforts have been undertaken to investigate outbreaks of GAS infection from a common nosocomial source. Contrarily, the current study findings, taken together with previous data (8,14), reveal that healthcare personnel test negative in most cases, and that infections are considered as being community acquired for the most part. The current study results are in accordance with earlier ones that reported a comparable rate of presumed staff-related transmission of GAS infection. The overall incidence of puerperal GAS infection in the current cohort was similar to that of a previous study from the same institution (14). Of all identified GAS infections in the current study, 86% occurred postpartum and 14% occurred antepartum and were followed by septic abortions, similar to previous (8).