Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI 48109-5680, USA.
Am J Reprod Immunol. 2012 Feb;67(2):91-100. doi: 10.1111/j.1600-0897.2011.01083.x. Epub 2011 Oct 24.
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.
A 组链球菌（GAS）是 historically 重要的产褥期感染和败血症病原体。洗手和 hospital hygiene 的改善极大地降低了产褥期败血症的发病率，但最近产后 GAS 感染的 incidence 和 severity 却 rising 不明原因。一些流行病学、宿主和微生物因素增加了产后妇女 GAS 感染和 mortality 的风险。这些因素包括 delivery 的方式（阴道分娩与 cesarean section）、分娩发生的地点、与 GAS 携带者的接触、与 pregnancy 相关的免疫 status 的改变、宿主的 genetic background、感染 GAS 菌株的毒力，以及与女性生殖道组织和器官相关的高度专业化的 immune responses。这篇综述将讨论导致分娩后 GAS 易感性增加的复杂因素，以及最近 morbidity 和 mortality 增加的潜在原因。
