Deaths of early-onset, invasive sepsis in full-term infants in Miyazaki: Nine cases from a regional population-based analysis from 1998-2006

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 I 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.