Puerperal Sepsis and the Colebrooks
outbreaks of streptococcal sepsis
Dora Colebrook, came to Queen Charlottes in 1930 to study the source of group A streptococci that were causing so many deaths from puerperal sepsis, a leading cause of death in women who had just given birth. Using defined serological techniques, she undertook groundbreaking work to demonstrate that the streptococci that caused uterine infections and deaths were the very same streptococci present in the throats of those in the household or healthcare workers caring for the women. This confirmed that simple procedures -including what we now think of as PPE- could reduce the incidence and transmission of puerperal sepsis and Strep A in many settings. We are making her 1935 MRC report available here .
Imperial's new NIHR BRC AMR Colebrook research laboratory at Charing Cross, which opened at the start of the COVID-19 pandemic, is named in honour of Dora and her brother Leonard.
antibacterial treatment of puerperal sepsis
Leonard Colebrook undertook the very first trials of antibacterials in the Isolation Unit at Queen Charlotte's hospital in 1936, evaluating Prontosil Red to treat streptococcal puerperal sepsis. Within a year, use of sulphonamides was widespread, avoiding restrictive patents, and pre-dated general use of penicillin by a decade. Mortality from puerperal sepsis plummeted, and providing the world with an appetite for antibacterials. Somewhat inevitably, resistance to sulphonamides proved problematic, as predicted by Colebrook.
Sulphonamides used by Leonard Colebrook and colleagues to successfully treat puerperal sepsis (Kenny & Colebrook, Lancet 1936) starting a revolution in antimicrobial use.
Prontosil Rubrum: treatment chart from the first trial and patient Jan 1936 (courtesy RCOG archive)
Patients and some unfortunate staff who contracted group A streptococcus
Bacteria studied by Leonard and Dora Colebrook
Group A streptococci 1932-39 studied by Dora Colebrook: molecular re-analysis underway.