scholarly journals Surgical site infection following cesarean section in a general hospital in Kuwait: trends and risk factors

2019 ◽  
Vol 147 ◽  
Author(s):  
W. Alfouzan ◽  
M. Al Fadhli ◽  
N. Abdo ◽  
W. Alali ◽  
R. Dhar
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Surgical Morbidity ◽  
Antibiotic Policy ◽  
Infection Surveillance ◽  
A Prospective Study

Abstract Surgical site infections (SSI) are a significant cause of post-surgical morbidity and mortality. The objectives of this study were to determine the prevalence of SSI and identify risk factors for infections following cesarean section (CS). A prospective study of SSI after CS was carried out from January 2014 to December 2016 using the methodology of the American National Nosocomial Infection Surveillance System. Suspected SSIs were confirmed clinically by the surgeon, and or, by culture. Seven thousand two hundred thirty five CS were performed with an overall SSI prevalence of 2.1%, increasing from 1.7% in 2014 to 2.95% in 2016 (P = 0.010). Of 152 cases of SSI, the prevalence of infection was 46.7% in women ⩽30 years and 53.3% in women >30 years (P = 0.119). Of 148 culture samples from as many women, 112 (75.7%) yielded growth of microorganisms with 42 (37.5%) of isolates being multi-drug resistant (MDR). Women who did not receive prophylactic antibiotics (35.5%) developed SSI more often than those who did (P < 0.0001). These findings suggest that emergency CS and inappropriate antibiotic prophylaxis are risk factors for developing SSI. In the light of the emergence of MDR bacteria there is a need to implement revised prophylactic antibiotic policy as part of antimicrobial stewardship to decrease SSI rates.

scholarly journals Analysis of risk factors associated with caesarean section surgical site infections: a case control study

2020 ◽  
Vol 9 (12) ◽  
pp. 5075
Author(s):  
Riya Rano ◽  
Purvi K. Patel
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Subcutaneous Tissue ◽  
White Blood Cells ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Patient Characteristics ◽  
Factors Associated ◽  
Operative Care ◽  
Duration Of Surgery

Background: Surgical site infection (SSI) is defined as infection occurring within 30 days after a surgical procedure and affecting either the incision or deep tissues at the operation site. SSIs are the most common nosocomial infections, accounting for 38% of hospital-acquired infections. Despite the advances in SSI control practices, SSIs remain common causes of morbidity and mortality among hospitalized patients. This study was undertaken with an objective to determine and analyze the risk factors associated with cesarean section SSIs.Methods: The study was carried out at Medical College and SSG Hospital, Baroda. After obtaining informed consent to be a part of the study, 140 subjects having cesarean section SSI as per the definition, were included as cases in the study. The controls (140) were also selected from the hospital subjects. The primary post-operative care was similar for the cases as well as controls. For patients who had SSI, samples of discharge from the cesarean section wound were collected and transported for culture. Antibiotics were given accordingly. Details about patient characteristics and outcomes were collected in the proforma for cases and controls and data analyzed.Results: The cesarean section SSI rate was 4.78%. Of the parameters studied, maternal age, parity, gestational age, HIV status, meconium stained amniotic fluid, amount of blood loss, previous surgery, duration of surgery were not associated with cesarean section SSI.Conclusions: Number of antenatal care (ANC) visits, haemoglobin, total white blood cells (WBC) count, pre eclampsia, premature rupture of membranes (PROM), non-progression in 2nd stage and subcutaneous tissue thickness were the independent significant risk factors associated with post-cesarean SSI.

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

2005 ◽  
Vol 26 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Piret Mitt ◽  
Katrin Lang ◽  
Aira Peri ◽  
Matti Maimets
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Fetal Monitoring ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Increased Risk ◽  
Multi Method Approach ◽  
Method Approach

AbstractObjectives:To evaluate a multi-method approach to postdischarge surveillance of surgical-site infections (SSIs) and to identify infection rates and risk factors associated with SSI following cesarean section.Design:Cross-sectional survey.Setting:Academic tertiary-care obstetric and gynecology center with 54 beds.Patients:All women who delivered by cesarean section in Tartu University Women's Clinic during 2002.Methods:Infections were identified during hospital stay or by postdischarge survey using a combination of telephone calls, healthcare worker questionnaire, and outpatient medical records review. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System.Results:The multi-method approach gave a follow-up rate of 94.8%. Of 305 patients, 19 (6.2%; 95% confidence interval [CI95)], 3.8-9.6) had SSIs. Forty-two percent of these SSIs were detected during postdischarge surveillance. We found three variables associated with increased risk for developing SSI: internal fetal monitoring (odds ratio [OR], 16.6; CI95, 2.2-125.8; P = .007), chorioamnionitis (OR, 8.8; CI95, 1.1-69.6; P = .04), and surgical wound classes III and IV (OR, 3.8; CI95, 1.2-11.8; P=.02).Conclusions:The high response rate validated the effectiveness of this kind of surveillance method and was most suitable in current circumstances. A challenge exists to decrease the frequency of internal fetal monitoring and to treat chorioamnionitis as soon as possible (Infect Control Hosp Epidemiol 2005;26:449-454).

Risk factors and clinical significance of abdomino-pelvic free fluid after cesarean section: a prospective study

2019 ◽  
Vol 34 (2) ◽  
pp. 287-292
Author(s):  
Zahra Naeiji ◽  
Sara Sotudeh ◽  
Elham Keshavarz ◽  
Narjes Naghshvarian ◽  
Nayereh Rahmati
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Prospective Study ◽  
Clinical Significance ◽  
Free Fluid ◽  
A Prospective Study

Incidence and modifiable risk factors of surveillance of surgical site infections in Egypt: A prospective study

2012 ◽  
Vol 40 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Soad Hafez ◽  
Tamer Saied ◽  
Elham Hasan ◽  
Manal Elnawasany ◽  
Eman Ahmad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Surgical Site Infections ◽  
Modifiable Risk Factors ◽  
A Prospective Study

scholarly journals Perioperative antimicrobial prophylaxis in patients receiving antibiotic therapy

2021 ◽  
Author(s):  
Yiwei Yin ◽  
Eljim P Tesoro ◽  
Alan E Gross ◽  
Jeffery J Mucksavage
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Surgical Site Infections ◽  
Dose Interval ◽  
Prophylactic Antibiotics ◽  
Antibiotic Administration

Objective: Antimicrobial prophylaxis is administered perioperatively to prevent surgical site infections. However, in patients who have already received antibiotics for the treatment of active infections prior to surgery, the risks and benefits of administering prophylactic antibiotics are unknown. We aimed to assess the necessity of perioperative prophylactic antibiotic administration in patients receiving antibiotic treatment for active infections. Method: This was a retrospective, chart-review cohort study. Between January 2018 to May 2018, adult patients who underwent inpatient surgery at the University of Illinois Hospital and Health Sciences System, and were prescribed prophylactic antibiotics based on institutional protocol, while receiving antibiotic treatment within 48 hours prior to surgery, were included in the study. The primary endpoint was the rate of duplicative antibiotic therapy, which was defined as the administered prophylactic antibiotic (1) exhibiting similar or narrower bacterial coverage as the treatment antibiotic(s), and (2) given within the dose interval of the treatment antibiotic(s). Results: A total of 158 patients were included in the study, of which 70 (44.3%) received duplicative antibiotic therapy, whereas 88 (55.7%) did not. Differences in the incidence of acute kidney injury, C. difficile infection, and surgery site infections were not statistically significant between the two groups. Conclusion We found that it was common for patients receiving therapeutic systematic antibiotics to perioperatively be prescribed additional prophylactic antibiotics at our institution. However, additional prophylactic antibiotics can be unnecessary in decreasing the incidence of surgical site infections.

scholarly journals Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

2018 ◽  
Vol 5 (8) ◽  
pp. 2899
Author(s):  
Prashanta Swami Pujar ◽  
K. B. Phuleker ◽  
Nagaraj Bhalki
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Research Centre ◽  
Chi Square ◽  
College Hospital ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
Chi Square Test ◽  
A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

scholarly journals The Association Between Preterm Premature Rupture of Membranes and Surgical Site Infection Following Cesarean Section

2016 ◽  
Author(s):  
Mehmet Çınar ◽  
Hakan Timur ◽  
Ali İrfan Güzel ◽  
Aytekin Tokmak ◽  
Burak Ersak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Clinical Characteristics ◽  
Positive Culture ◽  
Surgical Site Infections ◽  
Study Group ◽  
Obese Women ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Post Discharge

<p><strong>OBJECTIVE:</strong> To evaluate clinical characteristics of surgical-site infections (SSIs) following cesarean section (CS) and to identify infection rates and risk factors associated with SSIs following cesarean section. <br /><strong>STUDY DESIGN:</strong> A total of 197 patients who underwent cesarean and complicated with SSIs was evaluated during hospital stay or within 30 days following cesarean section by readmission to the hospital or by post discharge survey. The clinical characteristics, subsequent microbiological culture results and management were recorded. <br /><strong>RESULTS:</strong> There were 34 (17.25%) patients complicated with preeclampsia and 26 (13.17%) gestational diabetes mellitus (GDM) in the study group. Preterm rupture of membranes (PROM) rate was 17.31% and mean rupture period were 6.61 hours. In the study population, 66 patients had positive culture results. The most isolated microorganism was S. Aureus (n=13, 19.7%). Preeclampsia, GDM and PROM rates were statically significant high in patients with positive culture results (p&lt;0.05). There were 31 patients complicated with PROM in the study group. The rates of positive culture results were significantly increased by PROM (mean 45%, p&lt;0.05).<br /><strong>CONCLUSION:  </strong>Independent risk factors for post-cesarean SSIs are younger age, obesity, diabetes, hypertension, premature rupture of membranes. Information regarding higher rates of SSIs should be provided to obese women undergoing cesarean delivery, especially when diabetes and hypertension coexists.</p>

scholarly journals Risk of Complications in Spine Surgery: A Prospective Study

2015 ◽  
Vol 9 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Rodolfo Casimiro Reis ◽  
Matheus Fernandes de Oliveira ◽  
José Marcus Rotta ◽  
Ricardo Vieira Botelho
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Spine Surgery ◽  
Absolute Risk ◽  
Surgical Site Infections ◽  
Spine Instrumentation ◽  
Increased Risk ◽  
The Mean ◽  
A Prospective Study ◽  
Epidemiological Characteristics

Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications.

scholarly journals Successful control program to implement the appropriate antibiotic prophylaxis for cesarean section

2008 ◽  
Vol 50 (2) ◽  
pp. 79-82 ◽  
Author(s):  
Silvia Nunes Szente Fonseca ◽  
Maria Helena Sofia ◽  
Silvana Quintana ◽  
Fernanda Dos Santos Nogueira ◽  
Anna S. Levin
Keyword(s):  
Cesarean Section ◽  
Intervention Program ◽  
Antimicrobial Prophylaxis ◽  
Surgical Site Infections ◽  
Control Program ◽  
Post Discharge ◽  
Post Intervention ◽  
Successful Control ◽  
A Prospective Study ◽  
Government Reimbursement

OBJECTIVE: Describe implementation of a successful program to reduce doses (cefazolin 2 to 1 g) used for antimicrobial prophylaxis. METHODS: Evaluation of an intervention program to reduce prophylactic antimicrobial doses. The intervention included weekly staff discussions, automatic dispensation of 1g-vial of cefazolin by the pharmacy unless expressly requested by surgeon and increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction. In the pre and post intervention periods, a prospective study of antimicrobial consumption and surgical site infections were measured. RESULTS: There were 5,164 and 5,204 deliveries in 2001-2002 and 2003-2004, respectively; 1,524 (29.5%) and 1,363 (26%) were cesarean sections. There was a 45% decrease in cefazolin vials used on average per cesarean section (2.29 to 1.25). Patients evaluated increased from 16% to 67% and the SSI rates in both periods were 3.34% to 2.42%, respectively. CONCLUSION: An ample intervention, including administrative and educational measures, led to high compliance with dose reduction and saved more than US$4,000 in cefazolin, considered important because government reimbursement in Brazil for cesarean section is $80.

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