Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections

Objective To examine the association between perioperative Beta (β))-lactam versus non-β-lactam antibiotics and cesarean delivery surgical site infection (SSI). Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β-lactam versus non-β-lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders. Results Of the 929 women included, 826 (89%) received β-lactam prophylaxis and 103 (11%) received a non-β-lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β-lactam prophylaxis. SSI occurred in 7% of women who received β-lactam antibiotics versus 15% of women who received a non-β-lactam (p = 0.004). β-Lactam prophylaxis was associated with lower odds of SSI compared with non-β-lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22–0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI). Conclusion β-Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non-β-lactam antibiotics.

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Risk of surgical site infection in patients undergoing orthopedic surgery

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000600012 ◽

2011 ◽

Vol 19 (6) ◽

pp. 1362-1368 ◽

Cited By ~ 30

Author(s):

Flávia Falci Ercole ◽

Lúcia Maciel Castro Franco ◽

Tamara Gonçalves Rezende Macieira ◽

Luísa Cristina Crespo Wenceslau ◽

Helena Isabel Nascimento de Resende ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Descriptive Analysis ◽

Surgical Site Infections ◽

Incidence Rates ◽

Site Infection ◽

Chi Square ◽

Historical Cohort ◽

Surgical Site Infection Incidence ◽

Chi Square Test

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

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A comparative study on surgical site infections after primary closure and delayed primary closure in clean contaminated laparotomy cases

International Surgery Journal ◽

10.18203/2349-2902.isj20190836 ◽

2019 ◽

Vol 6 (3) ◽

pp. 989

Author(s):

T. J. Pauly ◽

T. V. Haridas ◽

E. Manoj Prabhakar ◽

Roshjo Roshan

Keyword(s):

Surgical Site Infection ◽

Primary Closure ◽

Surgical Site Infections ◽

P Value ◽

Skin Closure ◽

Site Infection ◽

Chi Square ◽

Delayed Primary Closure ◽

Laparotomy Wound ◽

Clean Contaminated

Background: Surgical site infection is a significant cause of post operative morbidity. Timing of skin closure following a surgery and its relation to incidence of infection has been studied. The debate whether primary or delayed primary closure have been around for a long time. The aim of this study is to compare the rate of infection in a laparotomy wound in clean contaminated laparotomy cases after primary and delayed primary closure.Methods: 132 patients who underwent laparotomy for clean contaminated were selected. Of this primary closure of the skin was done in 66 cases and delayed primary closure at 48 hours were done in the other 66 patients. Wounds were followed up till post op day 7. The results between two groups were compared using chi square test.Results: two out of 66 cases developed SSI in the delayed primary sutured group whereas 8 out of 66 cases developed SSI in primary suturing group. The results were compared using chi square test and the chi square statistic was 3.8951 and the p value is 0.048428 (<0.05) proving the result significant.Conclusions: The incidence of surgical site infection in laparotomy wound after a primary closure was higher compared to delayed primary closure in clean contaminated laparotomy wounds and the difference is significant based on statistical evaluation.

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Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00562-11 ◽

2011 ◽

Vol 55 (10) ◽

pp. 4659-4663 ◽

Cited By ~ 36

Author(s):

Barnaby Young ◽

Tat Ming Ng ◽

Christine Teng ◽

Brenda Ang ◽

Hwei Yee Tai ◽

...

Keyword(s):

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Univariate Analysis ◽

Surgical Site Infections ◽

Orthopedic Procedures ◽

Site Infection ◽

Chi Square ◽

Chi Square Test ◽

Prevention Guidelines ◽

Complication Of Surgery

ABSTRACTSurgical site infection (SSI) is a common and preventable complication of surgery, but the relative importance of individual measures recommended by guidelines has not been determined. Elective general surgical, neurological, and orthopedic procedures requiring antibiotic prophylaxis from a 3-month period were retrospectively studied to determine concordance with SSI prevention guidelines and to identify factors which predicted the development of SSIs. A total of 216 surgeries were reviewed, with 18 SSIs (8.3%). A mean of 1.4 antibiotic prophylaxis errors per surgery were identified, with correct antibiotic type identified for 64%, antibiotic timing for 83%, supplemental antibiotic dosing for 34%, and antibiotic duration of less than 24 h for 44%. Normothermia was present in 79% of surgeries, and normoglycemia was present in 17%. Univariate analysis of the SSI rate identified four significant factors. Antibiotic prophylaxis for less than 24 h postoperatively (odds ratio [OR], 0.213; 95% confidence interval [95% CI]0.060 to 0.757) and neurosurgery (OR, 0.118; 95% CI, 0.15 to 0.903) correlated with a reduced risk of SSI. The mean number of prophylaxis errors (OR, 1.6; 95% CI, 1.02 to 2.4) and a duration of surgical drainage for more than 3 days (OR, 2.679; 95% CI, 1.009 to 7.113) predicted SSI. By multivariate analysis, errors in individual antibiotic prophylaxis measures were not significantly associated with SSI; however, the presence of more than two errors was significant (OR, 4.030; 95% CI, 1.018 to 15.96). A strong correlation was identified between the degree of concordance to SSI prevention guidelines and the SSI rate (P= 0.001, Mantel-Haenszel linear-by-linear association chi-square test).

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Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i01/09 ◽

2018 ◽

Vol 3 (01) ◽

Author(s):

V Singh ◽

A B Khyriem, W V Lyngdoh ◽

C J Lyngdoh

Keyword(s):

Surgical Site Infection ◽

Multiple Drug Resistance ◽

Surgical Site Infections ◽

Multidrug Resistant ◽

Multiple Drug ◽

Site Infection ◽

Retrospective Case ◽

Acinetobacter Baumanii ◽

Health Care Centre ◽

North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

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58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

British Journal of Surgery ◽

10.1093/bjs/znab134.356 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

H Mistry ◽

B Woolner ◽

A John

Keyword(s):

Surgical Site Infection ◽

Open Cholecystectomy ◽

Surgical Site Infections ◽

Standard Operating Procedure ◽

Site Infection ◽

Infection Rates ◽

Local Evidence ◽

Audit Data ◽

The Impact ◽

To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

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256 Do Non-Beta-lactam antibiotics increase risk for surgical site infection after cesarean: a retrospective chart review

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.278 ◽

2021 ◽

Vol 224 (2) ◽

pp. S169-S170

Author(s):

Ariana L. Lewis ◽

Amanda M. Murray ◽

Luke A. Newton ◽

Shawna A. Mattathil ◽

Diana A. Rascon

Keyword(s):

Surgical Site Infection ◽

Chart Review ◽

Retrospective Chart Review ◽

Site Infection ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Increase Risk

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1054 Predictors of surgical-site infection after cesarean delivery in obese women receiving evidence-based preventive measures

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.1079 ◽

2021 ◽

Vol 224 (2) ◽

pp. S652-S653

Author(s):

Kelsey Pape ◽

Methodius G. Tuuli ◽

Chemen M. Neal ◽

David M. Haas ◽

Anthony L. Shanks ◽

...

Keyword(s):

Surgical Site Infection ◽

Cesarean Delivery ◽

Preventive Measures ◽

Evidence Based ◽

Site Infection ◽

Obese Women

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Surgical Site Infection as a Surrogate Marker of Physician Impairment

Infection Control and Hospital Epidemiology ◽

10.1086/647982 ◽

2009 ◽

Vol 30 (11) ◽

pp. 1120-1122 ◽

Cited By ~ 3

Author(s):

Robert J. Sherertz ◽

Tobi B. Karchmer

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Surgical Site Infection ◽

Surrogate Marker ◽

Surgical Site Infections ◽

Baseline Period ◽

Site Infection ◽

Hepatitis C Virus Infection ◽

Physician Impairment

Our report details an implant-associated outbreak of surgical site infections related to the adverse effects of treatment for hepatitis C virus infection administered to surgeon X. During the 12-month period of this outbreak, 14 (9.5%) of 148 of surgeon X's patients developed a surgical site infection, a rate of SSI that was 8-fold higher than the rate during the 14-month baseline period or the 14-month follow-up period (P = .001), and higher than the rate among peer surgeons (P = .02).

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