scholarly journals Cost–benefit analysis of surveillance for surgical site infection following caesarean section

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036919 ◽  
Author(s):  
Catherine Wloch ◽  
Albert Jan Van Hoek ◽  
Nathan Green ◽  
Joanna Conneely ◽  
Pauline Harrington ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Health Service ◽  
Surgical Site Infection ◽  
Effective Means ◽  
Surgical Site Infections ◽  
Infection Risk ◽  
Baseline Risk ◽  
Site Infection ◽  
Risk Of Infection ◽  
Surveillance Strategy

ObjectiveTo estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.DesignEconomic model to evaluate the costs and benefits of surveillance from community and hospital healthcare providers’ perspective.SettingEngland.ParticipantsWomen undergoing caesarean section in National Health Service hospitals.Main outcome measureCosts attributable to treatment and management of surgical site infection following caesarean section.ResultsThe costs (2010) for a hospital carrying out 800 caesarean sections a year based on infection risk of 9.6% were estimated at £18 914 (95% CI 11 521 to 29 499) with 28% accounted for by community care (£5370). With inflation to 2019 prices, this equates to an estimated cost of £5.0 m for all caesarean sections performed annually in England 2018–2019, approximately £1866 and £93 per infection managed in hospital and community, respectively. The cost of surveillance for a hospital for one calendar quarter was estimated as £3747 (2010 costs). Modelling a decrease in risk of infection of 30%, 20% or 10% between successive surveillance periods indicated that a variable intermittent surveillance strategy achieved higher or similar net savings than continuous surveillance. Breakeven was reached sooner with the variable surveillance strategy than continuous surveillance when the baseline risk of infection was 10% or 15% and smaller loses with a baseline risk of 5%.ConclusionSurveillance of surgical site infections after caesarean section with feedback of data to surgical teams offers a potentially effective means to reduce infection risk, improve patient experience and save money for the health service.

scholarly journals Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical College ◽  
Related Risk ◽  
Microbiological Methods ◽  
Duration Of Surgery ◽  
History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

scholarly journals Reducing Veterinary Waste: Surgical Site Infection Risk and the Ecological Impact of Woven and Disposable Drapes

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Molly Vasanthakumar
Keyword(s):  
Surgical Site Infection ◽  
One Health ◽  
Ecological Impact ◽  
Surgical Site Infections ◽  
Infection Risk ◽  
Site Infection ◽  
Veterinary Profession ◽  
Health Concept ◽  
The One

PICO questionIn animals undergoing surgery, does the use of disposable synthetic drapes reduce the risk of surgical site infections when compared to reusable woven drapes?Clinical bottom lineCurrent literature on the risk of surgical site infection with disposable and reusable drapes in animals is limited. Three human studies were reviewed, one systematic review and two controlled trials. Both these study types generally provide high levels of evidence; however their individual limitations reduce the quality of their data. Overall the results were mixed, and due to the small number of reviewed papers and the fact that only one study specifically measured surgical site infection as the outcome, it is not possible to conclude that disposable drapes reduce the risk of surgical site infections (SSI) when compared to reusable drapes.The impact of the veterinary profession on the ecosystem is often ignored. When following the One Health concept, vets must consider the ecological impact of clinical decisions. Choosing reusable drapes for certain clean, elective procedures may be a way to reduce waste without compromising the health of patients.

scholarly journals Surgical site infections in adults patients undergoing of clean and contaminated surgeries at a university Brazilian hospital

2010 ◽  
Vol 47 (4) ◽  
pp. 383-387 ◽  
Author(s):  
Maria de Lourdes Gonçalves Santos ◽  
Renata Rezende Teixeira ◽  
Augusto Diogo-Filho
Keyword(s):  
Surgical Site Infection ◽  
Risk Index ◽  
Surgical Site Infections ◽  
Infection Risk ◽  
University Hospital ◽  
Site Infection ◽  
Global Index ◽  
Post Discharge ◽  
Infection Surveillance

CONTEXT: Surgical site infections are a risk inherent to surgical procedures, especially after digestive surgeries. They occur up to 30 days after surgery, or up to a year later if a prosthesis is implanted. The Surgical-site Infection Risk Index (SIRI), NISS (National Nosocomial Infection Surveillance) methodology, is a method to evaluate the risk of surgical site infections, which takes into account the potential contamination of the surgery, the patient's health status and surgery duration. OBJECTIVES: To evaluate the correlation between the surgical-site infection risk index score on the 1st day postoperatively, and the development of surgical site infection up to 30 days postoperatively. METHODS: The postoperative surgical site infections (NNIS) was evaluated by following-up in hospital and as an outpatient. The patients followed prospectively were those submitted to elective surgeries, clean (hernioplasties) or contaminated (colorretal), performed by conventional approach at a university hospital, during the period from June 2007 to August 2008. The mean age of the patients was 55.5 years, 133 (65.5%) male; 120 (59.1%) submitted to clean surgeries and 83 (40.9%) contaminated. RESULTS: The global index of surgical site infections was 10.3%; 10 (8.3%) in clean procedures and 111(3.2%) in contaminated ones. Four (19.1%) of the surgical site infections were diagnosed at the time of hospitalization and 17 (80.9%) at post-discharge follow-up. Twelve (57.1%) of the surgical site infections were superficial, 2 (9.5%) deep and 7 (33.3%) at a specific site. Of these, 5 (6.6%) were in patients classified as SIRI 0 (76); 9 (15%) for SIRI 1 (60); 5 (9.1%) for SIRI 2 (55) and 2 (16.7%) for SIRI 3. CONCLUSION: The global index of surgical site infections and its incidence among contaminated procedures are within the expected limits. On the other hand according to SIRI, the surgical site infection indexes are above the expected standards both for the clean and for the contaminated procedures.

scholarly journals Surgical Site Infections by Mycobacterium after Cesarean Section in Bangladesh: A Case Report

2015 ◽  
Vol 1 (1) ◽  
pp. 18-21
Author(s):  
M. Saiful Islam ◽  
M. Abdullah Yusuf ◽  
Fatema Ashraf
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Mycobacterium Species ◽  
Acid Fast Bacilli ◽  
The Common ◽  
Beaded Appearance

Surgical site infection is very common in Bangladesh which is due to several reasons. During caesareansection it is not unlikely that this type of infection can be happened. In addition to the common bacteriaatypical bacteria sometimes causes the surgical site infection like Mycobacterium species. In this casereport a cesarean section-acquired Mycobacterium surgical site infections has been reported in Bangladeshwhich was presented as repeated abscess formation at the site of the caesarean section. Pus was drainedfrom the abscess and Zeil-Neelsen staining was performed and was found slender rod, beaded appearance Acid-fast bacilli. Then the patient was treated with anti-tubercular drugs and was totally cured.Bangladesh J Infect Dis 2014;1(1):18-21

scholarly journals Wound grading and surgical site infection following caesarean section

2021 ◽  
Vol 10 (7) ◽  
pp. 2667
Author(s):  
Kavita Arya ◽  
Kishna Ram ◽  
Nupur Hooja ◽  
Neha Singh ◽  
Aditi Jaiswal
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Purulent Discharge ◽  
Site Infection ◽  
Normal Wound Healing ◽  
Detailed Assessment ◽  
Labour Ward ◽  
Microbiological Flora

Background: Surgical site infection (SSI) following caesarean section can adversely influence the postpartum period for the women. The objective of the study was to study the extent of infection and the microbiological flora in cases of surgical site infection following caesarean section.Methods: Women undergoing caesarean section amongst women admitted in labour ward were followed till discharge for any surgical site infection Detailed assessment of the wound was done. Any discharge if present was taken for culture.Results: 88.88% had normal wound healing, implying no infection. Of those with abnormal wound, 22% had serosanguinous or purulent discharge. Most had superficial incisional SSI. Enterococcus faecalis and Staphylococcus were the commonest organisms grown on culture.Conclusions: All surgical site infections should be looked into as early as possible and managed appropriately.

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

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.

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

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.

scholarly journals Surgical Site Infection Following Caesarean Section by Acinetobacter Species: A Report from a Hyperendemic Setting in the Brazilian Amazon Region

2021 ◽  
Vol 9 (4) ◽  
pp. 743
Author(s):  
Blenda Gonçalves Cabral ◽  
Danielle Murici Brasiliense ◽  
Ismari Perini Furlaneto ◽  
Yan Corrêa Rodrigues ◽  
Karla Valéria Batista Lima
Keyword(s):  
Caesarean Section ◽  
Surgical Site Infection ◽  
Carbapenem Resistance ◽  
Brazilian Amazon ◽  
Amazon Region ◽  
Site Infection ◽  
Acinetobacter Species ◽  
Brazilian Amazon Region ◽  
Acinetobacter Spp ◽  
The Impact

Surgical site infection (SSI) following caesarean section is associated with increased morbidity, mortality, and significant health care costs. This study evaluated the epidemiological, clinical, and microbiological features of Acinetobacter spp. in women with SSIs who have undergone caesarean section at a referral hospital in the Brazilian Amazon region. This study included 69 women with post-caesarean SSI by Acinetobacter spp. admitted to the hospital between January 2012 and May 2015. The 69 Acinetobacter isolates were subjected to molecular species identification, antimicrobial susceptibility testing, detection of carbapenemase-encoding genes, and genotyping. The main complications of post-caesarean SSI by Acinetobacter were inadequate and prolonged antibiotic therapy, sepsis, prolonged hospitalization, and re-suture procedures. A. baumannii, A. nosocomialis and A. colistiniresistens species were identified among the isolates. Carbapenem resistance was associated with OXA-23-producing A. baumannii isolates and IMP-1-producing A. nosocomialis isolate. Patients with multidrug-resistant A. baumannii infection showed worse clinical courses. Dissemination of persistent epidemic clones was observed, and the main clonal complexes (CC) for A. baumannii were CC231 and CC236 (Oxford scheme) and CC1 and CC15 (Pasteur scheme). This is the first report of a long-term Acinetobacter spp. outbreak in women who underwent caesarean section at a Brazilian hospital. This study demonstrates the impact of multidrug resistance on the clinical course of post-caesarean infections.

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