scholarly journals Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Devjani De ◽  
Sonal Saxena ◽  
Geeta Mehta ◽  
Reena Yadav ◽  
Renu Dutta

Background. Lower segment caesarean section (LSCS) is a common mode of delivery now and surgical site infection is the second most common infectious complication in these patients. This study was planned with this background to have a comprehensive approach to SSI following LSCS. Methods. 500 consecutive patients undergoing LSCS, irrespective of indication, were studied. A questionnaire was developed to assess the risk factors associated with development of SSI. All patients were followed up from day one of surgery till discharge and then up till the postoperative day 30 after discharge. Results. SSI was identified in 121 (24.2%) out of 500 patients. In all age groups, Gram-negative bacilli were the commonest finding. The commonest isolate was Acinetobacter species (32.03%) followed by Staphylococcus aureus and coagulase negative Staphylococcus (21.09%). 23.8% of Staphylococcus aureus strains were MRSA. By multivariate logistic regression premature rupture of membrane (PROM), antibiotics given earlier than 2 hours and increased duration of stay in the hospital were found to be significant. Conclusions. A proper assessment of risk factors that predispose to SSI and their modification may help in reduction of SSI rates. Also, frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors affecting these practices.

2018 ◽  
Vol 40 (2) ◽  
pp. 211-213
Author(s):  
Jana Prattingerová ◽  
Emmi Sarvikivi ◽  
Kaisa Huotari ◽  
Jukka Ollgren ◽  
Outi Lyytikäinen

We investigated surgical site infections (SSIs) following hip and knee arthroplasties to evaluate predictors of SSI. We found a significant increase in deep Staphylococcus aureus (SA) SSIs despite the decreasing overall SSI rate. The risk of deep SA-SSI differed between genders and among age groups and was affected by timing of surgery.


2019 ◽  
Vol 9 (2) ◽  
pp. 90-96
Author(s):  
Sayma Afroz ◽  
Maliha Rashid

Background: Lower uterine caesarean section is a common mode of delivery now and surgical site infection is one of the most common and dreaded complication of surgery. It is associated with significant morbidity and delayed recovery and it lengthens hospital stay and costs. Identifying risk factors for surgical site infection in caesarean wound and modifying them can be beneficial for patient management during surgery and optimizing good clinical outcome. Identifying microorganisms with their sensitivity has epidemiological as well as therapeutic implications. Objective: To identify risk factors for surgical site infection in caesarean section wound and find out microorganisms responsible for such infection. Materials and Methods: In this study 100 women with surgical site infection after caesarean section were included. They were selected randomly from four maternity units of Dhaka Medical College Hospital. Each patient of caesarean section was followed strictly up to discharge from hospital and also for 30 days postoperatively for any evidence of infection. Wound swab was sent in each case for microbiological study. Data were collected in structured questionnaire and analysed by computer using spreadsheet. Results: Among 100 women studied, 73% had inadequate or no antenatal check-up, 52% had duration of labour pain >12 hours, 52% had duration of ruptured membrane >12 hours, 94% women underwent emergency caesarean section, 62% had operation time >1 hour, 61% had haemoglobin level <60%, 46% women had intervention by untrained birth attendant, and 43% women had >500 mL blood loss during operation. In bacteriological study, microorganisms were identified in 55% cases, among them Staphylococcus aureus (20%), E. coli (11%), Acinetobacter (7%), Pseudomonas (6%) and Proteus (5%). During sensitivity test Staphylococcus aureus was mostly sensitive to ceftriaxone (50%) and amikacin (33%) and E. coli to amikacin (80%). In four cases (2 proteus and 2 pseudomonas) out of 55 organisms were resistant to all antibiotics. Conclusion: Most of the risk factors for surgical site infection during caesarean section identified in this study can be modified through intervention. However, the microorganisms detected from our patients showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Enam Med Col 2019; 9(2): 90-96


Author(s):  
Monika Dalal ◽  
Smiti Nanda ◽  
Jagjit S. Dalal ◽  
Samiksha Kaushik ◽  
Meenakshi Chauhan ◽  
...  

Background: Women with previous LSCS often have to make a decision about mode of delivery of their second baby. As the rate of caesarean section is continuously increasing, vaginal birth after caesarean section (VBAC) is a good strategy to decrease caesarean rate. The present study was planned to assess the fetomaternal outcome in pregnancies with previous lower segment caesarean section undergoing trial of scar and to identify the factors, which can influence the outcome of trial of scar.Methods: This was a prospective observational study on 100 patients at a tertiary care institute. Pregnant women with previous LSCS were selected randomly for the study on the basis of the inclusion and exclusion criteria. Each labor monitored closely using a partogram. Decision for repeat emergency caesarean was taken by consultant. All women included in the study were followed through delivery and till discharge.Results: Out of 100 pregnant women 49 % cases had successful VBAC, 50% had emergency caesarean and one patient had laparotomy for rupture uterus. In women, who also had a prior vaginal delivery, 72% delivered vaginally, as compared to 40% of the women who did not undergo prior vaginal delivery (p value=0.003). Women who were in spontaneous labor, 59.21% delivered vaginally, whereas women who were induced, 16.6% delivered vaginally. The rate of perinatal complication was more in the patients who required an emergency CS after a failed trial. Conclusions: Our findings may encourage obstetricians to encourage VBAC in the properly screened ANC patients and decrease the rate of recommending caesarean section.


2018 ◽  
Vol 26 (2) ◽  
pp. 122-125
Author(s):  
Mukti Rani Saha ◽  
Nahid Yasmin ◽  
Afzalunnessa Chowdhury ◽  
Shahrin Ahmed ◽  
Kamrunnahar Sweety ◽  
...  

Objective: To determine the causes of high foetal head and their relative frequencies in primigravidae presenting at term and to determine the proportion of these patients undergoing lower segment caesarean section or vaginal delivery. Design: A descriptive study.Place and duration of study: The study was carried out at Mugda Medical College Hospital from March 2017 to June 2017.Materials and Methods: A total of 50 primigravidae patients presenting at term and having a single pregnancy were randomly selected. On the basis of history, Physical examination and abdominal ultrasonography, patients having a high foetal head were recognized and their causes documented.Results: Out of 50 primigravidae, with high foetal head there was foetal malpresentation 17(34%), Cephalopelvic disproportion 13(26%) , Foetal distress 12(24%). Lower segment caesarian section was the management of choice in more than half of the patients with high foetal head.Conclusions: Foetal malpresentation & Cephalopelvic disproportion were the major cause of high foetal head in this study and lower segment Caesarean section was the mode of delivery in more than half of the patients with high foetal head.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 122-125


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