SURGICAL SITE INFECTION RELATED RISK FACTORS AND USAGE OF ANTIBIOTICS IN TWO DIFFERENT TERTIARY CARE HOSPITALS OF DHAKA CITY, BANGLADESH

Objective: Surgical site infection (SSI) is the most common complications following surgical procedures. The aim of the study was to assess the risk factors for SSI and the antibiotic treatment pattern following post-operative infection.Methods: This retrospective study has been considered the data of 156 surgical patients from two tertiary care hospitals in Dhaka city of Bangladesh.Result: The majority (31.4%) of the surgical patients came from the age group 40 to 49 years. A total of 8 SSI cases were discovered, 5 cases (8.9%) from Hospital-1, which was relatively higher (3%) than Hospital-2. Wound class “contaminated” was found in 6 cases, and the ratio is almost 1:3 or 75%. The duration of surgery within 90–120 min for 50% of SSI patients (4/8). Most frequent types of surgery were colorectal surgery (56.4%, 88/156), followed by various grades of fistula (24.4%, 38/156). The prophylaxis antibiotic was ceftriaxone, used by 77 (49.4%) cases. Commonly used antibiotic was ciprofloxacin, administered in 33 (21.2%) patients as a single therapy. Third-generation cephalosporins (cefixime, ceftriaxone, and cefuroxime) were found at the drug of choice in combination with gentamicin/metronidazole/nitazoxanide or amikacin.Conclusion: This study tried to give a little overview of SSI in different hospital settings, whereas improvement of preventive measures, early detection, and management of SSI is the main concern of nowadays. Further research should be done to get the detail by considering all the relevant factors of SSI.

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Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v13i3.18402 ◽

2017 ◽

Vol 13 (3) ◽

pp. 314-317

Author(s):

Manisha Chhetry ◽

Shanti Subedi ◽

Basudeb Banerjee

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Care Center ◽

Tertiary Care ◽

Site Infection ◽

Emergency Procedures ◽

Membrane Rupture ◽

Duration Of Surgery ◽

Elective Cesarean ◽

Associated Risk Factors

Background & Objectives:Post cesarean surgical site infection (SSI) is one of the commonly encountered complications which considerably increase the burden to health care. It is caused due to the interplay of various patient related, procedure related and iatrogenic factors. This study aims at identifying common risk factors for post cesarean SSI at our centre.Materials & Methods:This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included and their risk factors were studied.Results:Emergency procedures (82.97%) were more likely to develop SSI as compared to elective cesarean (17%). Among the patient related risk factors most of them were nulliparous (48.9%), term gestation (42.6%), malnourished (53.1%) and had history of prolonged leaking (44.68%) The mean age was 24.04±4.6years.Most of the patients who developed SSI were operated for repeat cesarean and fetal indications. Most patients who had SSI had at three to five per vaginal examinations (2.72±2). 66% of patient who had SSI had duration of surgery more than one hour. 68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultantsConclusion:The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon.

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Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

Journal of Anesthesia ◽

10.1007/s00540-016-2266-2 ◽

2016 ◽

Vol 31 (1) ◽

pp. 120-126 ◽

Cited By ~ 6

Author(s):

Manuel C. Vallejo ◽

Ahmed F. Attaallah ◽

Robert E. Shapiro ◽

Osama M. Elzamzamy ◽

Michael G. Mueller ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Cesarean Delivery ◽

Medical Center ◽

Tertiary Care ◽

Site Infection ◽

Tertiary Care Medical Center ◽

Independent Risk Factors

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Assessment of risk factors for surgical site infection following caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194886 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4518

Author(s):

Aditi Sangwan ◽

Vani Malhotra

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Surgical Site Infection ◽

Site Infection ◽

Emergency Caesarean ◽

Group I ◽

Number Of Patients ◽

Duration Of Surgery ◽

Wound Discharge ◽

Group Ii

Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus. Mean duration of resuturing was 17.42±6.98 days. Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.

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Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

Infection Control and Hospital Epidemiology ◽

10.1086/590124 ◽

2008 ◽

Vol 29 (9) ◽

pp. 832-839 ◽

Cited By ~ 36

Author(s):

Deverick J. Anderson ◽

Luke F. Chen ◽

Kenneth E. Schmader ◽

Daniel J. Sexton ◽

Yong Choi ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Surgical Site Infection ◽

Functional Status ◽

Surgical Patients ◽

Control Group ◽

Site Infection ◽

Methicillin Resistant ◽

Increased Risk ◽

Duration Of Surgery ◽

Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

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Incidence and risk factors for surgical site infection post-hysterectomy in a tertiary care center

American Journal of Infection Control ◽

10.1016/j.ajic.2016.10.008 ◽

2017 ◽

Vol 45 (3) ◽

pp. 284-287 ◽

Cited By ~ 10

Author(s):

Aurora Pop-Vicas ◽

Jackson S. Musuuza ◽

Michelle Schmitz ◽

Ahmed Al-Niaimi ◽

Nasia Safdar

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Site Infection

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Incidence of Surgical Site Infection among Post C Section Women Presented in Surgical Emergency of tertiary care hospital

10.53350/pjmhs211581836 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1836-1837

Author(s):

S Aliza Z Bokhari ◽

M. Irfan Fazal ◽

Maha Naseem ◽

M. Adnan Mumtaz ◽

S. Mahum Z Bokhari ◽

...

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Surgical Site Infection ◽

Tertiary Care ◽

Care Hospital ◽

Site Infection ◽

Surgical Emergency ◽

Key Factor ◽

Questionnaire Form ◽

Aseptic Conditions

Aim: To rule out incidence and risk factors that are associated with infection at site of surgery after cesarean section. Method: A type of retrospective study was conducted on 100 women who underwent cesarean delivery procedures within a period of 8 month from September 2020 to April 2021 and presented in surgical emergency at Mayo Hospital Lahore. The socioeconomic, demographic and clinical parameters of patients were collected by a questionnaire form. A program known as SPSS version 20 was used for analysis of data that is collected in study. Result: After analyzing the data following factors are identified that causes surgical site infection: Higher BMI (more than 30kg/m2), loss of blood during cesarean section(more than 500mL), poor hygienic care after cesarean section, poor socioeconomic status leads to malnutrition of patient and that leads to poor wound healing and surgical site infection. Lack of education is also a key factor in SSIs. Cesarean done in emergency under improper aseptic conditions also promote SSIs. All these factors are associated with incidence of SSI. Conclusion: SSIS are conventional among women presented in surgical emergency of Mayo Hospital Lahore within 30 days of cesarean section. Management of risk factors causing SSIs in women after cesarean section may decrease the incidence of such infections. Keywords: Cesarean section, risk factors, infection at surgery site.

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Incidence and risk factors for post caesarean delivery surgical site infection in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212169 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2316

Author(s):

Smita S. Naik ◽

Ajit Nagarsenkar

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Incidence Rate ◽

Tertiary Care ◽

Prophylactic Antibiotic ◽

Public Health Care ◽

Care Hospital ◽

Site Infection ◽

Medical College ◽

Modifiable Factors

Background: Post-operative surgical site infection (SSI) is the most commonly reported nosocomial infection which constitutes a major public health care problem worldwide. SSI are the one of the most common complication after caesarean section (C-sec) and results in maternal morbidity and mortality, increased length of the hospital stays and economic burden. The aim of the study is to determine the incidence and risk factors of SSI in women undergoing C-sec.Methods: The prospective observational study carried out in department of Obstetrics and Gynaecology in Goa medical college, Bambolim Goa from 1st November 2017 to 30th May 2019. Collection of data was carried using predesigned and pretested proforma. SSI was examined for association of different risk factors and its distribution.Results: During this study period, 2106 patients underwent C-sec, out of which 103 patients developed post-operative SSI with the incidence rate being 4.89%. The incidence rate was found higher in emergency cases (6.55%) as compared to that of elective (1.21%) and median time to SSI was the 6th post- operative day. Majority of SSI, i.e., 102 out of 103 (99.08%) were superficial SSI, 1 (0.98%) were deep SSI and no organ/space SSI. The highest rate of SSI was found in 21-34 years of age group (84.47%). The common risk factors associated are anaemia, diabetes, hypertension and obesity.Conclusions: SSI results from multiple risk factors which include modifiable and non- modifiable factors and thorough analysis of these factors can help prevent SSI. The medical staff should focus on some of the modifiable risk factors can be eliminated by strict antisepsis, timely prophylactic antibiotic and maintaining normothermia as well as optimal glucose level.

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

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51148 ◽

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

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A prospective study of surgical site infection of orthopedic implant surgeries

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175651 ◽

2017 ◽

Vol 4 (1) ◽

pp. 1 ◽

Cited By ~ 2

Author(s):

Muhammad Thahir ◽

Suresh Gandhi ◽

Kalaivanan Kanniyan ◽

Ravi Kumar

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Surgical Site Infection ◽

Infection Rate ◽

Risk Index ◽

Univariate Analysis ◽

Cost Of Care ◽

Orthopaedic Implant ◽

Site Infection ◽

Duration Of Surgery

Background: Surgical-site infection accounts for approximately 10% of all hospital-acquired infections, which are estimated to double the cost of care and result in an additional mean of 6.5 days of hospital stay. We did prospective study of surgical site infection of orthopaedic implant surgeries.Methods: The aim of the study is to assess the clinical and microbiological outcome of 125 patients who had open reduction and internal fixation with implants and prosthesis at Southern Railway Hospital from January 2006 to January 2007, and its strength of association with major risk factors using univariate analysis. In our study, Patients were allocated in to three groups as NINS risk index group 0, 1 and 2 with risk factors as duration of surgery >2 hours and ASA class ≥3. Post-operative wound infection was diagnosed based on the criteria of Center of Disease Control and assessed for the period of 6 weeks using National Nosocomial Infections Surveillance Risk Index.Results: There were 87 male and 38 females in the study. From 125 Patients, 13 patients had post-operative superficial surgical site infection and presented within 21 days of operation. The infection rate was 10.4%. Two Patients developed deep infection after 6 weeks of study. All the cases with superficial infection were followed at regular intervals, 11 cases resolved with regular dressing and antibiotics but 2 cases continued to discharge sinus up to 3 months.Conclusions: The study showed that the risk of infection rate increased significantly with ASA score, duration of surgery, obesity and NINS risk index. There was no significant association of infection rate with age, diabetes and smoking.

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