STUDY OF VARIOUS BASELINE FACTORS AND PRE-OPERATIVE FACTORS AFFECTING SURGICAL SITE INFECTION IN CAESAREAN SECTION

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Khushali Shroff ◽  
Dhwani Desai ◽  
Ragini Verma ◽  
Ekta Patel
Keyword(s):  
Caesarean Section ◽  
Gestational Diabetes ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Fold Increase ◽  
P Value ◽  
Site Infection ◽  
Factors Affecting ◽  
History Of ◽  
Extrinsic Risk

Introduction: Caesarean section is one of the most commonly performed surgical procedure in hospitals. But it carries 5-20 fold increase risk of infection compared to vaginal delivery. Analysis of various baseline, intrinsic and extrinsic risk factors predisposing to surgical site infection is necessary to detect common links. obtained information is important to plan a strategy to reduce post caesarean wound infections and its complications. Material and Method: This is a prospective observational study enrolling 1500 sequentiall consenting subjects who had undergone caesarean section, on surgical site infection following caesarean section. Results: The cesarean section rate was found to be 41.2%.Subjects over 35 years of age had highest SSI rates of 16.7% and difference in SSI in subjects more than 35years was statistically significant (p value = 0.04)  (88.6%) of the total enrolled subjects undergoing LSCS were antenatally registered amongst which 3.3% developed SSI compared to 11.4% of the total subjects were antenatally unregistered amongst which 5.8% developed SSI (p value=0.04)  1% of the total enrolled subjects undergoing LSCS had a history of gestational diabetes mellitus amongst which 33.3% had SSI , while 99% of the subjects did not have history of gestational diabetes amongst whom SSI incidence was 3.3% (p value <0.01) which is significant. 7.6% of the total enrolled subjects undergoing LSCS had a history of hypertension amongst which 8.8% developed SSI compared to 92.4% of the subjects without hypertension had 3.2% SSI. (p value <0.01) there is a significant association of body mass index with SSI.    (p value <0.01). There is significant association found between preterm rupture of membrane and SSI (p value  <0.01). Conclusion: Strategies for the prevention of post operative BMI must aim to control mother’s pre-conceptual weight, their antenatal registration, follow standard intranatal mangement guidelines, timely administration of prophylactic antibiotic if decision to perform LSCS is to be taken. Keywords: Surgical site infection, caesarean section.

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 Comparative study on prophylactic antibiotic versus empirical antibiotic in prevention of surgical site infection

2019 ◽  
Vol 9 (2) ◽  
pp. 9-13
Author(s):  
S Rajarajan ◽  
T.H. Sreelekshmi Devi ◽  
Neeshma Mariam Simon ◽  
K.R. Navin Shankar ◽  
V. Ganesan
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotic ◽  
Operative Therapy ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
P Value ◽  
Site Infection

The main aim of the study was to comparative study of single dose prophylactic antibiotic versus empirical postoperative antibiotics in prevention of surgical site infection. The study was a prospective observational study conducted over a period of 8months. A total of 100 number of surgery cases were selected randomly, to groups of 50 each. The study group received a single dose of antibiotic preoperatively while the control group received 3 to 5 days of empirical antibiotic therapy. Data analysis and statistical analysis was done with the help of graph pad prism trial version software. Student t test was carried out for paired analysis to find P value. There was no significant association of surgical site infection, grades of infection, and other complications. The hospital stay of patients, cost to the patients, and number of antibiotics used in patients were significantly more. The single dose prophylactic antibiotics are better than empirical post operative therapy in reducing the hospital stay and hospital cost to patients. Since the complete eradication of surgical site infection is not possible, only the reduction in infection rate can be achieved to a minimal level. Keywords: Prophylactic antibiotics, surgical site infection, surgical complications, post operative antibiotics.

scholarly journals Incidence and predictors of surgical site infection following cesarean section in North-west Ethiopia: a prospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daniel Bekele Ketema ◽  
Fasil Wagnew ◽  
Moges Agazhe Assemie ◽  
Aster Ferede ◽  
Alehegn Aderaw Alamneh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Previous History ◽  
Site Infection ◽  
North West ◽  
North West Ethiopia ◽  
History Of

Abstract Background Following delivery by caesarean section, surgical site infection is the most common infectious complication. Despite a large number of caesarean sections performed at Debre Markos Referral Hospital, there was no study documenting the incidence of surgical site infection after caesarean section. Therefore, this study aimed to estimate the incidence of surgical site infection following caesarean section at Debre-Markos Referral Hospital in Amhara region, North-west Ethiopia. Methods A prospective cohort study was conducted among 520 pregnant women who had a caesarean section between March 28, 2019 and August 31, 2019. Preoperative, intraoperative, and postoperative data were collected using a standardized questionnaire. Data was entered using EpiData™ Entry Version 4.1 software and analyzed using R Version 3.6.1 software. A descriptive analysis was conducted using tables, interquartile ranges and median. The time to development of surgical site infection was estimated using Kaplan-Meier method. The Cox regression model for bivariable and multivariable analyses was done. Adjusted Hazard Ratio (AHR) with 95% Confidence Interval (CI) was reported to show the strength of association. Result The mean age of the study cohort was 27.4 ± 4.8 years. The overall cumulative incidence of surgical site infection was 25.4% with an incidence of 11.7 (95% CI:9.8,13.9) per 1000 person/days. Not able to read and write (AHR = 1.30,95% CI:1.19,2.11), no antenatal care (AHR = 2.16, 95%CI:1.05,4.53), previous history of CS (AHR = 1.21, 95% CI:1.11,2.31), HIV positive (AHR = 1.39, 95% CI:1.21,2.57), emergency procedure (AHR = 1.13, 95% CI:1.11,2.43), vertical type of incision (AHR = 2.60, 95% CI:1.05,6.44), rupture of membrane (AHR = 1.50, 95% CI:1.31,1.64), multiple vaginal examination (AHR = 1.88, 95% CI: 1.71, 3.20) were significant predictors of surgical site infection in this study. Conclusion This study concluded that the incidence of surgical site infection following caesarean section was relatively high compared to previous studies. Not able to read and write, have no ante natal care, previous history of caesarean section, HIV, emergency surgery, vertical type of incision, rupture of membranes before caesarean section, and multiple vaginal examinations were significant predictors of surgical site infection in this study. Therefore, intervention programs should focus on and address the identified factors to minimize and prevent the infection rate after caesarean section.

scholarly journals Subcutaneous Radiographic Measurement: A Marker to Evaluate Surgical Site Infection Risk in Elderly Hip Fracture Patients

2019 ◽  
Vol 4 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Martí Bernaus ◽  
Francesc Anglès ◽  
Berta Escudero ◽  
Margarita Veloso ◽  
Alfredo Matamala ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Surgical Site Infection ◽  
Fold Increase ◽  
Continuous Variable ◽  
Radiographic Measurement ◽  
Femoral Diaphysis ◽  
P Value ◽  
Site Infection ◽  
Retrospective Case ◽  
Significant Difference

Abstract. Objectives: Obesity is a documented comorbidity that is prevalent in the elderly population and a known predictor for surgical site infection (SSI). Body mass index is a convenient method to classify obesity, but it fails to account for fat distribution. The objective of our study was to evaluate the association between surgical site infection and a subcutaneous radiographic measurement (SRM) in elderly hip fracture patients.Materials and Methods: A retrospective case-control study was conducted to compare SRMs at the hip in patients diagnosed with surgical site infection after hip fracture surgery with patients that were not diagnosed with surgical site infection. Each case was matched to two controls. An SRM was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in anteroposterior hip radiographs. Clinical diagnosis of acute surgical site infection was based on Tsukayama criteria.Results: Patients with an SRM greater than 6.27cm had a 7-fold increase in the odds of surgical site infection (OR=7.42, 95% Confidence Interval (CI)=3.01-18.28, p<0.001) compared to those with smaller measurements. The odds ratio (OR) for infection of patients with an ASA score of 3 was 15.82(95% CI=5.11-48.9, p-value<0.001)A statistically significant difference between cases and controls was also found when SRM at the hip was analyzed as a continuous variable. Patients with an infection had a 2.24cm (95% CI=1.59 - 2.90; p<0.001) greater mean SRM.Conclusion: Results of our study suggest an association between the SRM at the hip and the risk of SSI in elderly patients with surgically treated hip fractures. SRM may be a helpful tool for evaluating the risk of SSI in elderly hip fracture patients.

scholarly journals Determinants of post cesarean section surgical site infection at public hospitals in Dire Dawa administration, Eastern Ethiopia: Case control study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250174
Author(s):  
Samuel Dessu ◽  
Serawit Samuel ◽  
Feleke Gebremeskel ◽  
Alemu Basazin ◽  
Zerihun Tariku ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infection ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Previous History ◽  
Public Hospitals ◽  
P Value ◽  
Site Infection ◽  
History Of ◽  
Control Study

Introduction Post cesarean section surgical site infection increases both the duration of a patient’s hospital stay and unplanned hospital costs. It can delays recovery, prolongs hospitalization, necessitates readmission, and adds to hospital bills and other morbidities as well as mortalities. Method Facility-based case-control study was conducted from 1st March to 20th April, 2019 among all the mother records enrolled from 1st January to 31st December, 2018 at Public hospitals in Dire Dawa administration. The records of the mothers’ who had post-cesarean section surgical site infection (119) was extracted by a census and every three consecutive controls (357) for each case were collected by trained data collectors using a structured data extraction tool. Variables which had p-value <0.25 in bivariate analysis were considered as candidates for multivariable analysis. Statistical significance was declared at P-value ≤0.05 with adjusted odd ratio and 95% confidence interval in the multivariable logistic regression model. Result Age 20–34 years (AOR:5.4; 95%CI:2.35,12.7), age >35 years (AOR:8.9; 95%CI:1.8,43.9), ≥4 per vaginal examinations (AOR: 4.2; 95%CI:2.16,8.22), current history of Chorioamnionitis (AOR:5; 95%CI:1.05,23.9), previous history of cesarean section (AOR:6.2; 95%CI: 2.72,14.36), provision of antibiotics prophylaxis (AOR:3.2; 95%CI:1.81,5.62), perioperative HCT level <30% (AOR:6.9; 95%CI:3.45,14.1) and duration of rupture of membrane >12 hours (AOR:5.4; 95%CI:1.84,15.87) were the independent determinants of post-cesarean section surgical site infection. Conclusion Increased in age of the mother, higher number of per vaginal examination, having a history of chorioamnionitis, having previous history of cesarean section, not receiving antibiotics prophylaxis, lower perioperative hematocrit level and longer duration of rupture of membrane were statistically significant in multivariable analysis. Therefore; emphasis should be given for mothers who have higher age category, previous cesarean scar and history of choriamnionitis. In addition; provision of antibiotics should be comprehensive for all mothers undergoing cesarean section.

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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