scholarly journals The Prevalence, Risk Factors, and Bacterial Profile of Cesarean Surgical Site Infections at a University Teaching Hospital in South Western Uganda

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Post Partum ◽  
Positive Culture ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Wound Sepsis ◽  
Cross Sectional ◽  
Antibiotics Use

Introduction: The single most important risk factor for post-partum maternal infection is Cesarean section (C/S) with a 5-20-fold greater risk for infection compared to a vaginal delivery. Post Cesarean wound infection is diagnosed in 2.5 to 16 percent of patients. Early wound infections (in the first 24 to 48 hours) are usually due to group A or B beta-hemolytic streptococcus and are characterized by high fever and cellulitis while later infections are likely due to Staphylococcus epidermises or aureus, Escherichia coli, or Proteus species. Objectives: To determine the prevalence, risk factors and bacterial profile of wound sepsis following Cesarean at Mbarara Regional Referral Hospital (MRRH). Methods: A cross sectional study of mothers who delivered by Cesarean at MRRH was conducted. Mothers were recruited consecutively until the sample size was achieved. The main dependent variable was wound sepsis confirmed by a positive culture for microorganisms. Results: Of the 359 mothers recruited in the study, 54 (15.5%) developed Cesarean wound sepsis. The risk factors associated with post Cesarean wound sepsis were severe anemia, lack of preoperative antibiotics use, poor antenatal attendance, mothers referred from peripheral health facilities, abnormal Body Mass Index (BMI), diabetes mellitus, more than five vaginal examinations, prolonged rupture of membranes before C/S, and prolonged labour. Staphylococcus aureus was isolated in 48.2% of all the septic cases and most of the bacterial isolates were susceptible to ceftriaxone, ceftazidime, ciprofloxacin and nalidixic acid and resistant to penicillin. Conclusion: The prevalence of post Cesarean wound sepsis is high with staphylococcus aureus being the most common bacteria isolated in infected wounds. Most of the bacteria were susceptible to third generation cephalosporins and quinolones. Antibiotics use was protective against developing wound sepsis.

scholarly journals Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

2020 ◽  
Vol 18 ◽  
pp. 205873922096054
Author(s):  
Faiz Ullah Khan ◽  
Yu Fang ◽  
Zakir Khan ◽  
Farman Ullah Khan ◽  
Zafar Iqbal Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transurethral Resection ◽  
Surgical Site Infections ◽  
Exploratory Laparotomy ◽  
Cross Sectional Study ◽  
Surgical Patients ◽  
Related Factors ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Associated Risk Factors

Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

scholarly journals Penggunaan Antibiotik Profilaksis pada Bedah Bersih di Rumah Sakit di Jakarta

2020 ◽  
pp. 7-12
Author(s):  
Anggita Bunga Anggraini ◽  
Syachroni Syachroni
Keyword(s):  
Medical Records ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
Prophylactic Antibiotics ◽  
Surgical Wound ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Cost Treatment ◽  
Antibiotics Use ◽  
Prophylactic Use

Abstrak Penggunaan antibiotik profilaksis bedah yang tidak tepat dapat meningkatkan risiko terjadinya Infeksi Luka Operasi (ILO) dan resistensi obat. Penelitian ini bertujuan untuk menilai ketepatan penggunaan antibiotik profilaksis bedah pada bedah bersih di rumah sakit (RS) di Jakarta. Penelitian ini merupakan studi potong lintang di sebuah RS pemerintah di Jakarta. Data yang diambil berasal dari rekam medis pasien dewasa yang menjalani pembedahan dengan kriteria kelas luka bedah bersih. Data diambil pada periode 1 Januari hingga 31 Desember 2013. Analisis data dilakukan secara deskriptif berdasarkan pedoman penggunaan antibiotik baik nasional maupun internasional. Hasil penelitian menunjukkan 837 pasien menjalani bedah bersih pada periode tersebut. Bedah yang banyak dilakukan adalah bedah abdominal (30%) dan thorak-non kardiak (23,5%) dan lebih dari 96% merupakan bedah elektif. Jenis antibiotik yang paling banyak digunakan adalah siprofloksasin (56,5%). Keseluruhan kesesuaian antibiotik profilaksis adalah 27,7% tepat indikasi prosedur bedah dan hanya 0,5% yang tepat obat. Sebagai kesimpulan, ketepatan penggunaaan antibiotik profilasis di salah satu RS di Jakarta masih rendah. Penggunaan antibiotik yang tepat dapat menurunkan risiko ILO dan mengurangi biaya pengobatan dengan mengurangi peresepan yang tidak perlu dan durasi penggunaan antibiotik. Kata kunci: antibiotik, bedah bersih, ketepatan, profilaksis Abstract Inappropriate use of surgical prophylactic antibiotics can increase the risk of Surgical Site Infections (SSI) and drug resistance. This study aimed to assess the appropriateness use of surgical prophylactic antibiotics in clean surgery wounds in a hospital in Jakarta. This cross-sectional study was conducted at a government hospital in Jakarta. Data were collected from medical records of adult patients undergoing surgery with clean surgical wound criteria from January 1 to December 31, 2013. Data were analyzed descriptively based on guidelines for antibiotics use both nationally and internationally. The result showed 837 patients classified into the clean surgical wound during this period. The most common surgeries were abdominal surgery (39%) and non-cardiac thoracic (23.5%) and more than 96% were elective surgeries. The overall antibiotic prophylactic appropriateness showed 27.7% in surgical procedures and only 0.5% in choice of antibiotics. In conclusion, the appropriateness of surgery antibiotics prophylactic use in one of the hospitals in Jakarta was still low. Appropriate use of antibiotics can reduce the risk of SSI and cost treatment by reducing unnecessary prescribing and duration of antibiotics use. Keywords: antibiotic, appropriate, prophylactic, clean surgery

scholarly journals Nasal Carriage and Methicillin Resistance of Staphylococcus Aureus Among Schoolchildren in Sana’a City, Yemen

2020 ◽  
Author(s):  
Arwa Mohammed Othman ◽  
Belques Sharaf Al-Huraibi ◽  
Rowa Mohammed Assayaghi ◽  
Huda Zaid Al-Shami
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Admission ◽  
Methicillin Resistance ◽  
Positive Culture ◽  
Nasal Carriage ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Carriage Rate ◽  
Cross Sectional ◽  
Nasal Swabs

Abstract Background: Staphylococcus aureus (S. aureus) is a frequent cause of serious health problems with high morbidity and mortality. The risk of S. aureus infections is increased with the emergence of methicillin-resistant S. aureus (MRSA). The aim of this study is to determine the nasal carriage rate of both S. aureus and MRSA among schoolchildren in Sana’a city.Methods: This is a cross-sectional study conducted from January 2018 to May 2020. Five hundred and eighty eight students were enrolled. Nasal swabs were collected from each student for culturing and methicillin susceptibility testing. Results: Out 588 nasal swab, 536 yielded bacterial growth. Students with positive culture were 271(51%) males and 265(49%) females. Their age ranged from 5 to 19 years old with mean age and standard deviation equaled to 13.3±3.5 years. S. aureus was isolated from 129 (24%) students whereas the overall prevalence of MRSA was 8(1.5%). S. aureus was significantly recovered from students at age group 10-14 years (χ2 = 7.02, p = 0.03), females than males (OR= 1.96, χ2 = 10.75, p = 0.001), and students who were admitted into hospitals (OR= 1.6, χ2 = 4.89, p = 0.03). Nevertheless, there were no significant differences between MRSA carriage and students’ age (χ2 = 2.3, p = 0.32), gender (OR= 1.02, χ2 = 0.001, p = 0.63), and hospital admission (OR= 1.4, χ2 = 0.25, p = 0.62). Conclusions: The prevalence of MRSA is low among schoolchildren in Sana’a city. Age, gender and previous hospital admission were statistically associated with nasal carriage of S. aureus but not MRSA nasal carriage.

Prevalence of and Risk Factors for Carriage of Panton-Valentine Leukocidin–Positive Methicillin-ResistantStaphylococcus aureusAmong Residents and Staff of a German Nursing Home

2006 ◽  
Vol 27 (2) ◽  
pp. 208-211 ◽  
Author(s):  
Ulla Raab ◽  
Dagmar Kahlau ◽  
Florian Wagenlehner ◽  
Udo Reischl ◽  
Vera Ehrenstein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Nursing Home ◽  
Nursing Care ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

The aims of this cross-sectional study were to determine the prevalence of and risk factors for carriage of Panton-Valentine leukocidin–producing methicillin-resistantStaphylococcus aureus(PVL-MRSA) in residents and personnel of a nursing home in Germany. In this study, PVL-MRSA carriage status among nursing home residents was associated with risk factors reflecting their dependence on nursing care. No specific risk factors were detected among staff.

scholarly journals Nasal Carriage and Methicillin Resistance of Staphylococcus aureus among Schoolchildren in Sana’a City, Yemen

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Arwa Mohammed Othman ◽  
Belques Sharaf Al-Huraibi ◽  
Rowa Mohammed Assayaghi ◽  
Huda Zaid Al-Shami
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Admission ◽  
Methicillin Resistance ◽  
Positive Culture ◽  
Nasal Carriage ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Carriage Rate ◽  
Cross Sectional ◽  
Nasal Swabs

Background. Staphylococcus aureus (S. aureus) is a frequent cause of serious health problems with high morbidity and mortality. The risk of S. aureus infections is increased with the emergence of methicillin-resistant S. aureus (MRSA). This study aims to determine the nasal carriage rate of both S. aureus and MRSA among schoolchildren in Sana’a city. Methods. This is a cross-sectional study conducted from January 2018 to May 2020. Five hundred and thirty-six students were enrolled. Their age ranged from 5 to 19 years with the mean age and standard deviation equal to 13.3 ± 3.5 years. Nasal swabs were collected from each student for culturing and methicillin susceptibility testing. Results. Students with positive culture were 271 (51%) males and 265 (49%) females. S. aureus was isolated from 129 (24%) students whereas the overall prevalence of MRSA was 8 (1.5%). S. aureus was significantly recovered from students at the age group of 10–14 years (χ2 = 7.02; p = 0.03 ), females than males (OR = 1.96; χ2 = 10.75; p = 0.001 ), and students who were admitted into hospitals (OR = 1.6; χ2 = 4.89; p = 0.03 ). Nevertheless, there were no significant differences between MRSA carriage and students’ age (χ2 = 2.3; p = 0.32 ), gender (OR = 1.02; χ2 = 0.001; p = 0.63 ), and hospital admission (OR = 1.4; χ2 = 0.25; p = 0.62 ). Conclusions. The prevalence of MRSA is low among schoolchildren in Sana’a city. Age, gender, and previous hospital admission were statistically associated with nasal carriage of S. aureus but not MRSA nasal carriage.

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

2018 ◽  
Vol 159 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Michael P. Veve ◽  
Joshua B. Greene ◽  
Amy M. Williams ◽  
Susan L. Davis ◽  
Nina Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Antibiotic Prophylaxis ◽  
Head And Neck ◽  
Neck Cancer ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
Microvascular Reconstruction ◽  
Cross Sectional

Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

scholarly journals Diabetics-Related Foot Deformity: Prevalence, Risk Factors, Knowledge and Practice

2021 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Amenu Tolera Wirtu ◽  
Keyword(s):  
Risk Factors ◽  
Weight Bearing ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Gait Patterns ◽  
Foot Posture ◽  
Associated Risk Factors ◽  
South West Ethiopia

Neuromusculoskeletal functions interplay in maintaining normal gait patterns. Changes in foot posture and architecture are results of diseases. For Instance, diabetes impacts human biomechanics of running and weight bearing of the foot. We conducted a prospective cross sectional study to assess the risk factors of anatomical foot changes in patients with Type-2 diabetes mellitus. It was carried out in normal 196 subjects at Mizan-Tepi University teaching hospital, Bench-Sheko zone, South-West, Ethiopia. Data were collected using a well-structured questionnaires and diabetic foot assessment checklists. Data analysis was done using SPSS, version 24. Whereas, randomly selected associated risk factors were assessed using multivariate linear regression model. Our results

scholarly journals Female Urinary Incontinence: Prevalence and Impact on the Quality of Life of Gynaecological Clinic Attendees in Lagos, Nigeria

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
FM Akinlusi ◽  
TA Ottun ◽  
YA Oshodi
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Urinary Incontinence ◽  
Cross Sectional Study ◽  
University Teaching ◽  
State University ◽  
Health Seeking ◽  
Cross Sectional ◽  
History Of

Aims: To determine the prevalence of urinary incontinence (UI); risk factors; impact on quality of life and symptom specific health seeking behaviour. Methods: A cross-sectional study of 395 women attending gynaecological clinic of the Lagos State University Teaching Hospital. UI was defined as the complaint of any involuntary leakage of urine in the previous six months. Socio-demographic characteristics, obstetrics, gynaecological, medical and surgical risk factors, impact on daily activities and treatment history were assessed. Univariate, bivariate and multivariable analyses were performed. Results: Participants age ranged from 25-67 years with a mean of 38.81 ± 10.1. Prevalence of UI was 32.9%.  Urge UI occurred in 18.0% of all respondents while the prevalence of stress and mixed incontinence was 7.3% and 7.6% respectively. Independent risk factors for urinary incontinence were age (OR= 0.49, 95%;CI = 0.26-0.92), higher body mass index (OR = 1.92; 95% CI =1.53-3.00) and history of constipation(OR = 2.11; 95% CI =1.30 - 3.43). About47%of those with UI admitted to having negative feelings such as despair, anxiety and depression while 45% had a cumulative moderate to severe affectation of their quality of life in all domains. Despite these, only 27.7% sought help. Conclusions: Despite thesubstantial impact of UI on the quality of life, majority do not seek help. Addressing modifiable risks factors, improving treatment seeking behaviour by correction of misconceptions and elimination of stigma will go a long way in reducing the prevalence of UI.

Prevalence and potential risk factors associated with methicillin resistant Staphylococcus aureus infection in Dairy farms

2020 ◽  
Vol 21 (2) ◽  
pp. 39-47
Author(s):  
Mohamed El-Fateh ◽  
Adel El-Gohary ◽  
Mona Elsayed ◽  
Fatma El-Gohary
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Environmental Samples ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Potential Risk Factors

Objective: A cross sectional study was conducted between June 2017 and August 2018 in around Dakahlia governorate to identify Methicillin resistant Staphylococcus aureus (MRSA) and to determine risk factors associated with the occurrence of mastitis in dairy cows. Design: Cross sectional study Animals and samples: 130 dairy cattle (744 samples) and 181 environmental samples (36 bedding, 37 bulk tank milk BTM, 27 feed troughs, 27 water troughs, 27 milk linear and 27 worker’s nasal swabs), with a total of 925 samples were studied. Procedures: Three hundred and seventy-two quarters were examined to detect clinical and subclinical mastitis by physical examinations and California mastitis test. In addition, bacteriological isolation and identification of Staphylococcus aureus and MRSA were carried on the above milk samples of above mentioned quarters, teat swabs and environmental samples. Results: The overall prevalence of Staphylococcus aureus and MRSA was 59.4 and 22.4, respectively. The MRSA were more prevalent in mastitic quarter (X2 = 31.146, P-value = 0.000), Holstein Friesian breed (P-value = 0.021), Old aged dairy cattle (>8 years) (P-value = 0.000), Multiparous cows (P-value = 0.000), large herd size (>=2000) (P-value = 0.000). Conclusion and clinical relevance: The present result indicates that MRSA is a major cause of mastitis in dairy farms at northern Egypt, where one of the key elements for controlling its spreading depends mainly on determining its potential risk factors responsible for its existence.

scholarly journals Proximal deep vein thrombosis among hospitalised medical and obstetric patients in Rwandan university teaching hospitals: prevalence and associated risk factors: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032604
Author(s):  
Regine Mugeni ◽  
Eugene Nkusi ◽  
Eric Rutaganda ◽  
Sanctus Musafiri ◽  
Florence Masaisa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Multivariate Regression ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Vein Thrombosis ◽  
Tertiary Hospitals

ObjectivesTo determine the prevalence of proximal deep vein thrombosis (DVT) by ultrasound scanning, as well as associated clinical features and known risk factors, among medical and obstetrics–gynaecology inpatients in two Rwandan tertiary hospitals.DesignCross-sectional study.SettingsRwanda teaching hospitals: Kigali and Butare University Teaching Hospitals.Participants901 adult patients admitted to the Departments of Internal Medicine and Obstetrics–Gynecology (O&G) who were at least 21 years of age and willing to provide a consent.OutcomesPrevalence of proximal DVT, clinical features and known risk factors associated with DVT.MethodsBetween August 2015 and August 2016, participants were screened for DVT by compressive ultrasound of femoral and popliteal veins, conducted as a monthly cross-sectional survey of all consenting eligible inpatients. Patients completed a self-report survey on DVT risk factors. Prevalence of proximal DVT by compression ultrasonography was the primary endpoint, with univariate and multivariate regression analyses performed to assess associated clinical features and risk factors.ResultsProximal DVT was found in 5.5% of the study population, with similar rates in medical and O&G inpatients. The mean age was 41±16 SD (range, 21–91), 70% were female and 7% were pregnant. Univariate analysis showed active malignancy, immobilisation, prolonged recent travel and history of DVT to be significant risk factors for proximal DVT (all p values <0.05); while only active malignancy was an independent risk factor on multivariate regression (OR 5.2; 95% CI 2.0 to 13). Leg pain or tenderness, increased calf circumference, unilateral limb swelling or pitting oedema were predictive clinical features of DVT on both univariate analysis and multivariate regression (all p values <0.05).ConclusionProximal DVT prevalence is high among hospitalised medical and O&G patients in two tertiary hospitals in Rwanda. For reducing morbidity and mortality, research to develop Africa-specific clinical prediction tools for DVT and interventions to increase thromboprophylaxis use in the region are urgently needed.

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