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 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 Trends of and factors associated with cesarean section related surgical site infections in Guinea

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Alexandre Delamou ◽  
Bienvenu Salim Camara ◽  
Sidikiba Sidibé ◽  
Alioune Camara ◽  
Nafissatou Dioubaté ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Retrospective Cohort ◽  
Surgical Site Infections ◽  
Obstetric Care ◽  
Medical Data ◽  
Site Infection ◽  
Care Policy ◽  
Factors Associated

Since the adoption of free obstetric care policy in Guinea in 2011, no study has examined the surgical site infections in maternity facilities. The objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in Guinean maternity facilities from 2013 to 2015. This was a retrospective cohort study using routine medical data from ten facilities. Overall, the incidence of surgical site infections following cesarean section showed a declining trend across the three periods (10% in 2013, 7% in 2014 and 5% in 2015, P<0.001). Women who underwent cesarean section in 2014 (AOR: 0.70; 95%CI: 0.57-0.84) and 2015 (AOR: 0.43; 95%CI: 0.34-0.55) were less likely to develop surgical site infections during hospital stay than women operated in 2013. In the contrary, women with comorbidities were more likely to experience surgical site infection (AOR: 1.54; 95% CI: 1.25-1.90) than those who did not have comorbidities. The reductions achieved in 2014 and 2015 (during the Ebola outbreak) should be sustained in the post-Ebola context.

scholarly journals Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s377
Author(s):  
Feah Visan ◽  
Jenalyn Castro ◽  
Yousra Siam Shahada ◽  
Naser Al Ansari ◽  
Almunzer Zakaria
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Body Mass Index ◽  
Risk Factor ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Body Mass ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

scholarly journals Surgical site infection and its association with rupture of membrane following cesarean section in Africa: a systematic review and meta-analysis of published studies

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alemayehu Gonie Mekonnen ◽  
Yohannes Moges Mittiku
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Subcutaneous Tissue ◽  
Meta Analysis ◽  
Surgical Site Infections ◽  
Forest Plot ◽  
Site Infection ◽  
Manual Search ◽  
Inconsistency Index

Abstract Introduction Surgical site infection occurs within 30 days after a surgical procedure and involves the skin, subcutaneous tissue, and soft tissue. Surgical site infection following cesarean section is a common postoperative complication and is associated with maternal morbidity and mortality in resource-limited settings. Even though the proportion of surgical site infection and some risk factors were reported by kinds of literature, varying results were stated across studies. There is also limited knowledge on the association between postpartum surgical site infection and the rupture of membrane. Hence, this systematic review and meta-analysis was designed to estimate the pooled proportion of surgical site infection and its association with rupture of membrane following cesarean section in Africa. Methods Studies published from January 01, 2000 to January 30, 2020 were searched from MEDLINE via PubMed, Scopus, Medscape, Web-science and CINAHL databases to search relevant published articles. We also performed a manual search of reference lists of key articles to retrieve additional relevant articles. Initially, 559 records were identified and 15 studies included in the analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger’s test. Pooled estimates of proportion and odds ratio were calculated by a random-effects model with a 95% confidence interval (CI). Results The overall pooled proportion of surgical site infection following cesarean section was 10.21% (I2 = 86.8, p < 0.000; 95% CI = 8.36, 12.06). The odds of developing surgical site infection among women who had the rupture of membrane before delivery were nearly 6 times higher than those who had not a rupture of the membrane (AOR = 5.65, 95% CI: 3.95–8.07). Conclusions The proportion of surgical site infections following the cesarean section is relatively high. Women who had rupture of the membrane before delivery were more likely to develop surgical site infections following the cesarean section. Due attention should be given to the provision of prophylactic antibiotics that can reduce surgical site infection after cesarean delivery.

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 The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lijun Li ◽  
Hongyan Cui
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Blood Loss ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Enterococcus Faecalis ◽  
Urinary Catheter ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Duration Of Surgery

Abstract Background Surgical site infections after cesarean section are very common clinically, it is necessary to evaluate the risk factors of surgical site infections after cesarean section, to provide evidences for the treatment and nursing care of cesarean section. Methods This study was a retrospective cohort study design. Patients undergone cesarean section in a tertiary hospital of China from May 2017 to May 2020 were identified, we collected the clinical data of the included patients, and we analyzed the infection rate, etiological characteristics and related risk factors of surgical site infection after caesarean section. Results A total of 206 patients with cesarean section were included, and the incidence of surgical site infection in patients with cesarean section was 23.30%. A total of 62 cases of pathogens were identified, Enterococcus faecalis (33.87%) and Escherichia coli (29.03%) were the most common pathogens. Both Enterococcus faecalis and Escherichia coli were highly sensitive to Cefoperazone, Meropenem, and Levofloxacin. Logistic regression analyses indicated that Age ≥ 30y (OR 4.18, 95%CI: 1.23–7.09), BMI ≥ 24 (OR 2.39, 95%CI: 1.02–4.55), duration of cesarean section ≥ 1.5 h (OR 3.90, 95%CI: 1.28–5.42), estimated blood loss ≥ 400 ml (OR 2.35, 95%CI: 1.10–4.37) and the duration of urinary catheter ≥ 24 h (OR 3.18, 95% CI: 1.21–5.71) were the independent risk factors of surgical site infection after cesarean section (all p < 0.05). Conclusions Age, BMI, duration of surgery, blood loss and urinary catheter use were associated with higher risk of the surgical site infection after cesarean section. Clinical preventions and interventions are warranted for those population to reduce the occurrence of surgical site infection.

scholarly journals Subcutaneous Tissue Irrigation with Povidone Iodine in Decreasing the Rate of Surgical Site Infection Following Cesarean Section: (Randomized Control Trial)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A H N Abdelrahman ◽  
M M Samy ◽  
M E A Shawky ◽  
G A Azmy
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infection ◽  
Povidone Iodine ◽  
Subcutaneous Tissue ◽  
Surgical Site Infections ◽  
Skin Closure ◽  
Site Infection ◽  
Negative Effects ◽  
Surgical Interventions ◽  
Added Benefit

Abstract Background Cesarean section remains to be one of the most common surgical procedures performed worldwide and available data indicate that surgical interventions constitute approximately 0.4%–40.5% of all deliveries. Surgical site infections (SSIs) are reported to occur in up to 8.4% of women having a caesarean section (CS) with many negative effects, including pain, prolonged hospitalisation or readmission, need for antibiotics, return to theatre and increasing costs. Objective In women undergoing elective caesarian section, subcutaneous tissue irrigation with povidone Iodine may decrease the rate of surgical site infection. Patients and Methods The study included any female from 20 to 35 years old of gestational age 38 week or older with viable fetus, BMI 20-30 Kg/m2. Patient excluded were those with preoperative haemoglobin less than 10, prolonged rupture of membranes, diabetic, hypertensive or with any medical disorder including autoimmune diseases. Results The result of our study demonstrated that the use of povidone iodine 1% solution doesn’t have an added benefit in decreasing the incidence of SSI. Conclusion We conclude that the use of povidone iodine 1% solution in irrigation of subcutaneous tissue prior to skin closure in elective caesarian deliveries does not have an added benefit in decreasing the incidence of SSI and is, thus, not recommended at time being.

scholarly journals Surgical Site Infections due to Non-Tuberculous Mycobacteria

2018 ◽  
Vol 56 (211) ◽  
pp. 696-700
Author(s):  
Rohit Prasad Yadav ◽  
Bashudev Baskota ◽  
Rabin Ratna Ranjitkar ◽  
Sandesh Dahal
Keyword(s):  
Surgical Site Infection ◽  
Histopathological Examination ◽  
Surgical Site Infections ◽  
Mycobacterial Infection ◽  
Site Infection ◽  
Wound Debridement ◽  
Acid Fast Bacilli ◽  
Atypical Mycobacterial Infection ◽  
Microbiological Techniques ◽  
High Level

Introduction: Non-tuberculous Mycobacteria are increasingly recognized, nowadays as an important pathogen in delayed surgical site infection in post operative cases. We here in describe cases of surgical site infection caused by Non-tuberculous Mycobacteria, seen in two centers in Jhapa. The aim of the study was to increase awareness of this atypical mycobacterial infection, prompt diagnosis, and treatment that may ultimately provide better care to patients. Methods: Forty four patients underwent different kinds of operations in two different private hospitals in Jhapa district of Nepal. All patients were presented with painful, draining subcutaneous nodules at the infection sites. Repeated aspiration of abscess, incision and drainage of the wound were done and specimen was sent for microbiological and histopathological examination. All patients were treated with repeated wound debridement and tab. Clarithromycin and inj. Tobramycin for 45days. Results: Mycobacterium Chelone were isolated from the purulent drainage obtained from wounds by routine microbiological techniques. Of the forty four cases, thirty of them had acid fast bacilli stain positive, two had acid fast bacilli culture positive. All the patients except two cases were treated with injection Tobramycin and Clarithromycin for six weeks. Conclusions: There should be high level of clinical suspicion for patients presenting with delayed post- operative wound infections for the diagnosis of non-tubercular mycobacreria as causative agents. These infections not only cause physical but also emotional distress that affects both the patients and the surgeon. Emphasis should be given on good sterilization technique to avoid such infections.

scholarly journals Incision length: an emerging risk factors for surgical‐site infection following cesarean section

2017 ◽  
Vol 6 (5) ◽  
pp. 1829 ◽  
Author(s):  
Tripti Nagaria ◽  
Avinashi Kujur ◽  
Neha Thakur
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Subcutaneous Tissue ◽  
Mode Of Delivery ◽  
Wound Complications ◽  
Late Nineteenth Century ◽  
Site Infection ◽  
Operating Characteristics ◽  
Incision Length

Background: Since late nineteenth century, the caesarean section first done there is a tremendous improvement in the surgical and anaesthetic skills. It has emerged as a safe mode of delivery but now, in the present era there is a continuous rising trend of caserean section. Objective of present study is to evaluate the effect of some specific gestational factors and other known variables associated with poor wound healing in women who delivered by cesarean section.Methods: A total of 1215 women delivered by cesarean section at Pt. JNM Medical college, Raipur, Chhattisgarh, India from May 2014 to April 2015 were included in this study. The BMI was measured at gestational age when she got operated, grade of surgeons was noted. Subcutaneous tissue depth was intra-operatively measured from the fascia to the skin surface, while the incision length was measured after skin closure.Results: Out of 1215 women operated 251 cases developed SSI with incidence of 20.5%. Incision length (OR 2.40, 95% CI 2.11-2.73; p<0.0001), Body mass index (BMI) at term (OR 2.9, 95% CI 1.82-4.44; <0.0001), previous caesarean section scar (OR 0.72, 95% CI 0.54-0.96; p=0.02), Grade of surgeon (OR 5.5, 95% CI 3.3-9.3; p<0.0001), subcutaneous tissue thickness (OR 1.88, 95% CI 1.60-2.23, p<0.0001) were found to be correlated with wound complications. The receiver operating characteristics curve analysis suggested a cut-off of 28.7 for the BMI at term with AUC 0.8 (0.79-0.84, p<0.0001) and 147 mm for the wound length with an AUC 0.8 (95% CI 0.78-0.82; p <0.0001). The multivariate logistic regression model, applied to these variables showed an independent correlation of incision length with SSI   incision length >14.7; OR 2.40, 95% CI 2.11-2.73, p<0.0001.Conclusions: Incision length by itself was found to be an independent risk factor for development of surgical site infection.

scholarly journals Supplemental Perioperative Oxygen (80% FIO2) for the Prevention of Surgical Site Infection after Emergency Cesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bleixen Admadé ◽  
Osvaldo Reyes
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infection ◽  
Controlled Trial ◽  
Surgical Site Infections ◽  
Supplemental Oxygen ◽  
Site Infection ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Significant Difference ◽  
Oxygen Group

Objective. Cesarean section can be a lifesaving procedure. However, as with many surgeries, it is not exempt of complications. Surgical site infections generate higher costs, serious morbidity, and mortality. This study evaluates the benefits of perioperative oxygen to prevent surgical site infections. Methods. We conducted a randomized controlled trial to assess the effects of perioperative oxygen to prevent surgical site infection after emergency cesarean section. Patients were randomized to receive either oxygen (80% FIO2) during cesarean section plus two hours postsurgery or no supplemental oxygen. A sample of 326 patients was calculated for the primary outcome (163 in each group) and they were evaluated daily before leaving the hospital, at days 15 and 30. Results. Initially, 360 patients were enrolled, from which 17 were excluded (sample size: 343 (179 patients in the air group and 164 in the oxygen group)). We found no significant difference in the incidence of surgical site infection between these two groups at any of the evaluation times. Conclusion. In this study of patients with emergency cesarean section, we showed that the use of supplemental oxygen does not reduce the incidence of surgical site infection. This trial is registeres with ClinicalTrials.gov NCT01340534.

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