Incidence and Risk Factors for Surgical Site Infection following Emergency Cesarean Section: A Retrospective Case-Control Study

Ousey, Karen; Blackburn, Joanna; Stephenson, John; Southern, Tom

doi:10.1097/01.asw.0000767368.20398.14

Cited by 5 publications

(3 citation statements)

References 47 publications

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“…BMI was strongly associated with SSIs due to poor prescription techniques that exclude patients’ BMI, longer incision time, and slow transit of antibiotics due to thick adipose tissue that result in impaired wound healing and decreased immunity. This view on BMI has been supported by Ousley et al [ 15 ]. According to Chu et al [ 27 ], younger age in women is associated with an increased risk for SSIs due to underdeveloped immunity to fight infections.…”

Section: Discussionsupporting

confidence: 53%

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Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review

Isigi,

Parsa,

Alasqah

et al. 2023

JMIR Public Health Surveill

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Background Nosocomial infections are infections incubating or not present at the time of admission to a hospital and manifest 48 hours after hospital admission. The specific factors contributing to the risk of infection during hospitalization remain unclear, particularly for the hospitalized population of the United Kingdom. Objective The aim of this systematic literature review was to explore the risk factors of nosocomial infections in hospitalized adult patients in the United Kingdom. Methods A comprehensive keyword search was conducted through the PubMed, Medline, and EBSCO CINAHL Plus databases. The keywords included “risk factors” or “contributing factors” or “predisposing factors” or “cause” or “vulnerability factors” and “nosocomial infections” or “hospital-acquired infections” and “hospitalized patients” or “inpatients” or “patients” or “hospitalized.” Additional articles were obtained through reference harvesting of selected articles. The search was limited to the United Kingdom with papers written in English, without limiting for age and gender to minimize bias. The above process retrieved 377 articles, which were further screened using inclusion and exclusion criteria following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The retained 9 studies were subjected to critical appraisal using the Critical Appraisal Skills Programme (cohort and case-control studies) and Appraisal Tool for Cross-Sectional Studies (cross-sectional studies) checklists. Finally, 6 eligible publications were identified and used to collect the study findings. A thematic analysis technique was used to analyze data extracted on risk factors of nosocomial infections in hospitalized patients in the United Kingdom. Results The risk factors for nosocomial infections that emerged from the reviewed studies included older age, intrahospital transfers, cross-infection, longer hospital stay, readmissions, prior colonization with opportunistic organisms, comorbidities, and prior intake of antibiotics and urinary catheters. Nosocomial infections were associated with more extended hospital stays, presenting with increased morbidity and mortality. Measures for controlling nosocomial infections included the use of single-patient rooms, well-equipped wards, prior screening of staff and patients, adequate sick leave for staff, improved swallowing techniques and nutritional intake for patients, improved oral hygiene, avoiding unnecessary indwelling plastics, use of suprapubic catheters, aseptic techniques during patient care, and prophylactic use. Conclusions There is a need for further studies to aid in implementing nosocomial infection prevention and control.

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Section: Discussionsupporting

confidence: 53%

“…This systematic review identified 5 cohort studies [ 16 - 20 ], 3 case-control studies [ 13 - 15 ], and 1 cross-sectional study [ 21 ]. After critical appraisal, 5 cohort studies [ 16 - 20 ] and 1 case-control study [ 13 ] were included for analysis.…”

Section: Resultsmentioning

confidence: 99%

Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review

Isigi,

Parsa,

Alasqah

et al. 2023

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…The pain in excess-weight patients was stronger on the fourth post-surgical day, and their CRP levels were higher. In other studies, obese patients developed septic postpartum complications more frequently [ 29 , 30 ], which could explain the presence of more severe pain and higher levels of CRP. However, in this study, obese patients more frequently developed septic complications, but the difference is not statistically significant, probably due to the small study population.…”

Section: Discussionmentioning

confidence: 96%

Impact of Intraoperative Factors on the Development of Postpartum Septic Complications

Andzane,

Miskova,

Krone

et al. 2023

Medicina

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Background and Objectives: Triclosan-coated sutures (antibacterial sutures) can reduce the risk of postoperative surgical site infection. This study aimed to investigate the effect of intraoperative factors, including antibacterial sutures, on the risk of postpartum septic complications. Materials and Methods: The prospective study included patients who underwent caesarean section. The exclusion criterion was chorioamnionitis. The investigation group patient’s (n = 67) uterus and fascial sheath of the abdominal wall were sutured with triclosan-coated polyglactin 910 sutures during surgery. The control group consisted of 98 patients using uncoated polyglactin 910 sutures only. The patients were contacted by phone after the 30th postoperative day. Results: No significant difference was found between the investigation group and the control group in the development of postpartum endometritis (11.7% in the investigation group vs. 8.4% in the control group, p = 0.401), wound infection (6.3% vs. 3.6%, p = 0.444) or patients experienced any septic complication (15.9% vs. 12%, p = 0.506). Postpartum endometritis was more common in patients who underwent instrumental uterine examination during the surgery (23.8% vs. 18%, p = 0.043). A moderately strong correlation was found for haemoglobin level on the third–fourth postoperative day with the development of postpartum septic complications, p < 0.001, Pearson coefficient −0.319. Post-caesarean delivery septic complications were not statistically more common in patients with blood loss greater than 1 L. The incidence of post-caesarean endometritis was 13.4%, and wound infection was 4.8% in this study’s hospital, having five to six thousand deliveries per year. Conclusions: Using antibacterial sutures during caesarean section does not affect the incidence of postpartum septic complications. Instrumental uterine examination during caesarean section increases the risk of post-caesarean endometritis and is, therefore, not recommended. Haemoglobin level on the 3rd–4th postoperative day, rather than the estimated blood loss during surgery, affects the development of postpartum septic complications.

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Incidence and influencing factors for surgical site infections after cesarean section in China: A systematic review and meta‐analysis

Guo,

Huang,

Sui

et al. 2024

J of Obstet and Gynaecol

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ObjectiveThis study aims to estimate the overall incidence of surgical site infections (SSIs) after cesarean section (CS) and the influencing factors in the Chinese population.Materials and MethodsThe study searched all relevant literature in English and Chinese search databases (English search bases: PubMed, Embase, Cochrane Library, Web of Science; Chinese search bases: China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) up to March 19, 2024, according to the search strategy. A random/fixed effects model was decided on the basis of the I2 statistic assessing the magnitude of study heterogeneity, and publication bias was assessed using the Begg's test.ResultsAfter the selection, a final selection of 25 articles was involved. The estimate of post‐CS SSIs in China was 2.4% (95%CI: 0.019, 0.029). Age ≥30 years (WMD: 3.8), pre‐pregnancy body mass index (BMI) ≥25 kg/m2 (WMD: 1.8), obesity (odds ratio [OR]: 3.0), vaginal cleanliness 3–4 (OR: 4.2), anemia (OR: 1.4), premature rupture of membranes (OR: 2.6), diabetes mellitus (OR: 2.7), National Nosocomial Infections Surveillance System 1–3 (OR: 5.6), emergency surgery (OR: 2.3), trial of labor (OR: 2.9), duration of surgery ≥60 min (OR: 2.0), and intraoperative blood loss >500 mL (OR: 3.5) were the risk factors for post‐CS SSIs.ConclusionsThe rate of post‐CS SSIs estimated was 2.4% in China. Both maternal conditions and surgical factors can potentially increase the risk of post‐CS SSIs.

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Incidence and Risk Factors for Surgical Site Infection following Emergency Cesarean Section: A Retrospective Case-Control Study

Cited by 5 publications

References 47 publications

Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review

Predisposing Factors of Nosocomial Infections in Hospitalized Patients in the United Kingdom: Systematic Review

Impact of Intraoperative Factors on the Development of Postpartum Septic Complications

Incidence and influencing factors for surgical site infections after cesarean section in China: A systematic review and meta‐analysis

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