Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study

Abstract

Background Surgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%. This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital. Methods This was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics. Results The incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%. Conclusions The obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases. Registration Local ethical committee (Registration number: MOBGYN0040).

Antibiotic Prescribing Patterns and Prevalence of Surgical Site Infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia

“…This study found a 6.0% prevalence of SSIs. This was in line with earlier findings from Egypt (5.3%) [33], Ankara (6.2%) [34], Pennsylvania (6.5%) [34], and SSA (7.3%) [35]. Conversely, the prevalence of SSIs found in our study was lower than what was found in similar studies with a prevalence of 10.9% in Tanzania [36], 11% in Ethiopia [37], 16.2% in Nigeria [38], 12.6% in Nepal [39] and 24.3% in Pakistan [40].…”

Racial-ethnic disparities in potentially preventable complications after cesarean delivery in Maryland: an observational cohort study

“…There are few studies describing the incidence of PPCs after CD. Cardiovascular events are reported to occur in 0.2% of CD patients [8], infectious complications are reported to occur in 5-9% of patients [9][10][11], and VTEs are reported to occur in 0.3% of patients [12]. To our knowledge and based on our literature review, few studies have explored racial disparities in PPCs after CD.…”

Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections—A Prospective Cohort Study

“…These complications contribute not only to mortality, but also to morbidity in patients [8]. Surgical site infections (SSIs) are defined as infections occurring within 30 days post-operation and affecting superficial or deep incisional sites, or deeper-lying spaces or organs [9,10]. SSIs are also associated with increased healthcare costs, longer hospitalization, and more patient dissatisfaction [11].…”