Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province, China

Gong, Shipeng; Guo, Haipeng; Zhou, Hongzhen; Chen, Li; Ye, Yu

doi:10.1111/j.1447-0756.2011.01746.x

Cited by 49 publications

(49 citation statements)

References 24 publications

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“…The wound swabs were sent at the time of admission and the common organisms; patients were given standard wound care, oral antibiotics and correction of co-morbidities along with supportive therapy. All analysis was carried out using the statistical software SPSS version 16 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition.…”

Section: Methodssupporting

confidence: 64%

“…68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultants Conclusion: The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon. 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition.…”

supporting

confidence: 78%

“…This will help in formulation of targeted evidence based protocols to decrease the hospital incidence of post cesarean SSI. 3,4 …”

Section: Introductionmentioning

confidence: 99%

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Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Chhetry¹,

Subedi

Banerjee

2017

J Coll Med Sci-Nepal

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Background & Objectives: Post cesarean surgical site infection (SSI) is one of the commonly encountered complications which considerably increase the burden to health care. It is caused due to the interplay of various patient related, procedure related and iatrogenic factors. This study aims at identifying common risk factors for post cesarean SSI at our centre. Materials & Methods: This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included and their risk factors were studied. Results: Emergency procedures (82.97%) were more likely to develop SSI as compared to elective cesarean (17%). Among the patient related risk factors most of them were nulliparous (48.9%), term gestation (42.6%), malnourished (53.1%) and had history of prolonged leaking (44.68%) The mean age was 24.04±4.6years.Most of the patients who developed SSI were operated for repeat cesarean and fetal indications. Most patients who had SSI had at three to five per vaginal examinations (2.72±2). 66% of patient who had SSI had duration of surgery more than one hour. 68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultants Conclusion: The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon. 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition. Both obesity and malnutrition have been associated with increased risk of SSI. 7,8 The association of obesity with SSI could be due to relative avascularity of adipose tissue and hence poor healing, difficulty in handling of tissues and hence more chance of micro-trauma and also failure in obliteration of dead spaces. Likewise malnutrition can lead to SSI due to poor healing of tissues and decreased immunity. In our study population malnutrition was a more common risk factor (53.1%) as compared to obesity (14.9%) and it is a reflection of the general population characteristic of our part of the world where most childbearing women are anemic and malnourished. Prolonged rupture of membrane (>8hrs) are established risk factors of SSI. 3,6,11 Even in the present study they were found to be significantly associated with SSI with prolonged PROM in 44.5% of patients and most patients with more than three per vaginal examinations. Loss of protective cervical mucus plug and barrier effect of fetal membranes and amniotic fluid after rupture of membranes are thought to be the culprits. The more the vaginal examinations the m...

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Section: Methodssupporting

confidence: 64%

supporting

confidence: 78%

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Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Chhetry¹,

Subedi

Banerjee

2017

J Coll Med Sci-Nepal

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“…It might act as a potential organism of infections in populations suffering from underlying diseases in adults. The mother in the current case had the typical risk factors associated with subsequent development of a SSI, such as GDM, chorioamnionitis [12], and slight anemia [18]. The patient experienced cesarean delivery and this exposure event could be a potential clue to the etiology of her SSI.…”

Section: Discussionmentioning

confidence: 99%

First molecular evidence of intrauterine and surgical-site infections caused by Streptococcus dysgalactiae subsp. equisimilis

Diao

Fang

et al. 2016

J Infect Dev Ctries

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S. dysgalactiae subsp. equisimilis (SDSE) is infrequently associated with maternal infections during delivery in pregnant women. A rare case is presented of a woman with intrauterine infection and surgical-site infection due to SDSE after cesarean section, which had colonized her genital tract and, via the ascending pathway, reached her intact fetal membrane. All isolates were identified as Streptococcus Lancefield group G, and their emm genes that coded M protein belonged to stG6.1. The isolates tested negative for a series of streptococcal superantigen virulence genes but positive for nonsuperantigenic virulence genes. In particular, molecular typing using pulsed-field gel electrophoresis analysis disclosed that the three isolates from the different infection sites had identical profiles. Furthermore, multilocus sequence typing indicated that the three isolates belonged to a new sequence typing. Our results indicated that SDSE is potentially pathogenic for pregnant women and newborns if colonized.

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“…12 Various other risk factors include improper antibiotic prophylaxis, labour chorioamnionitis, time period from rupture of membrane, emergency cases etc. [13][14][15][16] Increased duration of surgery and low haemoglobin levels also acts as substantial risk factor for surgical site infection.…”

mentioning

confidence: 99%

Assessment of incidence of post-operative wound infection in women undergoing caesarean section: a retrospective study

Sangavi

Rajkumari

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The surgical site infection is the second most common infectious complication occurring after caesarean section. Infections occurring after caesarean section represent a considerable burden to the healthcare systems and preventing these complications is a priority of healthcare systems especially in developing countries. The aim of this study was to determine the incidence of SSI in patients undergoing a LSCS at a RIMS teaching hospital, Raichur, and to identify risk factors, common bacterial pathogens and antibiotic sensitivity.Methods: The present retrospective study was conducted in RIMS Institute, during a period of 3 years i.e. from 2013-2016. In this study a total of 50 cases were collected from MRD department. They were divided into two groups- cases and controls, each having 50 subjects each. Wound infection was defined as inflammation or sepsis with or without positive bacterial cultures. With SSI, there may be fever, redness, swelling and/or pain in the area around the incision site. Complete information regarding demographic data, the type and indication for caesarean section, duration of labour, duration of surgery and rupture of membrane were recorded. Wound infections occuring after 30 days of LSCS & other gynaecological surgeries were excluded. All the results were analyzed by SPSS software 16.0. Chi-square test and student t test were used for the assessment of level of significance. Probability value of less than 0.05 was considered significant.Results: A total of 100 subjects were included in the present study, out of which, 50 were cases and the remaining 50 were controls. The mean age of the subjects was 37.45 years. There were 7 cases and 13 controls who were aged between 20-24 years. There was no significant difference amongst cases and controls regarding age. There was a significant difference in the haemoglobin levels amongst cases and controls. The third criterion that was assessed was duration of labour. Majority of the cases had prolonged labour whereas in majority of the controls, the duration of labour of labour was less than 6 hours. There was a significant difference in duration of labour amongst cases and controls (p<0.05). Elective c section was done in 2 cases and 6 controls. C section was performed in an emergency in 48 cases and 44 controls. There was a significant difference in the operation time between cases and controls (p<0.05). E.coli infection occurred in 15 cases in the present study followed by Actinobacter species which occurred in 13 cases. Absence of growth was seen in 5 cases.Conclusions: The risk factors associated with SSI in our study were, haemoglobin levels, prolonged labour, duration of operation. The most common organisms isolated were E. coli and Actinobacter species.

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Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province, China

Cited by 49 publications

References 24 publications

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

First molecular evidence of intrauterine and surgical-site infections caused by Streptococcus dysgalactiae subsp. equisimilis

Assessment of incidence of post-operative wound infection in women undergoing caesarean section: a retrospective study

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