Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section

De, Devjani; Saxena, Sonal; Mehta, Geeta; Yadav, Reena; Dutta, Renu

doi:10.1155/2013/283025

Cited by 51 publications

(68 citation statements)

References 27 publications

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“…Another study carried out by Motie MR et al [3] with a mean age of 47.13 years with a SD of 19.60 years for the study group showed that most infections were cleancontaminated (46.3% ) and 30.5% contaminated as compared to 27.9% clean-contaminated and 43.1% contaminated in our study group. The length of surgery and type of surgery were found to increase the risk of SSIs in their study which is consistent with the results of our [17] study group carried out on women undergoing lower segment caesarian section showed an infection rate of 24.2% and the most common microorganism isolated was Acinetobacter (32.03%) followed by Escherichia coli and Klebsiella species responsible for 18.75% and 14.8% of SSIs, respectively. This is in contrast to our study where Staphylococcus was the main causative microorganism with incidence rate of SSIs caused by it was 25.7% and the overall incidence of SSIs was about 11%.…”

Section: Discussionsupporting

confidence: 88%

Surgical Site Infections Incidence, their Predictors and Causative Organisms in a Teaching Hospital

Rawabdeh¹,

Mulhim²,

Khan³

2016

Int J Community Fam Med

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Purposes: Nosocomial infections (NCIs) are infections that generally occur 48 hours after hospitalization. Surgical site infections (SSIs) are the major contributor to patient morbidity, health care costs and death. The rational for this study was to assess the frequency of NCIs in surgical wards and investigate possible predictors for SSIs. Methods: It was an observational and prospective study for the purpose of providing structured opportunities for Hospital administration and health professionals in countering SSIs. The total number of patients were 1611 including Saudis and non-Saudi nationals. Each patient was followed up from the time of admission until discharge (with a maximum period of 30 days postoperatively). Surgical wounds were inspected at the time of the first dressing and weekly thereafter for 30 days. Also, swabs from a deeper part of the wound were taken from the infected surgical sites, and routinely from the surface of non-infected sites. The specimens were gram stained and examined for the presence of organisms (cultured aerobically and anaerobically). Findings: The main findings were: SSIs causative organisms were Staphylococcus aureus (25% incidence) followed by Echeriashia coli (23% incidence). The incidence rate of surgical site infections was 11.4%. The presences of co-morbidities were a risk factor for SSIs in this study and a higher level of education was related to decreases in SSIs. Recommendations: This article recommended proper nursing care, sterilization and disinfection of instruments and equipment with careful handling of intensive procedures to control infection which will improve the efficiency and quality of surgical care.

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Section: Discussionsupporting

confidence: 88%

Surgical Site Infections Incidence, their Predictors and Causative Organisms in a Teaching Hospital

Rawabdeh¹,

Mulhim²,

Khan³

2016

Int J Community Fam Med

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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: 72%

“…This is in accordance with other studies elsewhere. 15,16 This could be due to the simple reason that emergency procedures are mostly unplanned and associated with other risk factors like prolonged membrane rupture, multiple vaginal examinations and prolonged labor. Antibiotic prophylaxis is one of the most significant protective factors in decreasing SSI.…”

Section: Methodsmentioning

confidence: 99%

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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“…In present study 48% of the patients had anemia which is consistent with Devjani et al study. 11 Poor control of glucose during surgery and in the perioperative period increases the risk of infection and worsens outcome of sepsis. The results of present study are consistent with Olsen MA et al study.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections post cesarean section

Devi¹,

Durga²

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Surgical site infections are among the most common hospital acquired infections. They make upto 14-16% of inpatient infections. Objective of present study was to evaluate the risk factors associated with surgical site infections and the bacteria causing wound infections in obstetric operations and the antibiotic sensitivity and resistance pattern of the pathogens isolated.Methods: 100 women with wound infection during hospital stay or within 30 days following surgery. Pus samples were collected from the wound site with help of sterile swabs under aseptic precautions and immediately transported to microbiology laboratory for culture and sensitivity.Results: Most of the patients belonged to the age group of 21-25 years, contributing to 55% of the cases. Majority of the women are from rural areas (71%). 57% of the cases were unbooked. 90% of the SSI were seen in emergency surgeries. Anaemia (48%) was the most common medical risk factor followed by hypertensive disorders 25%. The risk of post operative infection has been shown to be proportional to volume of blood loss during cesarean section and duration of surgery. Staphylococcus aureus to be predominant organism of wound infection of which 21% were MRSA followed by Klebsiella and E.coli. The gram negative isolates were 100% resistant to ampicillin followed by 22.5% to third generation cephalosporins and aminoglycosides.Conclusions: Proper assessment of risk factors that predispose to SSI is critical for the development of strategies for reducing the incidence of SSI and for identifying high risk patients requiring intensive postoperative surveillance.

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Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section

Cited by 51 publications

References 27 publications

Surgical Site Infections Incidence, their Predictors and Causative Organisms in a Teaching Hospital

Surgical Site Infections Incidence, their Predictors and Causative Organisms in a Teaching Hospital

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

Surgical site infections post cesarean section

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