Risk factors for surgical site infection in children at the teaching hospital Gabriel Touré, Bamako

Aoyama, Togo; Coulibaly, Y; Dembélé, B T; Togo, Boubacar; Kéita, M; Kanté, L; Traoré, Abdramane; Diakité, I.; Ouologuem, H; Diallo, G

doi:10.1016/j.jhin.2011.08.007

Cited by 21 publications

(19 citation statements)

References 3 publications

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“…Our result that severe anaemia increases the risk of surgical site infection is similar to other studies in low income countries 19–22 . However, our finding that moderate and severe anaemia also increases the risk of other postoperative complications is novel and differs from the only other low income study on anaemia and postoperative complications 14 .…”

Section: Discussionsupporting

confidence: 92%

Effect of Pre‐operative Anaemia on Post‐operative Complications in Low‐Resource Settings

White¹,

Longstaff²,

Lai

2016

World j. surg.

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Background In high resource settings, even mild anaemia is associated with an increased risk of postoperative complications. Whether this is true in low resource settings is unclear. We aimed to evaluate the effect of anaemia on surgical outcomes in the Republic of Congo and Madagascar. Method Retrospective chart review of 2064 non-pregnant patients undergoing elective surgery with Mercy Ships. Logistic regression was used to determine the association between pre-operative anaemia and predefined surgical complications, and adjusted for age, gender, surgical specialty, and country. Results The average age of patients was 27.2 years; 56.7% were male. 62% of patients were not anaemic, and 22.7%, 13.9% and 1.4% met sex-related criteria for mild, moderate and severe anaemia. In adjusted analyses, the severe anaemia group had an 8.58 [3.65, 19.49] higher odds of experiencing any surgical complication (p < 0.001) compared to non-anaemic patients. Analysis of each complication showed a 33.13 [9.57, 110.39] higher odds of unexpected ICU admission (p<0.001); a 7.29 [1.98, 21.45] higher odds of surgical site infection (p<0.001); and 7.48 [1.79, 25.78] higher odds of requiring hospital readmission (p<0.001). Evaluating other anaemia categories, only those with moderate anaemia had a higher risk of requiring ICU admission (odds ratio 2.75 [1.00, 7.04], (p = 0.04) compared to those without anaemia. Conclusion Our results indicate that in low income settings, severe anaemia is associated with an increased risk of postoperative complications including unexpected ICU admission, surgical site infection, and hospital readmission, whereas mild anaemia was not associated with increased postoperative complications.

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Section: Discussionsupporting

confidence: 92%

Effect of Pre‐operative Anaemia on Post‐operative Complications in Low‐Resource Settings

White¹,

Longstaff²,

Lai

2016

World j. surg.

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“…The delay of infection appearance varied between 5 -10 days on average during different surveys. Our study is not different from those of others set [5] [6] [12].…”

Section: Commentscontrasting

confidence: 61%

“…The NNISS score is of multiple factors it represents a better indicator of more complex risk, predicting with a better liability. The occurrence of operating site infection, in comparison with ALTEMEIR class alone, we have noticed an increase in operating site infection with regard to the NNISS score in various sets [5] [6] [14].…”

Section: Commentsmentioning

confidence: 95%

“…In Senegal, a frequency of 5.3% of operating site infection has been found in 2003 [4]; 8.6% in Ivory Coast. In Mali, a survey carried out in 2007 at pediatric surgery department of Gabriel TOURE training Hospital has found 4.9% [5] against 8.81% of postoperative infection in 2001 at the service of general surgery and pediatric surgery Gabriel TOURE training hospital and 8.3% in 2004 at the same service [6].…”

Section: Introductionmentioning

confidence: 99%

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Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

Dembélé¹,

Traoré²,

Aoyama³

et al. 2015

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The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d'Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4; according to NNISS, 96 (25.7) were NNISS 0; 94 (51.9%) NNISS 1; 80 (21.4%) NNISS 2; and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier's class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients; 4.3% making 4 out of 93 type II patients; 11.9% making 5 out of 42 type III patients; 10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia coli (51.7), Proteus mirabilis (13.8), and Klebsiella pneumoniae (10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been B. T. Dembélé et al. 60 delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.

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“…where nosocomial infection control mechanisms [5] are established, and non-developed countries where they are almost non-existent. Thus, our results are similar to those of DEMBELE, which found a 23.63% incidence in the urology department of the teaching hospital of the G [6] in MALI, Togo et al reported a higher frequency of 65.60% [7]. The incidence of SSI is much lower in the United States and Europe, ranging from 1.77% to 7% [3] [8] [9].…”

Section: Discussionsupporting

confidence: 90%

Incidence and Risk Factors of Surgical Site Infections in Urological Surgery at Brazzaville Teaching Hospital

Atipo¹,

Ondziel²,

Odzébé³

et al. 2019

OJU

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Aim: To evaluate the incidence of surgical site infection in the Urology Department of Brazzaville teaching hospital. Methods: This was a prospective study performed in the Urology Department and operating room of the Brazzaville teaching hospital during six months from February 2 nd to July 2 nd 2017. The study concerned all patients who had undergone surgery, selected during the operating program and those who had been in emergency and then hospitalized in the urology department. These patients were followed for one month after the intervention date. Results: 209 patients were operated on of whom 48 had surgical site infection, a cumulative incidence of 22.96%. The average age of infected patients was 58.3 years ± 17.73 ds (extremes from 13 to 85 years). 43.75% infected patients had co-morbidity factors. The SSI rate was 70% in patients with positive urine culture. Urinary catheters were found in 33.33% of patients. The average length of preoperative hospital stay was two days. The rate of SSI in patients classified Asa I was 10.41%, Asa II 37.5% and Asa III 52.09%. The SSI rate was respectively 5.21%, 56.76% and 38.03%. The infected patients operated first in the operative program accounted for 10.42%. The group of patients who underwent prostatic surgery accounted for 42.58% of patients with an SSI rate of 47.91%. The practice of aseptic measures by staff was found in 70% of cases. The infection rate in patients with drain was 73.23%. The infection rate in patients with catheters was 54.26%. The SSI was superficial in 66.67% of cases, deep in 25% of cases and organ in 8.33% of cases. Escherichia coli was the most frequently isolated germ 50%. Conclusion: Surgical site infection (ISO) is a common feature in our practice. The advanced age of patients and comorbidity factors are associated with a high risk of occurrence of SSI. These infections were not inevitable, their incidence can be greatly reduced by specific preventive measures.

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Risk factors for surgical site infection in children at the teaching hospital Gabriel Touré, Bamako

Cited by 21 publications

References 3 publications

Effect of Pre‐operative Anaemia on Post‐operative Complications in Low‐Resource Settings

Effect of Pre‐operative Anaemia on Post‐operative Complications in Low‐Resource Settings

Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

Incidence and Risk Factors of Surgical Site Infections in Urological Surgery at Brazzaville Teaching Hospital

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