Surgical Site Infection After Cesarean Section in Ukraine: Results a Multicenter Study

Abstract

The aim: To obtain the first national estimates of the current prevalence rate of SSI after CSEC and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multhicentre cogort study based surveillance data was conducted from May 2017 to December 2019. The study population consisted of all women who had a cesarean section in 11 regional women hospitals of Ukraine. Definitions of SSI after cesarean section were used from the CDC/ NHSN. Results: A total of 2 326 CSEC operations and 14.7% SSI were identified within 30 days of the operation. Of these, 44.4% were superficial incisional SSI, 28.9% were deep incisional SSI, and 26.6% were organ/space SSI, 25.7% of which were classed as endometritis. Of all cases 70.5% of infections were detected post discharge. The most commonly identifed pathogen were Staphylococcus aureus (23.5%), Escherichiacoli (20%), Coagulase-negative staphylococci (8.1%), Enterococcus spp. (7.7%), Pseudomonasaeruginosa (7.7%), Enterobacter spp. (6.4%), and Streptococcus spp. (5.6%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 18.3% and of methicillin-resistance in S. aureus(MRSA) 13.9%. Resistance to third-generation cephalosporins was observed in 15.2% E.coli and 7.9% Klebsiellapneumoniae isolates. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Conclusions: The results of this study revealed high rates of SSI after CSEC and most causing pathogens were associated with resistant to antibiotic stranis. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of postoperative infections.

Post-Caesarean Wound Infections: Incidence, Bacterial Profiles, Antimicrobial Susceptibility Patterns and Associated Factors in Public Hospitals, Southern Ethiopia

“…In that study, the overall proportion of ESBL production among Enterobacteriaceae was 18.3% [27]. However, our results are quite contrary to a study done in Tanzania that described merely 2 (13%) of the enteric GNB as ESBL producers [29].…”

“…This nding is similar to the well-documented data found in the literature showing a preponderance of mono-bacterial infections in wound infections [24]. However, in a recent study done in Ukraine, 56.1% (192/342) reported that postcaesarean wound infections are bi-bacterial [27]. Regarding bi-bacterial infections, the most common agents involved are P. aeruginosa and S. aureus (42.9%) (12 out of 28 cases), warranting effective combination drugs.…”

“…The prevalence of post-cesarean wound infections with respect to MRSA was 47.7% (n = 31) and was higher than the value reported in a couple of studies done in Ukraine (13.9%) [27] and Ghana (9.8%) [31]. On the other hand, a study conducted in Uganda (9/10, 91%) reported a high rate of MRSA in post-cesarean wound infections [25].…”

“…Carbapenemase production was detected in 15 (38%) of the 40 ceftazidime-resistant Klebsiella species as per a study done in Uganda [25]. A study conducted in Ukraine also identi ed carbapenem resistance in 7.3% of P. aeruginosa isolates [27].…”

Prevalence, Risk Factors and Microbial Profile of Surgical Site Infection after Cesarean Section in a Tertiary Care Center in Western India

“…The global range of SSI is very wide. This study observed prevalence of SSI was 14.7% compared to many other studies like Jasim et al, 11 Nikita Dhote et al, 12 Aidyn G. Salmanov et al, 13 discordance to our study Meo et al, 14 , Ketcheson F et al, 15 Moulton LJ et al 16 and Noronha et al 17 observed very low (1.9% to 6.9%) prevalence of SSI and De Nardo P et al 18 found very high 48% prevalence of SSI. The difference of SSI prevalence could be due to different study samples, use of antibiotics, preexisting disease, data used for analysis.…”