Surgical site infections in women and their association with clinical conditions

Madeira, Maria Zélia de Araújo; Trabasso, Plı́nio

doi:10.1590/0037-8682-0125-2014

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Similar to our findings, there is a significant association between obesity and diabetes mellitus and the develpomenet of SSI following CS [ 17 ]. In addition, de Araújo et al in 2014 [ 42 ] and Alfonso-Sanchez et al in 2017 [ 43 ] reported a strong positive relationship between increased risk for SSI and anemia, hypertension, obesity and diabetes mellitus. Recently, Molla et al, in 2019 [ 5 ] found that cases with pregnancy-induced hypertension (PIH) were about five times more likely to develop SSI compared to normal ones.…”

Section: Discussionmentioning

confidence: 99%

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

Gomaa

Abdelraheim

Gelany

et al. 2021

BMC Pregnancy Childbirth

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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).

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Section: Discussionmentioning

confidence: 99%

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

Gomaa

Abdelraheim

Gelany

et al. 2021

BMC Pregnancy Childbirth

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“…As previously reported, there is an increased risk for SSI in the presence of other comorbidities [29] explicitly: anemias, obesity [30] hypertension, diabetes mellitus as well as other associated morbidities in the patient [31].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections after cesarean sections at the University Clinical Center of Kosovo: rates, microbiological profile and risk factors

2019

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Background Surgical site infections (SSI) are a common complication after a cesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, dissatisfaction of patients, longer hospital stays as well as higher treatment costs. The aim of this study is to determine the incidence rate and risk factors of surgical site infections in women undergoing caesarean section at the University Clinical Center of Kosovo (UCCK), in the Clinic for Obstetrics and Gynecology. Methods We conducted a prospective observational cohort study involving 325 women who underwent labor and scheduled C-sections from January, 2018 to September, 2018 at the University Clinical Center of Kosovo, Clinic for Obstetrics and Gynecology. Each woman was followed for 30-postoperative days. Data analysis included descriptive statistics, univariate and multivariate logistic regression analysis. Culture-based microbiological methods were used to identify causal agents in postoperative wounds. Results Overall the SSI rate was 9.85% and the median time to SSI was the 7th postoperative day. The mean age of the patients was 31.3 ± 5.5 years (range from 17 to 46 years). The average length of stay was 4.2 ± 3.4 days. Several factors reduced the risk of SSI. These included: age less than 35 years (RR 0.25; 95% CI; 0.199–0.906 and P = 0.027) preoperative use of antibiotics (RR 0.232; 95% CI; 0.107–0.502 and P = 0.000) and duration of the operation less than 1 h (RR 0.135; 95% CI; 0.054–0.338 and P = 0.000). Previous cesarean section and one or more co-morbidity were associated with 7.4 fold and 8 fold increased risk of SSI, respectively. We found a statistically significant association between SSI and co-morbidity, preoperative antibiotic use, duration of operation, age and history of previous cesarean section ( P = 0.000; 0.000; 0.0001; 0.023; 0.000; respectively using chi-square test). Multivariable logistic regression analysis confirmed that one or more co-morbidity, previous C-section, preoperative antibiotics and duration of the surgery < 1 h are predictors of SSI. Conclusion The high incidence rate of SSIs after C-sections in this study highlight the need for prioritizing SSI control and surveillance. Patient demographics, procedures utilized and surgical factors must be incorporated in programs to reduce the infection rate. Additionally, an effort must be given to decrease number of the C-sections performed for the first time through assuring optimal care for the mother and child. The National Committee for Prevention and Control of Nosocomial infection in Kosovo should provide updated guidelines for control and prevention of the nosocomial infections.

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“…were found in the previous study by Bhadauriya et al with E.coli as the most common responsible pathogen (36.62%) followed by Klebsiella species (6.10%). In contrast, Staphylococcus aureus was found to be the most common pathogen responsible [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Postoperative wound infection after obstetrics and gynaecology surgeries: A study from the tribal tertiary healthcare centre

Parmar¹,

Damor²

2020

Obg Rev J Obstet Gynecol

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Aims and Objectives: the study was conducted to find out the incidence of postoperative wound infection among obstetric and gynaecological surgeries in the tribal area of Rajasthan region with the objective to identify various preventable risk factors and common responsible pathogen. Material and methods: It was a prospective study conducted in the department of Gynaecology in Government Medical College and Hospital, Dungarpur during the period of six months from August 2019 to January 2020. Results: Out of 300 surgeries performed, 210 surgeries were obstetrics and 90 surgeries were gynaecological. The mean age of obstetrics cases was 26.89±2.5 years and of gynaecological cases was 48.22±4.8 years. Frequency of wound infection in obstetrics cases was 5.23% (11 cases) and was 11.11% (10 cases) in gynaecological surgeries with a total frequency of 7% (21 cases). Mean postoperative day of wound infection was 9.81±5.6, mean postoperative hospital stay was 8.10±5.6 days and the mean duration of surgery was 1.29±0.45 hours. Body mass index (BMI) was >25 (obese) in 61.90% of infected cases. 15 patients (10.41%) out of 144 patients who did not receive antibiotic prophylaxis, developed wound infection. On culture, Escherichia Coli (E.coli) was found to be the most common responsible pathogen (38.09%) followed by Klebsiella species and Staphylococcus aureus (19.04%). Conclusion: Early identification of various risk factors for postoperative wound infection in obstetric and gynaecological surgeries is essential to prevent further morbidities.

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Surgical site infections in women and their association with clinical conditions

Cited by 14 publications

References 11 publications

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

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

Surgical site infections after cesarean sections at the University Clinical Center of Kosovo: rates, microbiological profile and risk factors

Postoperative wound infection after obstetrics and gynaecology surgeries: A study from the tribal tertiary healthcare centre

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