Does surgical site infection after Caesarean section in Polish hospitals reflect high-quality patient care or poor postdischarge surveillance? Results from a 3-year multicenter study

Różańska, Anna; Jarynowski, Andrzej; Kopeć-Godlewska, Katarzyna; Wójkowska‐Mach, Jadwiga; Misiewska-Kaczur, Agnieszka; Lech, M; Rozwadowska, Małgorzata; Karwacka, Marlena; Liberda, Joanna; Domańska, Joanna

doi:10.1016/j.ajic.2017.07.025

Cited by 17 publications

(25 citation statements)

References 19 publications

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“…e rate, however, might be underestimated due to a significant number of lost participants. e rate, 15.1%, is significantly high compared to the results of studies done in Polish hospital, US academic institution, Israel health institution, ai-Myanmar border hospital, a hospital in Oman, two hospitals in Libya, three sub-Saharan African countries, and Tanzania which showed an incidence rate of 0.5%, 5.5%, 3.7%, 6.2%, 2.6%, 2.53-3.07%, 7.6%, and 10.9%, respectively [6,[16][17][18][19][20][21][22][23]. is difference might be due to a difference in SSI definition, distribution of risk factors among the studied group, study time, socioeconomic status, and healthcare delivery system.…”

Section: Discussionmentioning

confidence: 91%

“…Medically indicated cesarean section has a pronounced influence to prevent life-threatening conditions, such as obstetric fistula and birth asphyxia, and save maternal and child life [3]. However, CD also accompanies the risk of infection, hemorrhage, and uterine rupture and placentation problems in current and future pregnancies [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

Lijaemiro

Lemlem

Deressa

2020

Obstetrics and Gynecology International

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Background. One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation. Objective. The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019. Method. A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had p<0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. Result. From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 – 1.933, p=0.001))), ((AOR = 0.019, 95% CI: (0.001 – 0.291, p=0.004))), ((AOR = 1.108, 95% CI: (1.025 – 1.197, p=0.009))), and ((AOR = 13.076, 95% CI: (1.018 – 168.002, p=0.048))), respectively. Conclusion and recommendation. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

Lijaemiro

Lemlem

Deressa

2020

Obstetrics and Gynecology International

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“…Charrier and colleagues reported that 85.0% of SSI infections developed after caesarean operations were observed after hospital discharge 37 . In a study conducted in southern Poland almost half (48.7%) of all SSIs were diagnosed prior to patients discharged from hospital 28 . This appeared to reflect relatively the effectiveness of active postdischarge detection of SSI in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have demonstrated that antimicrobial prophylaxis reduces post-operative surgical infection by reducing the likelihood of resident bacteria overcoming the immune system 27 . Lacking pre-operative antibiotic prophylaxis, increases American Society Anaesthesiologist ASA score and extended surgery duration were found potential predictors for acquisition of post-surgical SSI in Polish Hospitals after caesarean delivery 28 . Re-hospitalizations due to surgical site infections were significantly more often recorded among women living outside big cities and consequently giving birth in primary referral hospitals with a low level of healthcare quality 29 .…”

Section: Introductionmentioning

confidence: 95%

Surgical site infections following caesarean sections at Emirati teaching hospital: Incidence and implicated factors

Alnajjar

Alashker

2020

Sci Rep

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The rate of delivery by caesarean sections is increasing globally and, therefore, the incidence of post-caesarean surgical site infections (SSIs) is probably also going to rise. The aim of the present study was to determine the incidence of SSIs after caesarean operations and to explore the factors associated with an increased risk of post-caesarean SSIs. A retrospective study was performed to assess all women who underwent caesarean sections from January 2016 to December 2017 at Al Ain Hospital in the United Arab Emirates (UAE). Backward multivariate logistic regression analysis was utilized to specify the variables that were significantly and independently connected with the development of post-caesarean SSIs. In total, 807 women underwent caesarean deliveries at the study site hospital during the two-year study period (January 2016–December 2017). Post-operative SSI was detected in 11 (1.4%) of the women who underwent caesarean operations. Of these, 11 (100%) women were diagnosed post-discharge, within 30 days after the date of the surgery. Multivariate logistic regression analysis showed that increased gestational age (P = 0.045) was significantly and independently associated with the development of post-caesarean SSI. Increased gestational age was found to be an independent predictor of post-caesarean SSIs. This identified risk factor should inform targeted health care policies to reduce the rate of SSIs.

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“…Similar results in other Polish studies were reported by Dubiel et al in the field of thoracic surgery [ 5 ] or Różańska etc. in obstetrics [ 22 ]. A substantial problem for patients of surgical wards in the hospital studied turned out to be other HAIs, which amounted to over a half of all cases, which is a clue pointing to the fact that the basic problem in HAI prevention is general medical care and that limiting surveillance to SSI only would worsen the patients’ prognoses greatly.…”

Section: Discussionmentioning

confidence: 99%

Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Poland

Kołpa

Wałaszek

Różańska

et al. 2018

IJERPH

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Healthcare-associated infections (HAIs) are adverse complications of hospitalisation resulting in delayed recovery and increased costs. The aim of this study was an analysis of epidemiological factors obtained in the framework of constant, comprehensive (hospital-wide) infection registration, and identification of priorities and needs in infection control, both with regard to targeted surveillance, as well as preventative actions. The study was carried out according to the methodology recommended by the HAI-Net (Surveillance Network) coordinated by the European Centre for Disease Prevention and Control, in the multiprofile hospital in Southern Poland, between 2012 and 2016. A total of 159,028 patients were under observation and 2184 HAIs were detected. The incidence was 1.4/100 admissions (2.7/1000 patient-das of hospitalisation) and significantly differed depending on the type of the patient care: in intensive care units (ICU) 16.9%; in surgical units, 1.3%; non-surgical units, 1.0%; and paediatric units, 1.8%. The most common HAI was gastrointestinal infections (GIs, 28.9%), followed by surgical site infections (SSIs, 23.0%) and bloodstream infections (BSIs, 16.1%). The vast majority of GIs, BSIs, urinary tract infections, and incidents of pneumonia (PN) were detected in non-ICUs. As many as 33.2% of cases of HAI were not confirmed microbiologically. The most frequently detected etiologic agent of infections was Clostridium difficile—globally and in GI (49%). Comprehensive analysis of the results allowed to identify important elements of surveillance of infections, i.e., surveillance of GI, PN, and BSI not only in ICU, but also in non-ICU wards, indicating a need for implementing rapid actions to improve compliance with HAI prevention procedures.

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Does surgical site infection after Caesarean section in Polish hospitals reflect high-quality patient care or poor postdischarge surveillance? Results from a 3-year multicenter study

Cited by 17 publications

References 19 publications

Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

Surgical site infections following caesarean sections at Emirati teaching hospital: Incidence and implicated factors

Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Poland

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