Factors Associated with Acquired Infections Caesarian Wounds in Maternity Mbuji-Mayi/DR Congo

Bukasa, Jean Christophe; Kadiata, Augustin; Kabongo, André Guillaume; Lepelletier, Didier; Banza, Decas Blood; Bukasa, Jean Jacques; Ilunga, Félicien Ilunga; Mutombo, Augustin Mulangu; Mbo, Senghor Ngoyi; Bandimuna, Angélique; Kashimpo, Sébatien; Ntambwe, Alexis; Stany, Wembonyama

doi:10.4236/oalib.1104437

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…Our study reported a cumulative incidence rate of HAIs of 25% (CI: The data from this study showing a high incidence of HAIs in the three main hospitals in Bobo Dioulasso are similar to those reported in previous studies in the African literature [12,[18][19][20][21]. The frequency of HAIs obtained in our study remains higher than those reported in studies from both developed countries [2,22,23] and other African studies [10,11,16,24,25].…”

Section: Discussionsupporting

confidence: 88%

Risk and outcomes of healthcare-associated infections in three hospitals in Bobo Dioulasso, 2022 (Burkina Faso): a longitudinal study

Hema,

Some,

Kaboré

et al. 2024

Preprint

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BackgroundHealthcare-associated infections (HAIs) are one of the most common adverse events in healthcare and represent a major public health problem. However, 40% to 70% of HAIs are considered to be preventable. The present study was conducted to analyze the incidence, etiological factors, and outcomes of HAIs through active surveillance in three hospitals in the city of Bobo Dioulasso.MethodsA prospective, longitudinal, multicenter study was conducted from May 1thto November 30rd, 2022, in two district hospitals (DO and Dafra) and the Sourô Sanou Teaching Hospital (CHUSS). Consenting patients hospitalized for reasons other than infection, cancer, immunosuppression in the postoperative care ward of DO or of Dafra district hospitals, intensive care unit (ICU)/CHUSS, neonatal ward/CHUSS, and gynecology and obstetrics postoperative care ward/CHUSS during a 2-month inclusion period in district hospitals and 4 months for CHUSS wards. For this study, we used the operational definitions of the French Technical Committee for Nosocomial Infections and Healthcare-associated Infections, with slight modifications. Logistic regression was used to analyze predictors of HAIs.ResultsOf the 664 patients enrolled, 166 experienced an HAI, with a cumulative incidence rate of 25% (CI: 21.7%-28.3%) or an incidence density rate of 36.7 per 1000 patient-days (CI: 31.7-42.9). Surgical site infections (SSI) (44%), followed by neonatal infections (42%) were the most common HAIs. Enterobacteriaceae represented 60% of the bacteria identified in HAIs, and 38.9% of them were extended spectrum β-lactamase (EBLSE) producers. Factors associated with HAIs were admission in the neonatal ward (aOR=7.4; CI:1.3-42.7), ICU (aOR=3.7; CI:1.4-9.5), hospital stay longer than 2 days (aOR=2.1; CI:1.2-3.4), or male sex (aOR=1.8; CI:1.1-3.1). In addition, HAIs were associated with longer follow-up, hospitalization, and mortality (18.1%; 95% CI:12.1 - 24.4). Deaths were only recorded in the ICU and neonatal ward, with case fatality rates of 45.4% (95% CI: 27.5 - 63.4) and 21.4% (95% CI: 11.6 - 31.3), respectively, p=0.019.ConclusionsThe incidence of HAIs was relatively high in the three hospitals in Bobo Dioulasso. A national strategy to reduce HAIs should be implemented to achieve better control of HAIs.

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Section: Discussionsupporting

confidence: 88%

Risk and outcomes of healthcare-associated infections in three hospitals in Bobo Dioulasso, 2022 (Burkina Faso): a longitudinal study

Hema,

Some,

Kaboré

et al. 2024

Preprint

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“…Surgical site infections (SSIs) are the most common c-section-associated complication, with an estimated 10–48% of women delivering via c-section in SSA developing an SSI [ 5 6 7 8 9 10 ]. The World Health Organization (WHO) developed antibiotic prophylactic guidelines for SSI prevention [ 5 ], however, adherence to these guidelines appears low in SSA [ 11 ] with empirical antibiotic selection often based on drug availability and provider preferences [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda

Velin

Umutesi

Riviello

et al. 2021

Annals of Global Health

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Background: As the volume of surgical cases in low- and middle-income countries (LMICs) increases, surgical-site infections (SSIs) are becoming more prevalent with anecdotal evidence of antimicrobial resistance (AMR), despite a paucity of data on resistance patterns. Objectives: As a primary objective, this prospective study aimed to describe the epidemiology of SSIs and the associated AMR among women who delivered by cesarean at a rural Rwandan hospital. As secondary objectives, this study also assessed patient demographics, pre- and post-operative antibiotic use, and SSI treatment. Methods: Women who underwent cesarean deliveries at Kirehe District Hospital between September 23rd, 2019, and March 16th, 2020, were enrolled prospectively. On postoperative day (POD) 11 (+/– 3 days), their wounds were examined. When an SSI was diagnosed, a wound swab was collected and sent to the Rwandan National Reference Laboratory for culturing and antibiotic susceptibility testing. Findings: Nine hundred thirty women were enrolled, of whom 795 (85.5%) returned for the POD 11 clinic visit. 45 (5.7%) of the 795 were diagnosed with SSI and swabs were collected from 44 of these 45 women. From these 44 swabs, 57 potential pathogens were isolated. The most prevalent bacteria were coagulase-negative staphylococci (n = 12/57, 20.3% of all isolates), and Acinetobacter baumannii complex (n = 9/57, 15.2%). 68.4% (n = 39) of isolates were gram negative; 86.7% if excluding coagulase-negative staphylococci. No gram-negative pathogens isolated were susceptible to ampicillin, and the vast majority demonstrated intermediate susceptibility or resistance to ceftriaxone (92.1%) and cefepime (84.6%). Conclusions: Bacterial isolates from SSI swab cultures in rural Rwanda predominantly consisted of gram-negative pathogens and were largely resistant to commonly used antibiotics. This raises concerns about the effectiveness of antibiotics currently used for surgical prophylaxis and treatment and may guide the appropriate selection of treatment of SSIs in rural Rwanda and comparable settings.

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Factors Associated with Acquired Infections Caesarian Wounds in Maternity Mbuji-Mayi/DR Congo

Cited by 2 publications

References 10 publications

Risk and outcomes of healthcare-associated infections in three hospitals in Bobo Dioulasso, 2022 (Burkina Faso): a longitudinal study

Risk and outcomes of healthcare-associated infections in three hospitals in Bobo Dioulasso, 2022 (Burkina Faso): a longitudinal study

Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda

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