Surgical site infection after cesarean delivery: incidence and risk factors at a US academic institution

Moulton, Laura J.; Munoz, Jessian L.; Lachiewicz, Mark; Liu, Xiaobo; Goje, Oluwatosin

doi:10.1080/14767058.2017.1330882

Cited by 43 publications

(53 citation statements)

References 37 publications

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“…e study also showed giving birth by CD at term was 98.1% protective ((AOR � 0.019, 95% CI: (0.001-0.291))) for the incidence of SSI compared to that of postterm deliveries. Even though direct association between preterm delivery and the outcome variable could not be found in this study, it agrees with studies in the USA and Israel that labouring at term can protect infection by avoiding complications of preterm labour such as hastened labour [16,17].…”

Section: Discussionsupporting

confidence: 85%

“…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: 97%

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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: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 97%

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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“…This bias has been eliminated by including in the control group only patients without history of infection or the use of antibiotics until 30th postpartum day, apart from prophylaxis. Risk factors well documented in the literature, such as emergency cesarean section, duration of ruptured membranes, duration of surgery, excessive vaginal manipulation, obesity, and surgical risk must be analyzed for prophylaxis antibiotic treatment (7)(8)(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Surgical Site Infection in Post-Cesarean Section: A Case-Control Study in a Peruvian Hospital

Yerba¹,

Failoc-Rojas²,

Zeña-Ñañez³

et al. 2020

Ethiop J Health Sci

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BACKGROUND: Surgical site infection is the main cause of morbidity and mortality in post-cesarean section patients. The objective of this study was to determine the preoperative factors associated with the surgical site infection in patients undergoing cesarean emergency section in the Goyeneche Hospital of Arequipa.METHODS: We conducted a cases-control study on women who presented with surgical site infection after cesarean section in a hospital in Arequipa, Peru. We evaluated associated factors to surgical site infection after cesarean section (sociodemographics and clinical variables). For the inferential analysis, we estimated logistic regression using odds ratio.RESULTS: Out of a total of 4346 cesarean sections, only 2.4% developed surgical site infection. The associated factors to surgicalsite infection were mild anemia (OR: 2.80), moderate anemia (OR:2.71), number of vaginal examinations higher than five (OR:2.71) and onset of labor (OR: 1.95).CONCLUSION: Patients with risk factors such as anemia, onset of labor and five or more vaginal examinations should be evaluated after surgery to prevent surgical site infection.

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“…Patients' demographic data was retrospectively collected through an analysis of patient medical charts. Factors were identified as important data collection points following a review of related literature and so that NHSN risk indexes could be generated [9][10][11][12][13]. The following factors were recorded: age of patient, gestational age at time of operation, nature of caesarean section (emergency or elective), American Society of Anesthesiologists (ASA) score, wound class, if prophylactic antibiotics were used, if the patient experienced premature rupture of membranes (PROM) or had a predisposing illness, and length of procedure from cut to close.…”

Section: Methodsmentioning

confidence: 99%

Incidence of surgical site infections after caesarean sections in a community hospital

Rouse

Nascu

Dawson

et al. 2019

CJIC

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Background: Rates of performed caesarean sections have increased globally [1]. Surgical site infections (SSIs) following a caesarean section pose a threat to the safety of the patient. This study intended to determine the current SSI rate after caesarean sections at one community hospital. The rate of incidence of these infections was compared to benchmark rates from various studies, including a report from the American National Healthcare Safety Network (NHSN). This comparative study provides objective evidence of performance in relation to SSIs. Method: The primary data collection method included a form completed by the obstetrician-gynecologists of the individual patients at the six-week post-partum follow-up visit. Demographic data was collected retrospectively through analysis of medical records. Patients who underwent a caesarean section in the seven-month data collection period (between November 2015 and May 2016) were asked to participate, and consent was obtained. Results: A total of 118 caesarean sections were reviewed and seven SSIs diagnosed. A crude SSI rate was calculated at 5.9%. For further insight, NHSN risk-adjusted SSI rates were calculated. The NHSN risk-adjusted SSI rate was determined at 6.1% for those patients presenting with a risk index level of 0 and at 5.9% for those with a risk index level of 1. Both NHSN risk index levels of 2 and 3 were identified to have an adjusted SSI rate of 0.0%. Conclusion: This study, while limited in scope, does add to the collective literature on SSI rates following caesarean sections. Most significantly, it provides a methodology for other centres interested in determining their own infection rates and could lead to improved practices and better patient outcomes.

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Surgical site infection after cesarean delivery: incidence and risk factors at a US academic institution

Abstract: Several patient and surgical variables are associated with increased rate of SSI after CD. Identification of risk factors for SSI after CD is important for targeted implementation of quality improvement measures and infection control interventions.

Cited by 43 publications

References 37 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

Factors Associated with Surgical Site Infection in Post-Cesarean Section: A Case-Control Study in a Peruvian Hospital

Incidence of surgical site infections after caesarean sections in a community hospital

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