Study of surgical site infection in patients undergoing caesarean section at tertiary care center, Gujarat
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20220567Keywords:
Cesarean delivery, Incidence of SSI, Microorganism, Risk factor, Surgical site infectionAbstract
Background: Surgical site infection following cesarean delivery leads to increasing the duration of patient hospitalization, hospital costs and raise the burden on our healthcare system. The incidence of SSI after cesarean range from 3% to 5%. Objective of current investigation was to study the risk factor & microbial agents responsible for SSI in LSCS and impact of SSI on perinatal outcome.
Methods: This prospective study was done among 324 pregnant women undergoing LSCS at department of obstetrics and Gynecology in GMERS medical college & hospital, Sola, Ahmedabad during April 2015 to April 2016. All patients were following up to 7thpostoperative day.SSI was defined by CDC criteria.
Results: The incidence of SSI noted in present study was 8.02%. Almost 46.2% cases had BMI ≥25 kg/m2, 65.4% multipara, 34.6% resided in rural area of SSI group. PIH, PROM, LSCS in emergency, multiple vaginal examination (>3), perioperative blood glucose (≥110 mg/dl), duration of surgery (≥60 min), past H/O of LSCS noted in participants of SSI was 30.8%, 30.8%, 96.1, 19.3%, 84.6%, 23.1%), 73.1% respectively. Staphylococcus aureus was the most common microorganism identified and incidence of NICU admission was 11.5% in SSI group.
Conclusions: Incidence of SSI in present is 8.02%. BMI, PIH, PROM, LSCS in emergency, multiple vaginal examination (>3), perioperative blood glucose (≥110 mg/dl), duration of surgery (≥60 min), Past H/O of LSCS were noted statistically significantly higher among the participants of SSI group. Staphylococcus aureus was the most common organism identified.
References
Kelemu A, Amlaku M, Feleke H, Birhanu W, Liknaw B. Surgical site infection and its associated factors following cesarean section. BMC. 2017; 11(17):2-8.
Betra´n A, Merialdi M, Lauer J, Bing-Shun W, Thomas J, Look PV, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2): 98-113.
American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. Obstet Gynecol. 2014; 123(3):693-711.
Blumenfeld YJ, El-Sayed YY, Lyell DJ. Risk factors for prolonged postpartum length of stay following cesarean delivery. Am J Perinatol. 2015;32(9):825-32.
Al Jama FE. Risk factors for wound infection after lower segment cesarean section. Qatar Med J. 2012; 2012(2):26-31.
Vijayan C, Mohandas S, Nath AG. Surgical site infection following cesarean section in a teaching hospital. Int J Sci Stud. 2016;3(12):97-101.
Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk factors for surgical site infection after low transverse cesarean section. Infect Control Hosp Epidemiol. 2008;29(6):477-84.
Jalil MHA, Hammour KA, Alsous M, Awad W, Hadadden R, Bakri F, et al. Surgical site infections following caesarean operations at a Jordanian teaching hospital: frequency and implicated factors. Sci Rep. 2017;7(1):12210.
Gong SP, Guo HX, Zhou HZ, Chen L, Yu YH. Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province, China. J Obstet Gynaecol Res. 2012;38(3):509-15.
Shrestha S, Shrestha R, Shrestha B, Dongol A. Incidence and risk factors of surgical site infection following cesarean section at Dhulikhel hospital. Kathmandu Univ Med J. 2014;46(2):113-6.
Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control. 2014;3(1):25.
Smaill F, Hofmeyr GJ. Antibiotic prophylaxis for cesarean section. Cochrane Database Syst Rev. 2002; 5:CD933.
Wloch C, Wilson J. Risk factors for surgical site infection following caesarean section in England: results from a multicentre cohort study. BJOG. 2012; 119(11):1324-33.
Gupta S, Manchanda V, Sachdev P, Saini RK, Joy M. Study of incidence and risk factors of surgical site infections in lower segment caesarean section cases of tertiary care hospital of north India. Indian J Med Microbiol. 2021;39(1):1-5.
Gelaw K, Aweke AM. Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia. Patient Safety Surg. 2017;11:18.
De D, Saxena S, Mehta G, Yadav R, Dutta R. Risk Factor Analysis and Microbial Etiology of Surgical Site infection following lower segment cesarean section. Int J Antibiotics. 2013;2013:283025.
Filbert J, Stephen E, Mariam M , Benson R , Balthazar G, Imirzalioglu C et al. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resi Infect Control. 2014;3(25):1-10.
Bhadauria AR. Clinical study of post operative wound infections in obstetrics and gynaecological surgeries in a tertiary care set up. Int J Reprod Contracept Obstet Gynecol. 2013;2(4):631-8.
Rahman J. Factors of Post-operative wound infection in abdominal surgeries of Obstetrics and Gynaecology department. J Dhaka Nat Med College Hospital. 2012;18(1):39-42.
Dessu S, Samuel S, Gebremeskel F, Basazin A, Tariku Z, Markos M. Determinants of post cesarean section surgical site infection at public hospitals in Dire Dawa administration, Eastern Ethiopia: Case control study. PLoS ONE. 2021;16(4):e0250174.
Amenu D, Belachew T, Araya F. Surgical site infection rate and risk factors among obstetric cases of Jimma University Specialized Hospital, southwest Ethiopia. Ethiop J Health Sci. 2011;21:91-200.
Bizimana J, Ndoli J, Bayingana C, Baluhe I, Gilson G. Prevalence and risk factors for post cesarean delivery surgical site infection in a teaching hospital setting in rural Rwanda: A prospective cross sectional study. Int J Curr Microbiol App Sci. 2016; 5:631-41.
Chu K, Maine R, Trelles M. Cesarean section surgical site infections in sub-saharan africa: a multi country study from medecins sans frontieres. World J Surj. 2014:1-7.
Karl W. Reducing the complications of caesarean section. Adv Obstetr Gynaecol 2017;20:141-52.
Callaghan W, Creanga A, Kuklina E. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol. 2012;120:1029-36.
Dhar H. A study of post-caesarean section wound infections in a regional referral hospital. Oman. Sultan Qaboos Univ Med J. 2014;14(2):e211.
Mhaske G, Vadhera P, Kalra K. Study of surgical site infection (SSI) in patients undergoing caesarean section (CS): A retrospective study. Int J Clin Obstet Gynaecol. 2020;4(1):350-3.
Bhavani K, Prasanthi S, Jyothsna Y, Vani I, Uma N. A critical review of post-operative caesarean section sepsis: A retrospective study. IAIM. 2017;4(11):153-9.
