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Federación Mexicana de Ginecología y Obstetricia, A.C.

2024, Number 12

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Ginecol Obstet Mex 2024; 92 (12)

Risk factors in surgical wound infection after cesarean section

Mimbela OJE, Mejía LC, Gutarra VRB

Language: Spanish
References: 34
Page: 483-491
PDF size: 311.28 Kb.


ABSTRACT

Objective: To identify risk factors for surgical wound infection after cesarean section.
Materials and Methods: Retrospective case-control study nested in a cohort of patients terminating pregnancy by cesarean section performed between 2019 and 2023 at Hospital Vitarte, Lima, Peru. Bivariate and multivariate logistic regression analyses were performed; a value of p ‹ 0.05 and 95% CI was considered significant.
Results: During the study period, 17,637 obstetric attendances were recorded, of which 6812 (38.62%) were cesarean deliveries. Twenty-nine cases of surgical wound infection were identified and analyzed along with 91 controls. There was no statistically significant difference in anthropometric variables. The OR of each variable was calculated to determine the association: absence of antibiotic prophylaxis 5.22 (1.51- 18.04), preterm delivery 7.3 (1.70-31.47), multiple vaginal lacerations 6.60 (1.77-24.60), premature rupture of membranes 17.92 (1.99-160.7), anemia 3.80 (1.57-9.22). The remaining variables had a p-value greater than 0.005.
Conclusions: Prolonged labor, lack of antibiotic prophylaxis, multiple vaginal tactus, preterm delivery, premature rupture of membranes, and anemia significantly increase the risk of surgical site infection after cesarean section.


REFERENCES

  1. Ministerio de Salud. NTS 163- MINSA/2020/CDC: Normatécnica de salud para la vigilancia de las infecciones asociadasa la atención de salud. RM N° 523-2020-MINSA.pag.52.https://www.dge.gob.pe/portalnuevo/wp-content/uploads/2021/04/NTS_N163_MINSA-020-CDC.

  2. Gillespie BM, Harbeck E, Rattray M, et al. Worldwide incidenceof surgical site infections in general surgical patients:A systematic review and meta-analysis of 488,594 patients.Int J Surg 2021; 95: 106136. https://doi.org/10.1016/j.ijsu.2021.106136

  3. Hou Y, Collinsworth A, Hasa F, et al. Incidence and impact ofsurgical site infections on length of stay and cost of care forpatients undergoing open procedures. Surg Open Sci 2022;11: 1-18. https://doi.org/10.1016/j.sopen.2022.10.004

  4. Saleem Z, Godman B, Hassali MA, et al. Point prevalencesurveys of health-care-associated infections: a systematicreview. Pathog Glob Health 2019; 113 (4): 191-205. https://doi.org/10.1080/20477724.2019.1632070

  5. Abubakar U, Amir O, Rodríguez-Baño J. Healthcareassociatedinfections in Africa: a systematic review andmeta-analysis of point prevalence studies. J Pharm PolicyPract 2022; 15 (1): 99. https://doi.org/10.1186/s40545-022-00500-5

  6. Lü Y, Cai MH, Cheng J, et al. A multi-center nested casecontrolstudy on hospitalization costs and length of staydue to healthcare-associated infection. Antimicrob ResistInfect Control 2018; 7: 99. https://doi.org/10.1186/s13756-018-0386-

  7. Antoine C, Young BK. Cesarean section one hundred years1920-2020: the Good, the Bad and the Ugly. J Perinat Med2020; 49 (1): 5-16. https://doi.org/10.1515/jpm-2020-0305

  8. Betran AP, Ye J, Moller AB, et al. Trends and projections ofcaesarean section rates: global and regional estimates. BMJGlob Health 2021; 6 (6): e005671. https://doi.org/10.1136/bmjgh-2021-005671

  9. Farid Mojtahedi M, Sepidarkish M, Almukhtar M, et al.Global incidence of surgical site infections following caesareansection: a systematic review and meta-analysis. JHosp Infec. 2023; 139 :82-92. https://doi.org/10.1016/j.jhin.2023.05.019

  10. Wondmeneh TG, Mohammed JA. The incidence of surgicalsite infection and its predictors among women deliveredvia cesarean sections in Ethiopia: a systematic review andmeta-analysis. Front Med 2024; 11: 1395158. https://doi.org/10.3389/fmed.2024.1395158

  11. Dessu S, Samuel S, Gebremeskel F, et al. Determinants ofpost cesarean section surgical site infection at public hospitalsin Dire Dawa administration, Eastern Ethiopia: Casecontrol study. PLoS One 2021; 16 (4): e0250174. https://doi.org/10.1371/journal.pone.0250174

  12. Dong H, Song J, Jia Y, et al. A comprehensive study on therisk factors and pathogen analysis of postoperative woundinfections following caesarean section procedures. IntWound J 2024; 21 (1): e14609. https://doi.org/10.1111/iwj.14609

  13. Regmi A, Ojha N, Singh M, et al. Risk factors associatedwith surgical site infection following cesarean section intertiary care hospital, Nepal. Int J Reprod Med 2022; 2022:4442453. https://doi.org/10.1155/2022/4442453

  14. Getaneh T, Negesse A, Dessie G. Prevalence of surgicalsite infection and its associated factors after cesareansection in Ethiopia: systematic review and meta-analysis.BMC Pregnancy Childbirth 2020; 20 (1): 311. https://doi.org/10.1186/s12884-020-03005-8

  15. Gomaa K, Abdelraheim AR, El Gelany S, et al. Incidence, riskfactors and management of post cesarean section surgicalsite infection (SSI) in a tertiary hospital in Egypt: a five-yearretrospective study. BMC Pregnancy Childbirth 2021; 21(1): 634. https://doi.org/10.1186/s12884-021-04054-3

  16. Basany K, Chaudhuri S, Shailaja PL, et al. Prospectivecohort study of surgical site infections following singledose antibiotic prophylaxis in caesarean section at atertiary care teaching hospital in Medchal, India. PLoSOne 2024; 19 (1): e0286165. https://doi.org/10.1371/journal.pone.0286165

  17. Mezemir R, Olayemi O, Dessie Y. Incidence, bacterial profileand predictors of surgical site infection after cesarean sectionin Ethiopia, a prospective cohort study. Int J WomensHealth 2023; 15: 1547-60. https://doi.org/10.2147/IJWH.S425632

  18. Lake ES, Alamrew A, Belay WS, et al. Surgical site infectionfollowing cesarean section and its predictors in Ethiopia:A systematic review and meta-analysis. PLoS One 2024;

  19. 19 (3): e0296767. https://doi.org/10.1371/journal.pone.029676719. Erritty M, Hale J, Thomas J, et al. Evaluation of independentrisk factors associated with surgical site infections fromcaesarean section. Arch Gynecol Obstet 2023; 308 (6):1775-83. https://doi.org/10.1007/s00404-022-06885-7

  20. Adane A, Gedefa L, Eyeberu A, et al. Predictors of surgicalsite infection among women following cesarean delivery ineastern Ethiopia: a prospective cohort study. Ann Med Surg(Lond) 2023; 85 (4): 738-45. http://dx.doi.org/10.1097/MS9.0000000000000411

  21. Yerba K, Failoc-Rojas V, Zeña-Ñañez S, Valladares-GarridoM. Factors associated with surgical site infection in postcesareansection: a case-control study in a PeruvianHospital. Ethiop J Health Sci 2020; 30 (1): 95-100. http://dx.doi.org/10.4314/ejhs.v30i1.12

  22. Hospital Vitarte del Ministerio de Salud de Lima-Perú.Análisis de la situación de Salud Hospitalaria ASISHO 2023.https://hvitarte.hlev.gob.pe:8443/DetalleTransparencia.aspx?idtransparencia=12

  23. Statistical modeling in epidemiologic research: Some basicconcepts, Clinical Epidemiology and Global Health 2013;1 (1): 32-36. https://doi.org/10.1016/j.cegh.2013.01.003

  24. Williams MJ, Carvalho Ribeiro do Valle C, Gyte GM. Differentclasses of antibiotics given to women routinelyfor preventing infection at caesarean section. CochraneDatabase Syst Rev 2021; 3 (3): CD008726. https://doi.org/10.1002/14651858.CD008726.pub3

  25. Song Q, Yan J, Bu N, et al. Efficacy and safety of broadspectrumpenicillin with or without beta-lactamaseinhibitors vs first and second generation cephalosporinsas prophylactic antibiotics during cesarean section: asystematic review and meta-analysis. J Obstet Gynaecol2023; 43 (1): 2195946. https://doi.org/10.1080/01443615.2023.2195946

  26. Martínez-Martínez C, Ignacio García-De la Torre J, Cepeda-Nieto A. Evaluación del control de infecciones poscesáreamediante la implementación de un programa preventivo.Ginecol Obstet Mex 2019; 87 (4): 228-233. https://doi.org/10.24245/gom.v87i4.2859

  27. Mohanty T, Doke PP, Khuroo SR. Effect of bacterial vaginosison preterm birth: a meta-analysis. Arch Gynecol Obstet2023; 308 (4): 1247-55. https://doi.org/10.1007/s00404-022-06817-5

  28. Daskalakis G, Psarris A, Koutras A, et al. Maternal Infectionand preterm birth: from molecular basis to clinicalimplications. Children (Basel) 2023; 10 (5): 907. https://doi.org/10.3390/children10050907

  29. Lacroix G, Gouyer V, Gottrand F, et al. The cervicovaginalmucus barrier. Int J Mol Sci 2020; 21 (21): 8266. https://doi.org/10.3390/ijms21218266

  30. Ketema DB, Wagnew F, Assemie MA, et al. Incidence andpredictors of surgical site infection following cesareansection in North-west Ethiopia: a prospective cohort study.BMC Infect Dis 2020; 20 (1): 902. https://doi.org/10.1186/s12879-020-05640-0

  31. Ye H, Hu J, Li B, et al. Can the use of azithromycin during labourreduce the incidence of infection among puerperae andnewborns? A systematic review and meta-analysis of randomizedcontrolled trials. BMC Pregnancy Childbirth 2024;24 (1): 200. https://doi.org/10.1186/s12884-024-06390-6

  32. Ikeda M, Oshima Y, Tsumura K, et al. Antibiotic administrationreduced intra-amniotic inflammation 7 daysafter preterm premature rupture of the membranes withintra-amniotic infection. J Matern Fetal Neonatal Med2023; 36 (2): 2286189. https://doi.org/10.1080/14767058.2023.2286189

  33. Sim WH, Ng H, Sheehan P. Maternal and neonatal outcomesfollowing expectant management of preterm prelaborrupture of membranes before viability. J Matern FetalNeonatal Med 2020; 33 (4): 533-41. https://doi.org/10.1080/14767058.2018.1495706

  34. Tian ML, Ma GJ, Du LY, et al. Prevalence and adverseperinatal outcomes of anaemia in the third trimester ofpregnancy in Hebei Province, China. Int Health 2024; 16(1): 91-96. https://doi.org/10.1093/inthealth/ihad028




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