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Tytuł pozycji:

Surgical site infections after cesarean sections at the University Clinical Center of Kosovo: rates, microbiological profile and risk factors.

Tytuł :
Surgical site infections after cesarean sections at the University Clinical Center of Kosovo: rates, microbiological profile and risk factors.
Autorzy :
Zejnullahu VA; Department of Obstetrics and Gynecology, University Clinical Center of Kosovo, Pristina, Kosovo.
Isjanovska R; Institute of Epidemiology, Biostatistics and Medical Informatics, Ss. Cyril and Methodius University, Skopje, Macedonia.
Sejfija Z; Department of Oral Surgery, University Clinical Center of Kosovo, Pristina, Kosovo.
Zejnullahu VA; Departments of Abdominal Surgery, University Clinical Center of Kosovo, Pristina, Kosovo. .
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Źródło :
BMC Infectious Diseases [BMC Infect Dis] 2019 Aug 28; Vol. 19 (1), pp. 752. Date of Electronic Publication: 2019 Aug 28.
Typ publikacji :
Journal Article; Observational Study
Język :
Journal Info :
Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect. Dis. Subsets: MEDLINE
Imprint Name(s) :
Original Publication: London : BioMed Central, [2001-
MeSH Terms :
Antibiotic Prophylaxis/*statistics & numerical data
Cesarean Section/*adverse effects
Surgical Wound Infection/*epidemiology
Surgical Wound Infection/*microbiology
Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis/methods ; Cesarean Section/statistics & numerical data ; Cohort Studies ; Comorbidity ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Female ; Humans ; Kosovo/epidemiology ; Middle Aged ; Pregnancy ; Prospective Studies ; Risk Factors ; Surgical Wound Infection/drug therapy ; Surgical Wound Infection/prevention & control
Contributed Indexing :
Keywords: Antibiotics; Bacteriological profile; Cesarean delivery; Kosovo; Surgical site infections
Substance Nomenclature :
0 (Anti-Bacterial Agents)
Entry Date(s) :
Date Created: 20190829 Date Completed: 20191127 Latest Revision: 20191127
Update Code :
Czasopismo naukowe
Background: Surgical site infections (SSI) are a common complication after a cesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, dissatisfaction of patients, longer hospital stays as well as higher treatment costs. The aim of this study is to determine the incidence rate and risk factors of surgical site infections in women undergoing caesarean section at the University Clinical Center of Kosovo (UCCK), in the Clinic for Obstetrics and Gynecology.
Methods: We conducted a prospective observational cohort study involving 325 women who underwent labor and scheduled C-sections from January, 2018 to September, 2018 at the University Clinical Center of Kosovo, Clinic for Obstetrics and Gynecology. Each woman was followed for 30-postoperative days. Data analysis included descriptive statistics, univariate and multivariate logistic regression analysis. Culture-based microbiological methods were used to identify causal agents in postoperative wounds.
Results: Overall the SSI rate was 9.85% and the median time to SSI was the 7th postoperative day. The mean age of the patients was 31.3 ± 5.5 years (range from 17 to 46 years). The average length of stay was 4.2 ± 3.4 days. Several factors reduced the risk of SSI. These included: age less than 35 years (RR 0.25; 95% CI; 0.199-0.906 and P = 0.027) preoperative use of antibiotics (RR 0.232; 95% CI; 0.107-0.502 and P = 0.000) and duration of the operation less than 1 h (RR 0.135; 95% CI; 0.054-0.338 and P = 0.000). Previous cesarean section and one or more co-morbidity were associated with 7.4 fold and 8 fold increased risk of SSI, respectively. We found a statistically significant association between SSI and co-morbidity, preoperative antibiotic use, duration of operation, age and history of previous cesarean section (P = 0.000; 0.000; 0.0001; 0.023; 0.000; respectively using chi-square test). Multivariable logistic regression analysis confirmed that one or more co-morbidity, previous C-section, preoperative antibiotics and duration of the surgery < 1 h are predictors of SSI.
Conclusion: The high incidence rate of SSIs after C-sections in this study highlight the need for prioritizing SSI control and surveillance. Patient demographics, procedures utilized and surgical factors must be incorporated in programs to reduce the infection rate. Additionally, an effort must be given to decrease number of the C-sections performed for the first time through assuring optimal care for the mother and child. The National Committee for Prevention and Control of Nosocomial infection in Kosovo should provide updated guidelines for control and prevention of the nosocomial infections.
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