Prospective cohort study of surgical site infections following single dose antibiotic prophylaxis in caesarean section at a tertiary care teaching hospital in Medchal, India.

Autor: Basany K; Department of Obstetrics and Gynecology, Society for Health Allied Research and Education, INDIA MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India., Chaudhuri S; Department of Epidemiology, Indian Institute of Public Health, Hyderabad, Telangana, India., Shailaja P L; Department of Obstetrics and Gynecology, Fernandez Hospital, Hyderabad, Telangana, India., Agiwal V; Department of Epidemiology, Indian Institute of Public Health, Hyderabad, Telangana, India., Angaali N; Department of Microbiology, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India., A Y N; Department of Epidemiology, Indian Institute of Public Health, Hyderabad, Telangana, India., D S; Department of Pharmacology, SHARE INDIA, MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India., Haggerty C; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America., Reddy PS; Department of Obstetrics and Gynecology, Society for Health Allied Research and Education, INDIA MediCiti Institute of Medical Sciences, Hyderabad, Telangana, India.; Division of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jan 25; Vol. 19 (1), pp. e0286165. Date of Electronic Publication: 2024 Jan 25 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0286165
Abstrakt: Background: Caesarean section (CS) is considered to be a life-saving operative intervention for women and new-borns in certain antepartum and intrapartum conditions. Caesarean delivery may be accompanied by several complications including surgical site infections (SSI). However, there is a significant lack of uniformity in the administration of antibiotics for preventing surgical site infections (SSI) following caesarean deliveries. The present study was conducted to determine the incidence of post CS SSI following the adoption of single-dose antibiotic prophylaxis as recommended by WHO at a tertiary care teaching hospital in Medchal, India. Also, to identify the risk factors of SSI and reported the bacteriological profiles and the antimicrobial susceptibility pattern of the culture positive isolates.
Main Objectives: To estimate the incidence of surgical site infections (SSI's) according to CDC criteria following WHO-recommended single-dose antibiotic prophylaxis for caesarean section at a tertiary care teaching hospital in Medchal, India.
Methods: A prospective hospital-based study was conducted between June 2017 and December 2019, in which women who underwent caesarean delivery were followed up for 30 days post-delivery. Clinical details were collected using a structured questionnaire, and participants were followed up weekly after discharge to document any signs and symptoms of SSI. Symptomatic patients were requested to come to the hospital for further investigation and treatment. Standard microbiological tests were conducted to detect microorganisms and their antibiotic sensitivity.
Results: The study included 2,015 participants with a mean age of 24.1 years. The majority were multigravida (n = 1,274, 63.2%) and underwent emergency caesarean delivery (n = 1,232, 61.1%). Ninety two participants (4.6%, 95% CI: 3.7% to 5.6%) developed surgical site infections, with 91 (98.9%) having superficial and 1 (1.1%) having a deep infection. Among those who developed an SSI, 84 (91.3%) did so during their hospital stay, while 8 (8.7%) developed an SSI at home. The adjusted relative risk (a RR) for developing an SSI was 2.5 (95% CI: 1.4 to 4.6; power 99.9%) among obese women and 2.3 (95% CI: 1.1 to 4.7; power 100%) among women aged 25 years or younger. Microbial growth in culture was observed from 55 (75.8%) out of total 66 samples. The most common organisms identified were Staphylococcus aureus (n = 7(12.3%)23, 46.0%), Klebsiella sp. (n = 13, 26.0%), and Escherichia coli (n = 12, 24.0%).
Conclusion: The rate of SSI following caesarean deliveries subjected to single dose antibiotic prophylaxis was low. Young women and obese women were at high risk of developing SSI.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze: MEDLINE
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