Implementing a combined infection prevention and control with antimicrobial stewardship joint program to prevent caesarean section surgical site infections and antimicrobial resistance: a Tanzanian tertiary hospital experience
| Autor: | Zainab Chaula, Giuseppe Ippolito, Peter Torokaa, Pasquale De Nardo, Boniface Nguhuni, Caroline Damian, Alimuddin Zumla, Paola Mencarini, Alessandro Piscini, Francesco Vairo, Elisa Gentilotti, Emanuele Nicastri |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty medicine.medical_treatment Drug resistance Antimicrobial stewardship Gram-Positive Bacteria Antimicrobial resistance Drug Prescriptions Tanzania lcsh:Infectious and parasitic diseases Tertiary Care Centers Young Adult Antibiotic resistance Medical microbiology Pregnancy Internal medicine Drug Resistance Bacterial medicine Humans Surgical Wound Infection Infection control Caesarean section lcsh:RC109-216 Pharmacology (medical) Antibiotic prophylaxis Infection Control Evidence-Based Medicine Cesarean Section business.industry Research Public Health Environmental and Occupational Health Antimicrobial Resource-limited settings Anti-Bacterial Agents Infectious Diseases Female business Surgical site infection |
| Zdroj: | Antimicrobial Resistance and Infection Control, Vol 9, Iss 1, Pp 1-11 (2020) Antimicrobial Resistance and Infection Control |
| ISSN: | 2047-2994 |
| DOI: | 10.1186/s13756-020-00740-7 |
| Popis: | Background Surgical site infections are a leading cause of morbidity and mortality after caesarean section, especially in Low and Middle Income Countries. We hypothesized that a combined infection prevention and control with antimicrobial stewardship joint program would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods The intervention included: 1. formal and on-job trainings on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was post-caesarean section surgical site infections prevalence and secondary outcome the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were ascertained. Results Total 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p p = 0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p p p Staphylococus aureus was detected in the post-intervention survey. Conclusions Further researches are needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings. |
| Databáze: | OpenAIRE |
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