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Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section

机译:下段剖宫产术后手术部位感染的危险因素分析和微生物病因

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Background. Lower segment caesarean section (LSCS) is a common mode of delivery now and surgical site infection is the second most common infectious complication in these patients. This study was planned with this background to have a comprehensive approach to SSI following LSCS.Methods. 500 consecutive patients undergoing LSCS, irrespective of indication, were studied. A questionnaire was developed to assess the risk factors associated with development of SSI. All patients were followed up from day one of surgery till discharge and then up till the postoperative day 30 after discharge.Results. SSI was identified in 121 (24.2%) out of 500 patients. In all age groups, Gram-negative bacilli were the commonest finding. The commonest isolate wasAcinetobacterspecies (32.03%) followed byStaphylococcus aureusand coagulase negativeStaphylococcus(21.09%). 23.8% ofStaphylococcus aureusstrains were MRSA. By multivariate logistic regression premature rupture of membrane (PROM), antibiotics given earlier than 2 hours and increased duration of stay in the hospital were found to be significant.Conclusions. A proper assessment of risk factors that predispose to SSI and their modification may help in reduction of SSI rates. Also, frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors affecting these practices.
机译:背景。下段剖腹产(LSCS)是目前常见的分娩方式,而手术部位感染是这些患者中第二常见的感染并发症。计划在此背景下进行这项研究,以针对LSCS.Methods采取全面的SSI方法。研究了500例连续接受LSCS的患者,无论其适应症如何。编制了调查表以评估与SSI发生相关的危险因素。从手术第一天至出院,然后出院后至术后第30天对所有患者进行随访。 500例患者中有121例(24.2%)被确定患有SSI。在所有年龄组中,革兰氏阴性杆菌是最常见的发现。最常见的分离株是不动杆菌属(32.03%),其次是金黄色葡萄球菌和凝固酶阴性葡萄球菌(21.09%)。金黄色葡萄球菌菌株的23.8%是MRSA。通过多因素logistic回归分析发现胎膜早破(PROM),发现2小时以上给予抗生素和住院时间增加很重要。适当评估易患SSI及其改变的危险因素可能有助于降低SSI发生率。此外,频繁的抗菌素审核和定性研究可以洞悉当前的抗生素处方做法以及影响这些做法的因素。

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