Anna Różańska1, Andrzej Jarynowski2, Katarzyna Kopeć-Godlewska3, Jadwiga Wójkowska-Mach4, Agnieszka Misiewska-Kaczur5, Marzena Lech6, Małgorzata Rozwadowska7, Marlena Karwacka8, Joanna Liberda9, Joanna Domańska10. 1. Department of Microbiology, Jagiellonian University Medical College, Kraków, Poland. 2. Smoluchowski Institute of Physics, Jagiellonian University, Kraków, Poland. 3. Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland. 4. Department of Microbiology, Jagiellonian University Medical College, Kraków, Poland. Electronic address: mbmach@cyf-kr.edu.pl. 5. Voivodeship Hospital, Bielsko-Biała, Poland. 6. SPZZOZ Hospital, Staszów, Poland. 7. Ujastek Obstetrics and Gynaecology Hospital, Kraków, Poland. 8. SPWZOS MSWiA Hospital, Bydgoszcz, Poland. 9. Henryk Klimontowicz Specialistic Hospital, Gorlice, Poland. 10. Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Gliwice, Poland.
Abstract
BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net. For each procedure, the following data were registered: age, American Society of Anesthesiologists score, procedure time, elective or emergency procedure, use of perioperative antibiotic prophylaxis, microbiology, the treatment used, and other information. RESULTS: SSI incidence was 0.5% and significant differences were noted among hospitals (between 0.1% and 1.8%), for different American Society of Anesthesiologists scales (between 0.2% and 4.8%) and different values of standardized SSI risk index (between 0.0% and 0.8%). In 3.1% of procedures, with no antibiotic prophylaxis, SSI risk was significantly higher. Deep infections dominated: 61.5% with superficial infections in only approximately 30% of cases and 2.6% of infections were detected postdischarge without readmissions. CONCLUSIONS: Results showed high incidence of SSI in Poland without perioperative antibiotic prophylaxis, and secondly, ineffective surveillance according to CS status, considering outpatient obstetric care. Without postdischarge surveillance, it is not possible to recognize the epidemiologic situation, and further, to set priorities and needs when it comes to infection prophylaxis, especially because such low incidence may indicate no need for improvement in infection control.
BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net. For each procedure, the following data were registered: age, American Society of Anesthesiologists score, procedure time, elective or emergency procedure, use of perioperative antibiotic prophylaxis, microbiology, the treatment used, and other information. RESULTS: SSI incidence was 0.5% and significant differences were noted among hospitals (between 0.1% and 1.8%), for different American Society of Anesthesiologists scales (between 0.2% and 4.8%) and different values of standardized SSI risk index (between 0.0% and 0.8%). In 3.1% of procedures, with no antibiotic prophylaxis, SSI risk was significantly higher. Deep infections dominated: 61.5% with superficial infections in only approximately 30% of cases and 2.6% of infections were detected postdischarge without readmissions. CONCLUSIONS: Results showed high incidence of SSI in Poland without perioperative antibiotic prophylaxis, and secondly, ineffective surveillance according to CS status, considering outpatient obstetric care. Without postdischarge surveillance, it is not possible to recognize the epidemiologic situation, and further, to set priorities and needs when it comes to infection prophylaxis, especially because such low incidence may indicate no need for improvement in infection control.
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