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Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Ruxmaniben Deepchand Gardi Med Coll, Dept Paediat, Ujjain, Madhya Pradesh, India.; Karolinska Inst, Dept Publ Hlth Sci, Global Hlth Hlth Syst & Policy, Stockholm, Sweden..
Ruxmaniben Deepchand Gardi Med Coll, Dept Obstet & Gynecol, Ujjain, Madhya Pradesh, India..
Ruxmaniben Deepchand Gardi Med Coll, Dept Obstet & Gynecol, Ujjain, Madhya Pradesh, India..
Ruxmaniben Deepchand Gardi Med Coll, Dept Obstet & Gynecol, Ujjain, Madhya Pradesh, India..
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2017 (Engelska)Ingår i: Antimicrobial Resistance and Infection Control, ISSN 2047-2994, E-ISSN 2047-2994, Vol. 6, artikel-id 66Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital.

Methods: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included. Surveillance for SSI was based on the Centre for Disease Control (CDC) definition and methodology. Incidence and risk factors for SSI, including those for specific procedure, were calculated from data collected on daily ward rounds.

Results: A total of 1173 patients underwent a surgical procedure during the study period. The incidence of SSI in the cohort was 7.84% (95% CI 6.30-9.38). Majority of SSI were superficial. Obstetric surgeries had a lower SSI incidence compared to gynecological surgeries (1.2% versus 10.3% respectively). The risk factors for SSI identified in the multivariate logistic regression model were age (OR 1.03), vaginal examination (OR 1.31); presence of vaginal discharge (OR 4.04); medical disease (OR 5.76); American Society of Anesthesia score greater than 3 (OR 12.8); concurrent surgical procedure (OR 3.26); each increase in hour of surgery, after the first hour, doubled the risk of SSI; inappropriate antibiotic prophylaxis increased the risk of SSI by nearly 5 times. Each day increase in stay in the hospital after the surgery increased the risk of contacting an SSI by 5%.

Conclusions: Incidence and risk factors from prospective SSI surveillance can be reported simultaneously for the Obstetric and Gynecological surgeries and can be part of routine practice in resource-constrained settings. The incidence of SSI was lower for Obstetric surgeries compared to Gynecological surgeries. Multiple risk factors identified in the present study can be helpful for SSI risk stratification in low-middle income countries.

Ort, förlag, år, upplaga, sidor
BIOMED CENTRAL LTD , 2017. Vol. 6, artikel-id 66
Nyckelord [en]
Surgical site infection, Healthcare associated infections, Obstetric and gynecological surgeries, Incidence, Risk factors, India
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Hälsovetenskaper
Identifikatorer
URN: urn:nbn:se:uu:diva-329675DOI: 10.1186/s13756-017-0223-yISI: 000403480000002PubMedID: 28630690OAI: oai:DiVA.org:uu-329675DiVA, id: diva2:1142566
Forskningsfinansiär
Vetenskapsrådet, K2007-70X-20,514-01-3Tillgänglig från: 2017-09-19 Skapad: 2017-09-19 Senast uppdaterad: 2017-11-29Bibliografiskt granskad

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Pathak, Ashish
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Internationell mödra- och barnhälsovård (IMCH)
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Antimicrobial Resistance and Infection Control
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