Microbiology Unit, Department of Laboratories, Safat, Kuwait.
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Epidemiol Infect. 2019 Oct 10;147:e287. doi: 10.1017/S0950268819001675.
Surgical site infections (SSI) are a significant cause of post-surgical morbidity and mortality. The objectives of this study were to determine the prevalence of SSI and identify risk factors for infections following cesarean section (CS). A prospective study of SSI after CS was carried out from January 2014 to December 2016 using the methodology of the American National Nosocomial Infection Surveillance System. Suspected SSIs were confirmed clinically by the surgeon, and or, by culture. Seven thousand two hundred thirty five CS were performed with an overall SSI prevalence of 2.1%, increasing from 1.7% in 2014 to 2.95% in 2016 (P = 0.010). Of 152 cases of SSI, the prevalence of infection was 46.7% in women ⩽30 years and 53.3% in women >30 years (P = 0.119). Of 148 culture samples from as many women, 112 (75.7%) yielded growth of microorganisms with 42 (37.5%) of isolates being multi-drug resistant (MDR). Women who did not receive prophylactic antibiotics (35.5%) developed SSI more often than those who did (P < 0.0001). These findings suggest that emergency CS and inappropriate antibiotic prophylaxis are risk factors for developing SSI. In the light of the emergence of MDR bacteria there is a need to implement revised prophylactic antibiotic policy as part of antimicrobial stewardship to decrease SSI rates.
手术部位感染（SSI）是术后发病率和死亡率的重要原因。本研究的目的是确定剖宫产术后 SSI 的发生率，并确定感染的危险因素。采用美国全国医院感染监测系统的方法，对 2014 年 1 月至 2016 年 12 月剖宫产术后 SSI 进行前瞻性研究。疑似 SSI 由外科医生临床确诊，或通过培养确诊。共进行了 7235 例剖宫产术，SSI 总发生率为 2.1%，2014 年为 1.7%，2016 年为 2.95%（P=0.010）。在 152 例 SSI 中，年龄 ⩽30 岁的女性感染率为 46.7%，年龄 >30 岁的女性感染率为 53.3%（P=0.119）。对 148 名女性的 148 份培养样本进行了分析，其中 112 份（75.7%）样本中有微生物生长，42 份（37.5%）分离物为多药耐药菌（MDR）。未接受预防性抗生素治疗的女性（35.5%）比接受治疗的女性更容易发生 SSI（P<0.0001）。这些发现表明，紧急剖宫产术和抗生素预防使用不当是发生 SSI 的危险因素。鉴于 MDR 细菌的出现，有必要实施修订后的预防性抗生素政策，作为抗菌药物管理的一部分，以降低 SSI 发生率。
