Mwandah Daniel Chans, Yadesa Tadele Mekuriya, Ibanda Ivan, Komakech Aboda Alex, Kyambadde Deo, Ngonzi Joseph
Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.
Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda.
Ther Adv Infect Dis. 2024 Oct 9;11:20499361241286838. doi: 10.1177/20499361241286838. eCollection 2024 Jan-Dec.
The risk of infection following cesarean delivery is 5-20 times higher than that following normal delivery, contributing to 10% of pregnancy-related mortality. In 2019, Mbarara Regional Referral Hospital (MRRH) performed cesarean section for 40% of deliveries, surpassing the WHO's recommended 15%-20%. The availability and provision of effective prophylactic antibiotics are crucial in preventing surgical site infections (SSIs).
To determine the prevalence and predictors of SSIs among mothers after cesarean section, length of hospital stay, and antibiotic use at MRRH.
This was an observational retrospective study conducted in the maternity ward of the MRRH.
Data on the diagnosis of SSI, length of hospital stay, and antibiotic use were extracted and entered into EpiData software version 3.1 and analyzed using STATA version 15. We conducted logistic regression analysis to identify factors independently associated with SSIs. We also compared the length of hospital stay.
The prevalence of post-cesarean SSIs was 7.9% (95% CI: 6.3%-9.9%). Mothers aged 25 years and younger were less likely to develop SSIs (adjusted odds ratio (aOR): 0.53, 95% CI: 0.30-0.93; = 0.027). Those with more than six pregnancies were more likely to develop SSIs (aOR: 3.4; 95% CI: 1.35-8.58; = 0.009). The median length of stay was 8 days for mothers who developed an SSI (interquartile range (IQR): 5, 16) and 3 (IQR: 3, 4) days for those who did not ( < 0.001). Prophylactic antibiotics were prescribed to 83.4% of the women (95% CI: 80.7-85.8). Ampicillin (88.2%) was the most prescribed prophylactic antibiotic, and metronidazole was the most prescribed postoperatively (97.8%) and at discharge (77.6%).
The current prevalence of post-cesarean SSIs is higher in Uganda than in developed countries. Older age and having had more than six pregnancies are independent predictors of SSIs, and post-cesarean SSI significantly prolonged hospital stay.
剖宫产术后感染风险比顺产高5至20倍，占妊娠相关死亡率的10%。2019年，姆巴拉拉地区转诊医院（MRRH）40%的分娩采用剖宫产，超过了世界卫生组织建议的15%-20%。有效预防性抗生素的可及性和供应对于预防手术部位感染（SSI）至关重要。
确定MRRH剖宫产术后母亲中SSI的患病率及预测因素、住院时间和抗生素使用情况。
这是一项在MRRH产科病房进行的观察性回顾性研究。
提取关于SSI诊断、住院时间和抗生素使用的数据，并录入EpiData 3.1软件，使用STATA 15版本进行分析。我们进行逻辑回归分析以确定与SSI独立相关的因素。我们还比较了住院时间。
剖宫产术后SSI的患病率为7.9%（95%置信区间：6.3%-9.9%）。25岁及以下的母亲发生SSI的可能性较小（调整后的优势比（aOR）：0.53，95%置信区间：0.30-0.93；P = 0.027）。有六次以上妊娠的母亲更易发生SSI（aOR：3.4；95%置信区间：1.35-8.58；P = 0.009）。发生SSI的母亲的中位住院时间为8天（四分位间距（IQR）：5，16），未发生SSI的母亲为3天（IQR：3，4）（P < 0.001）。83.4%的女性接受了预防性抗生素治疗（95%置信区间：80.7-85.8）。氨苄西林（88.2%）是最常用的预防性抗生素，甲硝唑是术后（97.8%）和出院时（77.6%）最常用的抗生素。
乌干达目前剖宫产术后SSI的患病率高于发达国家。年龄较大和有六次以上妊娠是SSI的独立预测因素，剖宫产术后SSI显著延长了住院时间。
