Key result
Missing more than 51% of post-caesarean antibiotic doses was independently associated with a significantly increased risk of surgical site infection (OR 2.52).
Why the study?
Infections cause 11% of maternal deaths in Sierra Leone, but the real burden and risk factors of post-caesarean section surgical site infection remain unknown.
Case-Control (n=1,016)
No
In a Sierra Leone hospital, post-caesarean surgical site infections occurred in 10.9% of cases and were significantly associated with missed antibiotic doses, delayed surgery, and socioeconomic factors.
Answers are grounded in this paper and cite their sources.
Missed post-CS antibiotics and delays associate with higher infection rates; observational data leaves open whether targeted interventions reduce risk.
Sierra Leone is the country with highest maternal mortality and infections are the underlying cause in 11% of maternal deaths, but the real burden remains unknown. This study aims to determine the incidence and risk factors of surgical site infection (SSI) post-caesarean section (CS) in women admitted to Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone. A prospective case-control (1:3 ratio) study was implemented from 1 May 2018 to 30 April 2019 and 11 women presenting with suspected or confirmed infection post-CS were screened for inclusion as a case. For each case, three patients undergoing CS on the same day and admitted to the same ward, but not presenting with SSI, were selected as controls. The post-CS infection rate was 10.9%. Two hundred and fifty-four clinically confirmed cases were enrolled and matched with 762 control patients. By multivariable analysis, the risk factors for SSI were: being single (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.36-1.66), low education level (OR 1.68, 95% CI 1.55-1.84), previous CS (OR 1.27, 95% CI 1.10-1.52), presenting with premature membranes rupture (OR 1.49, 95% CI 1.18-1.88), a long decision-incision time (OR 2.08, 95% CI 1.74-2.24) and a high missing post-CS antibiotic doses rate (OR 2.52, 95% CI 2.10-2.85).
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Gennaro et al. (2020) conducted a case-control in Surgical site infection post-caesarean section (n=1,016). Missing post-CS antibiotic doses (>51%) vs. Missing post-CS antibiotic doses (0-50%) was evaluated on Surgical site infection (SSI) post-caesarean section (OR 2.52, 95% CI 2.10-2.85, p=<0.0001). Missing more than 51% of post-caesarean antibiotic doses was independently associated with a significantly increased risk of surgical site infection (OR 2.52).
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