///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

The Trend of Surgical-Site Infections following Cesarean Delivery from 2015 to 2017: A Retrospective Study

Abstract Number: F3B-549
Abstract Type: Original Research

Jie Zhou MD, MS, MBA, FASA1 ; Sue Yuan PhD2

Background

Surgical-site infections (including endometritis and wound infection, SSIs) complicate 5 to 12% of cesarean deliveries (CDs), which results in extra burden on the new mother and may prolong hospitalization. The aim of our study was to assess the prevalence of infection and the distribution of infectious disease due to CDs.

Methods

With IRB approval, retrospective review of all parturients from 01/01/2015 to 12/31/2017 who delivered at the hospitals of Partner HealthCare System was conducted. Data including demographic information, diagnosis, health history, operative notes, culture reports and procedures were collected. Percentage, mean and standard deviation were used to descriptive these variables.

Results

In a total of 11,408 parturients, 333 (2.3%) cases with infection following CD were identified. The morbidity of infection from 2015 to 2018 were 3.49%, 2.66% and 2.81%, respectively. The mean body mass index (BMI) of these patients was 33. In the total of 333 infection cases, 233 patients (69.97%) experienced the outcome of SSIs, 76 (22.82%) had wound disruption, 26 (7.81%) had endometritis, and 8 (2.40%) parturients deteriorated into sepsis within the 30-day postoperative period. The most common anesthesia mode during these cesarean procedures was spinal anesthesia (34.83%) and no infection due to anesthesia procedure was found. Specimens from 167 patients’ blood or abdominal/wound were collected to culture. 38 (22.75%) were positive of staphylococcus aureus, 20 were enterococcus faecalis and one case of Methicillin- resistant staphylococcus aureus (MRSA) among 88 abdominal/wound specimens. Staphylococcus aureus were found in 3 of 79 blood specimens.

Discussion

Postoperative infectious morbidity in women undergoing CD is devastating. Fortunately, our study demonstrated a downward trend of the morbidity compared to previous studies. We also found that BMI > 30 was an important characteristic among these parturients. We further confirmed that staphylococcus aureus and enterococcus faecalis are the common organism leading to hospital acquired infection among parturients. Further study is warranted to identify the risk factors related to SSIs following CDs and the prevention strategies.

References

1. Tita A, et al. N Engl J Med 2016; 1231:1241.

2. Methodius G, et al. N Engl J Med 2018; 647:655.

3. Childress KM, et al. Am J Obstet Gynecol 2016;214;285.

SOAP 2019