乌干达姆巴拉拉地区转诊医院剖腹产术后母亲手术部位感染的发生率和相关因素:一项观察性回顾研究。

IF 3.8 Q2 INFECTIOUS DISEASES Therapeutic Advances in Infectious Disease Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.1177/20499361241286838
Daniel Chans Mwandah, Tadele Mekuriya Yadesa, Ivan Ibanda, Aboda Alex Komakech, Deo Kyambadde, Joseph Ngonzi
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引用次数: 0

摘要

背景:剖宫产后的感染风险是顺产的5-20倍,占妊娠相关死亡率的10%。2019 年,姆巴拉拉地区转诊医院(MRRH)实施剖宫产的比例为 40%,超过了世界卫生组织建议的 15%-20% 的比例。提供有效的预防性抗生素对预防手术部位感染(SSI)至关重要:确定剖宫产术后产妇中 SSI 的发生率和预测因素、住院时间以及 MRRH 的抗生素使用情况:这是一项在瑞金医院产科病房进行的观察性回顾研究:提取有关 SSI 诊断、住院时间和抗生素使用的数据并输入 EpiData 软件 3.1 版,然后使用 STATA 15 版进行分析。我们进行了逻辑回归分析,以确定与 SSIs 独立相关的因素。我们还比较了住院时间:结果:剖宫产后 SSI 感染率为 7.9%(95% CI:6.3%-9.9%)。25 岁及以下的母亲发生 SSI 的几率较低(调整后的几率比(aOR):0.53,95% CI:0.30-0.93;P = 0.027)。怀孕六次以上者更容易发生 SSI(aOR:3.4;95% CI:1.35-8.58;p = 0.009)。发生 SSI 的产妇的住院时间中位数为 8 天(四分位间距(IQR):5-16),未发生 SSI 的产妇的住院时间中位数为 3 天(四分位间距(IQR):3-4):乌干达目前的剖腹产后 SSI 发病率高于发达国家。年龄较大和妊娠次数超过六次是 SSI 的独立预测因素,而剖腹产后 SSI 会显著延长住院时间。
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Prevalence and factors associated with surgical site infections among mothers after cesarean section at Mbarara Regional Referral Hospital, Uganda: an observational retrospective study.

Background: 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).

Objectives: To determine the prevalence and predictors of SSIs among mothers after cesarean section, length of hospital stay, and antibiotic use at MRRH.

Design: This was an observational retrospective study conducted in the maternity ward of the MRRH.

Methods: 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.

Results: 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; p = 0.027). Those with more than six pregnancies were more likely to develop SSIs (aOR: 3.4; 95% CI: 1.35-8.58; p = 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 (p < 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%).

Conclusion: 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.

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CiteScore
5.30
自引率
8.80%
发文量
64
审稿时长
9 weeks
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