Maternal caesarean section infection (MACSI) in Sierra Leone: a case-control study
Maternal caesarean section infection (MACSI) in Sierra Leone: a case-control study
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DOI：
10.1017/s0950268820000370
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Putoto, G.
中科院分区：
文献类型：
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作者：
Di Gennaro, F.;Marotta, C.;Putoto, G.
塞拉利昂是孕产妇死亡率最高的国家，感染是 11% 孕产妇死亡的根本原因，但真正的负担仍然未知。本研究旨在确定塞拉利昂弗里敦基督教公主妇产医院 (PCMH) 收治妇女剖腹产 (CS) 后手术部位感染 (SSI) 的发生率和危险因素。 2018年5月1日至2019年4月30日实施了一项前瞻性病例对照（1:3比例）研究，筛选了11名在CS后出现疑似或确诊感染的女性，以纳入病例。对于每个病例，选择三名在同一天接受 CS 并入住同一病房但未出现 SSI 的患者作为对照。 CS后感染率为10.9%。纳入了 254 名临床确诊病例，并与 762 名对照患者进行匹配。通过多变量分析，SSI的危险因素为：单一（比值比（OR）1.48，95%置信区间（CI）1.36-1.66）、低教育水平（OR 1.68，95% CI 1.55-1.84）、既往CS（OR 1.27，95% CI 1.10-1.52）、胎膜早破（OR 1.49，95% CI 1.18-1.88），决策切口时间长（OR 2.08，95% CI 1.74-2.24）和 CS 后抗生素剂量缺失率高（OR 2.52，95% CI 2.10-2.85）。
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).