Insidensi dan Faktor Risiko Infeksi Luka Operasi pada Bedah Obstetri dan Ginekologi di Rumah Sakit

https://doi.org/10.22146/jmpf.48024

Farahdina Chairani(1), Ika Puspitasari(2*), Rizka Humardewayanti Asdie(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, UGM, Yogyakarta
(2) Departemen Farmakologi & Farmasi Klinik, Fakultas Farmasi, UGM, Yogyakarta
(3) Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran UGM, RSUP Dr. Sardjito, Yogyakarta
(*) Corresponding Author

Abstract


Surgical Site Infection (SSI) is a type of Healthcare-associated infections (HAIs) which caused postoperative morbidity. SSI is widely reported in developing countries with a combined incidence of 11.8 episodes per 100 surgical procedures. This study aimed to identify risk factors for SSI in patients undergoing obstetric and gynecological surgeries at Dr. Sardjito General Hospital Yogyakarta. Data collection was conducted retrospectively using patient’s medical records during the period of January 1, 2017 to December 31, 2018. A total of 102 patients underwent obstetric and gynecological surgeries in the study period. The incidence of SSI in the cross sectional study was 9.80%. Obstetric surgeries had a lower SSI incidence compared to gynecological surgeries (1.96% versus 7.84% respectively). The risk factors for SSI identified in the bivariate analysis were comorbidity (P= 0.03), concomitant surgery (OR 8.25), intraoperative blood loss (OR 0.51), perioperative blood transfusion (OR 18.6), and duration of prophylactic antibiotics (OR 1.22). The results of multivariate analysis showed a significant relationship between intraoperative blood loss and SSI (OR 0.038, CI 95% 0.002-0.761; P= 0.032). Incidence and risk factors from our retrospective study on obstetric and gynecological surgeries can be reported simultaneously. Some of the risk factors identified in this study can be helpful for SSI risk stratification in hospital.

Keywords


antibiotic; surgical site infections; health care associated infection

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References

1. Pathak A, Mahadik K, Swami MB, et al. Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India. Antimicrobial Resistance & Infection Control. 2017;6(1). doi:10.1186/s13756-017-0223-y

2. Mamo T, Abebe TW, Chichiabellu TY, Anjulo AA. Risk factors for surgical site infections in obstetrics: a retrospective study in an Ethiopian referral hospital. Patient Safety in Surgery. 2017;11(1). doi:10.1186/s13037-017-0138-9

3. Muttaqien MI, Hamidy MY, Rustam RP. THE OVERVIEW OF SURGICAL SITE INFECTION OF PASCA CAESAREAN SECTION AT ARIFIN ACHMAD GENERAL HOSPITAL OF RIAU PROVINCE 1 JANUARY – 31 DECEMBER 2014 PERIOD. 2016;3:15.

4. Lake AG, McPencow AM, Dick-Biascoechea MA, Martin DK, Erekson EA. Surgical site infection after hysterectomy. Am J Obstet Gynecol. 2013;209(5). doi:10.1016/j.ajog.2013.06.018

5. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surgery. 2017;152(8):784. doi:10.1001/jamasurg.2017.0904

6. Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update. Infection Control & Hospital Epidemiology. 2014;35(06):605-627. doi:10.1086/676022

7. Assawapalanggool S, Kasatpibal N, Sirichotiyakul S, Arora R, Suntornlimsiri W, Apisarnthanarak A. The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study. Antimicrobial Resistance & Infection Control. 2018;7(1). doi:10.1186/s13756-018-0304-6

8. Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrobial Resistance and Infection Control. 2014;3(1):25. doi:10.1186/2047-2994-3-25

9. Shenoy D, Nalluri K, Manasa C, Reddy, P, Srinivasan R. A study on evaluation of risk factors and anti-microbial prophylaxis in the prevention of surgical site infection. 2019;09(2):159-156. doi:http://dx.doi.org/10.22270/jddt.v9i2-s.2477

10. Nelson G, Bakkum-Gamez J, Kalogera E, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations—2019 update. International Journal of Gynecologic Cancer. 2019;29(4):651-668. doi:10.1136/ijgc-2019-000356

11. Anderson DJ, Sexton DJ. Antimicrobial prophylaxis for prevention of surgical site infection in adults. UpToDate. September 2018:1-35.

12. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health-System Pharmacy. 2013;70(3):195-283. doi:10.2146/ajhp120568

13. Paul S, Paul D, Haque A, et al. Bacteriological analysis of infected wound and their antibiotic sensitivity following emergency caesarean section-a study of 100 cases. KYAMC Journal. 2018;9(2):61-64. doi:10.3329/kyamcj.v9i2.38149

14. Kemenkes RI. Pedoman Umum Penggunaan Antibiotik. Peraturan Menteri Kesehatan RI Nomor 2406/Menkes/Per/XII/2011; 2011.

15. Ierano C, Manski-Nankervis J-A, James R, Rajkhowa A, Peel T, Thursky K. Surgical antimicrobial prophylaxis. Australian Prescriber. 2017;40(6):225-229. doi:10.18773/austprescr.2017.073

16. Megawati S, Rahmawati F. EVALUATION OF THE USE OF ANTIBIOTIC PROPHYLAXIS IN SURGERY PATIENTS. JMPF. 2015;5(2):127-134. doi:https://doi.org/10.22146/jmpf.138

17. Mahdi H, Goodrich S, Lockhart D, DeBernardo R, Moslemi-Kebria M. Predictors of Surgical Site Infection in Women Undergoing Hysterectomy for Benign Gynecologic Disease: A Multicenter Analysis Using the National Surgical Quality Improvement Program Data. Journal of Minimally Invasive Gynecology. 2014;21(5):901-909. doi:10.1016/j.jmig.2014.04.003

18. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. American Journal of Health-System Pharmacy. 2013;70(3):195-283. doi:10.2146/ajhp120568

19. World Health Organization. Global Guidelines for the Prevention of Surgical Site Infection. 2016. http://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf;jsessionid=480A0E10AA4196DCEDC5308C75232AFE?sequence=1. Accessed April 6, 2018.

20. Khan M, Rooh-ul-Muqim null, Zarin M, Khalil J, Salman M. Influence of ASA score and Charlson Comorbidity Index on the surgical site infection rates. J Coll Physicians Surg Pak. 2010;20(8):506-509. doi:08.2010/JCPSP.506509

21. Morgan DM, Swenson CW, Streifel KM, et al. Surgical site infection following hysterectomy: adjusted rankings in a regional collaborative. Am J Obstet Gynecol. 2016;214(2):259.e1-259.e8. doi:10.1016/j.ajog.2015.10.002

22. Singh R, Singla P, Chaudhary U. Surgical Site Infections: Classification, Risk factors, Pathogenesis and Preventive Management. 2014;2:12.

23. Ketcheson F, Woolcott C, Allen V, Langley JM. Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study. CMAJ Open. 2017;5(3):E546-E556. doi:10.9778/cmajo.20160164

24. Vallejo MC, Attaallah AF, Shapiro RE, Elzamzamy OM, Mueller MG, Eller WS. Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center. J Anesth. 2017;31(1):120-126. doi:10.1007/s00540-016-2266-2

25. Horowitz JA, Puvanesarajah V, Jain A, et al. Rheumatoid Arthritis Is Associated With an Increased Risk of Postoperative Infection and Revision Surgery in Elderly Patients Undergoing Anterior Cervical Fusion: SPINE. 2018;43(17):E1040-E1044. doi:10.1097/BRS.0000000000002614

26. Tran CW, McGree ME, Weaver AL, et al. Surgical site infection after primary surgery for epithelial ovarian cancer: Predictors and impact on survival. Gynecologic Oncology. 2015;136(2):278-284. doi:10.1016/j.ygyno.2014.12.007

27. O’Donnell RL, Angelopoulos G, Beirne JP, et al. Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation. BMJ Open. 2019;9(1):e024853. doi:10.1136/bmjopen-2018-024853



DOI: https://doi.org/10.22146/jmpf.48024

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