Post-cesarean delivery infectious morbidity: Focus on preoperative antibiotics and methicillin-resistant Staphylococcus aureus - 11/08/11
, Yadira Anca, MD b, Cassandra A. White, BS b, David E. Soper, MD c
Address correspondence to Andrea Ries Thurman, MD, Associate Professor of Obstetrics and Gynecology, Eastern Virginia Medical School Clinical Research Center, 601 Colley Ave, Norfolk, VA 23507.Abstract |
Background |
Randomized controlled trials show that administering preoperative antibiotics prior to cesarean delivery (CD) significantly reduces the incidence of post-CD infectious morbidity. Methicillin-resistant Staphylococcus aureus (MRSA) has become prevalent in obstetrics and gynecology. The objective of this trial is to examine infectious morbidity in a clinical setting before versus after implementation of a preoperative antibiotic policy and, further, to describe the organisms cultured from CD wound infections.
Methods |
We used a retrospective chart review of women delivering by CD before and after implementation of preoperative antibiotic policy.
Results |
Prior to instituting the preoperative antibiotic policy, the incidence of post-CD infectious morbidity was 20.7% and dropped to 8.5% after the policy was established (P < .001). Study cohorts were similar (P > .05) in several risk factors for infection. MRSA was the most common organism isolated from post-CD wound infections (18/34, 53%). Endomyometritis accounted for the majority of post-CD infections (143/191, 74.9%), and most infections occurred within 7 days of CD (170/191, 89.0%).
Conclusion |
The incidence of post-CD infectious complications decreased after a policy of administering preoperative antibiotics was instituted. MRSA was the most common organism isolated from post-CD wound infections. Further studies into the benefit of MRSA coverage in CD preoperative antibiotic regimens are needed.
Le texte complet de cet article est disponible en PDF.Key Words : Methicillin-resistant Staphylococcus aureus, cesarean section, wound infection
Plan
Vol 38 - N° 8
P. 612-616 - octobre 2010 Retour au numéro
Article précédent
- A stepwise approach to control an outbreak and ongoing transmission of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit
- Xiaoyan Song, Sandy Cheung, Karl Klontz, Billie Short, Joseph Campos, Nalini Singh
- The use of adenosine triphosphate bioluminescence to assess the efficacy of a modified cleaning program implemented within an intensive care setting
- Ginny Moore, Debbie Smyth, Julie Singleton, Peter Wilson
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?