Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients.

Sommerstein, Rami; Marschall, Jonas; Atkinson, Andrew; Surbek, Daniel; Dominguez-Bello, Maria Gloria; Troillet, Nicolas; Widmer, Andreas F (2020). Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients. Antimicrobial resistance and infection control, 9(1), p. 201. BioMed Central 10.1186/s13756-020-00860-0

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BACKGROUND

The World Health Organization (WHO) recommends administration of surgical antimicrobial prophylaxis (SAP) in cesarean section prior to incision to prevent surgical site infections (SSI). This study aimed to determine whether SAP administration following cord clamping confers an increased SSI risk to the mother.

METHODS

Study design: Cohort.

SETTING

75 participating Swiss hospitals, from 2009 to 2018.

PARTICIPANTS

A total of 55,901 patients were analyzed.

MAIN OUTCOME MEASURES

We assessed the association between SAP administration relative to incision and clamping and the SSI rate, using generalized linear multilevel models, adjusted for patient characteristics, procedural variables, and health-care system factors.

RESULTS

SAP was administered before incision in 26'405 patients (47.2%) and after clamping in 29,496 patients (52.8%). Overall 846 SSIs were documented, of which 379 (1.6% [95% CI, 1.4-1.8%]) occurred before incision and 449 (1.7% [1.5-1.9%]) after clamping (p = 0.759). The adjusted odds ratio for SAP administration after clamping was not significantly associated with an increased SSI rate (1.14, 95% CI 0.96-1.36; p = 0.144) when compared to before incision. Supplementary and subgroup analyses supported these main results.

CONCLUSIONS

This study did not confirm an increased SSI risk for the mother in cesarean section if SAP is given after umbilical cord clamping compared to before incision.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Sommerstein, Rami; Marschall, Jonas; Atkinson, Andrew and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2047-2994

Publisher:

BioMed Central

Language:

English

Submitter:

Monika Zehr

Date Deposited:

13 Jan 2021 09:59

Last Modified:

14 Mar 2021 16:20

Publisher DOI:

10.1186/s13756-020-00860-0

PubMed ID:

33349269

Uncontrolled Keywords:

Cesarean section Microbiome Modelling Obstetrics Surgical antimicrobial prophylaxis Surgical site infection

BORIS DOI:

10.48350/150230

URI:

https://boris.unibe.ch/id/eprint/150230

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