Surgical site infection after cesarean section in Ukraine: results a multicenter study

Abstract

The aim: To obtain the first national estimates of the current prevalence rate of SSI after CSEC and antimicrobial resistance of causing pathogens in Ukraine. Materials and methods: We performed a retrospective multhicentre cogort study based surveillance data was conducted from May 2017 to December 2019. The study population consisted of all women who had a cesarean section in 11 regional women hospitals of Ukraine. Definitions of SSI after cesarean section were used from the CDC/ NHSN. Results: A total of 2 326 CSEC operations and 14.7% SSI were identified within 30 days of the operation. Of these, 44.4% were superficial incisional SSI, 28.9% were deep incisional SSI, and 26.6% were organ/space SSI, 25.7% of which were classed as endometritis. Of all cases 70.5% of infections were detected post discharge. The most commonly identifed pathogen were Staphylococcus aureus (23.5%), Escherichiacoli (20%), Coagulase-negative staphylococci (8.1%), Enterococcus spp. (7.7%), Pseudomonasaeruginosa (7.7%), Enterobacter spp. (6.4%), and Streptococcus spp. (5.6%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 18.3% and of methicillin-resistance in S. aureus(MRSA) 13.9%. Resistance to third-generation cephalosporins was observed in 15.2% E.coli and 7.9% Klebsiellapneumoniae isolates. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Conclusions: The results of this study revealed high rates of SSI after CSEC and most causing pathogens were associated with resistant to antibiotic stranis. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of postoperative infections.