Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients
Abstract 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 i...
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| Format: | Article |
| Language: | English |
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BMC
2020-12-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | https://doi.org/10.1186/s13756-020-00860-0 |
| _version_ | 1818623370449649664 |
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| author | Rami Sommerstein Jonas Marschall Andrew Atkinson Daniel Surbek Maria Gloria Dominguez-Bello Nicolas Troillet Andreas F. Widmer Swissnoso |
| author_facet | Rami Sommerstein Jonas Marschall Andrew Atkinson Daniel Surbek Maria Gloria Dominguez-Bello Nicolas Troillet Andreas F. Widmer Swissnoso |
| author_sort | Rami Sommerstein |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-16T18:39:59Z |
| format | Article |
| id | doaj.art-c0deed6f608b4b73b73a2c1dc0be48c2 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-16T18:39:59Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-c0deed6f608b4b73b73a2c1dc0be48c22022-12-21T22:21:04ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-12-01911910.1186/s13756-020-00860-0Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patientsRami Sommerstein0Jonas Marschall1Andrew Atkinson2Daniel Surbek3Maria Gloria Dominguez-Bello4Nicolas Troillet5Andreas F. Widmer6SwissnosoDepartment of Infectious Diseases, Bern University Hospital, University of BernDepartment of Infectious Diseases, Bern University Hospital, University of BernDepartment of Infectious Diseases, Bern University Hospital, University of BernDepartment of Obstetrics and Gynaecology, Bern University Hospital, University of BernDepartment of Biochemistry and Microbiology, Rutgers School of Environmental and Biological ScienceSwissnoso, National Center for Infection ControlSwissnoso, National Center for Infection ControlAbstract 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.https://doi.org/10.1186/s13756-020-00860-0Cesarean sectionMicrobiomeModellingObstetricsSurgical antimicrobial prophylaxisSurgical site infection |
| spellingShingle | Rami Sommerstein Jonas Marschall Andrew Atkinson Daniel Surbek Maria Gloria Dominguez-Bello Nicolas Troillet Andreas F. Widmer Swissnoso 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 Cesarean section Microbiome Modelling Obstetrics Surgical antimicrobial prophylaxis Surgical site infection |
| title | Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients |
| title_full | Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients |
| title_fullStr | Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients |
| title_full_unstemmed | Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients |
| title_short | Antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection: a cohort study with 55,901 patients |
| title_sort | antimicrobial prophylaxis administration after umbilical cord clamping in cesarean section and the risk of surgical site infection a cohort study with 55 901 patients |
| topic | Cesarean section Microbiome Modelling Obstetrics Surgical antimicrobial prophylaxis Surgical site infection |
| url | https://doi.org/10.1186/s13756-020-00860-0 |
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