Researchers found that illicit drug use, history of smoking, prior cesarean section and higher BMI were associated with an increased risk for cesarean section infections.
The findings are from a retrospective chart review performed at the University of Florida (UF) Health Jacksonville after staff reported an unexpectedly high number of cesarean section infections at the facility, which were largely due to common commensal organisms, according to research presented at the Association for Professionals in Infection Control and Epidemiology (APIC) conference.
Infection preventionists Stefanie Buchanan, RN, BSN, CIC, and Marko Predic, MS, examined the records of 30 women who developed an infection following a cesarean section and 60 women who did not develop an infection after a cesarean section. They found that women with infections were 25.3 times more likely to have a history of illicit drug use; 8.41 times more likely to have had a prior cesarean section; and 3.8 times more likely to have a history of smoking. Having a higher BMI also was a significant predelivery risk factor, with the average BMI being 42.4 among women with an infection vs. 36.9 among controls.
After further review of the cases, Buchanan and Predic concluded that more patient education is needed to prevent cesarean section infections among women.
“We found that women leave the hospital with a breadth of information on caring for a newborn and often overlook the education provided on caring for their wound,” Buchanan said in a news release.
In light of these findings, the standard of care for women who undergo cesarean section has been updated at the UF Health Jacksonville. Nurses now provide women with additional resources for wound care and show them how to properly clean their wounds during an assisted shower demonstration. In addition, because many infections were caused by common commensals, patients are now bathed with chlorhexidine gluconate before their surgery.
With these changes, the researchers said they expect there will be a significant reduction in cesarean section infections.
“The UF Health Jacksonville infection prevention team’s work contributes to our understanding of risk factors associated with C-section infections,” APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC, said in the release. “They have used [these] data to design better processes of care for their patients, improving the health and safety of new mothers.”
Buchanan S, Predic M. Risk Factors associated with cesarean section infections. Presented at: APIC 2018; June 13-15, 2018; Minneapolis.
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