Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

Introduction: In Cambodia, we implemented a pilot surveillance of superficial surgical site infections (SSSI) following caesarean deliveries (CD) in a provincial hospital, to estimate their incidence, describe their clinical management, and determine their causative pathogens. Methodology: Betwe...

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Main Authors: Sok Srun, Yin Sinath, An Thoun Seng, Meas Chea, Mony Borin, Somary Nhem, Amanda Daniel, Nora Chea, Nima Asgari, Anne Rachline, Za Reed, Rodney Hoff, Philippe Cavailler, Sophie Goyet
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2013-08-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/2981
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author Sok Srun
Yin Sinath
An Thoun Seng
Meas Chea
Mony Borin
Somary Nhem
Amanda Daniel
Nora Chea
Nima Asgari
Anne Rachline
Za Reed
Rodney Hoff
Philippe Cavailler
Sophie Goyet
author_facet Sok Srun
Yin Sinath
An Thoun Seng
Meas Chea
Mony Borin
Somary Nhem
Amanda Daniel
Nora Chea
Nima Asgari
Anne Rachline
Za Reed
Rodney Hoff
Philippe Cavailler
Sophie Goyet
author_sort Sok Srun
collection DOAJ
description Introduction: In Cambodia, we implemented a pilot surveillance of superficial surgical site infections (SSSI) following caesarean deliveries (CD) in a provincial hospital, to estimate their incidence, describe their clinical management, and determine their causative pathogens. Methodology: Between October 2010 and February 2011, all women admitted for CD were included in the surveillance. Their clinical condition was monitored for a post-operative period of 30 days, including two assessments performed by surgeons. Cases were clinically diagnosed by surgeons, with bacterial cultures performed. Results: Of the 222 patients admitted for CD, 176 (79.3%) were monitored for 30 days. Of these, 11 were diagnosed with a SSSI, giving an incidence rate of 6.25% (95% CI 3.2-10.9). Four of the cases (36.4%) were detected after hospital discharge.  Length of hospitalization was significantly longer for the SSSI cases. All 222 patients were prescribed antibiotics.  Ampicillin was administered intravenously to 98.6% of them, with subsequent oral amoxicillin given to 82.9%. Three of six pus samples collected were positive on culture: two with Staphylococcus aureus and one with Staphylococcus lugdunensis. One S.aureus was methicillin resistant (MRSA). The other was clindamycin and erythromycin resistant. Conclusion: Surveillance of health-care associated infections in a setting with limited resources is challenging but feasible. Effective post-discharge surveillance was essential for the estimation of the incidence rate of SSSI following caesarean deliveries.   This surveillance led to a peer-review of medical practices.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-9aa9e2461e74460fbca44159f48dc7db2025-08-20T02:57:18ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802013-08-0170810.3855/jidc.2981Surveillance of post-caesarean surgical site infections in a hospital with limited resources, CambodiaSok Srun0Yin Sinath1An Thoun Seng2Meas Chea3Mony Borin4Somary Nhem5Amanda Daniel6Nora Chea7Nima Asgari8Anne Rachline9Za Reed10Rodney Hoff11Philippe Cavailler12Sophie Goyet13Department of Hospital Services, Ministry of Health, Phnom Penh, CambodiaProvincial Referral Hospital, Kampong Cham, CambodiaDepartment of Hospital Services, Ministry of Health, Phnom Penh, CambodiaProvincial Referral Hospital, Kampong Cham, CambodiaProvincial Referral Hospital, Kampong Cham, CambodiaMicrobiology laboratory, Provincial Referral Hospital, Kampong Cham, CambodiaDepartment of Hospital Services, Ministry of Health, Phnom Penh, CambodiaCambodian office of World Health Organization (WHO), Phnom Penh, , CambodiaCambodian office of World Health Organization (WHO), Phnom Penh, , CambodiaRegional Emerging Diseases Intervention (REDI) Center, SingaporeRegional Emerging Diseases Intervention (REDI) Center, Singapore-city, SingaporeRegional Emerging Diseases Intervention (REDI) Center, Singapore-city, SingaporeRegional Emerging Diseases Intervention (REDI) Center, Singapore-city, SingaporeRegional Emerging Diseases Intervention (REDI) Center, Singapore Introduction: In Cambodia, we implemented a pilot surveillance of superficial surgical site infections (SSSI) following caesarean deliveries (CD) in a provincial hospital, to estimate their incidence, describe their clinical management, and determine their causative pathogens. Methodology: Between October 2010 and February 2011, all women admitted for CD were included in the surveillance. Their clinical condition was monitored for a post-operative period of 30 days, including two assessments performed by surgeons. Cases were clinically diagnosed by surgeons, with bacterial cultures performed. Results: Of the 222 patients admitted for CD, 176 (79.3%) were monitored for 30 days. Of these, 11 were diagnosed with a SSSI, giving an incidence rate of 6.25% (95% CI 3.2-10.9). Four of the cases (36.4%) were detected after hospital discharge.  Length of hospitalization was significantly longer for the SSSI cases. All 222 patients were prescribed antibiotics.  Ampicillin was administered intravenously to 98.6% of them, with subsequent oral amoxicillin given to 82.9%. Three of six pus samples collected were positive on culture: two with Staphylococcus aureus and one with Staphylococcus lugdunensis. One S.aureus was methicillin resistant (MRSA). The other was clindamycin and erythromycin resistant. Conclusion: Surveillance of health-care associated infections in a setting with limited resources is challenging but feasible. Effective post-discharge surveillance was essential for the estimation of the incidence rate of SSSI following caesarean deliveries.   This surveillance led to a peer-review of medical practices. https://jidc.org/index.php/journal/article/view/2981hospital-acquired infectioninfection controlsurgical site infectionCambodiahealth systemcaesarean delivery
spellingShingle Sok Srun
Yin Sinath
An Thoun Seng
Meas Chea
Mony Borin
Somary Nhem
Amanda Daniel
Nora Chea
Nima Asgari
Anne Rachline
Za Reed
Rodney Hoff
Philippe Cavailler
Sophie Goyet
Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
Journal of Infection in Developing Countries
hospital-acquired infection
infection control
surgical site infection
Cambodia
health system
caesarean delivery
title Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
title_full Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
title_fullStr Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
title_full_unstemmed Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
title_short Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia
title_sort surveillance of post caesarean surgical site infections in a hospital with limited resources cambodia
topic hospital-acquired infection
infection control
surgical site infection
Cambodia
health system
caesarean delivery
url https://jidc.org/index.php/journal/article/view/2981
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