Global incidence of surgical site infections following caesarean section: a systematic review and meta-analysis

(2023) Global incidence of surgical site infections following caesarean section: a systematic review and meta-analysis. Journal of Hospital Infection. pp. 82-92. ISSN 0195-6701

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Abstract

Background: Surgical site infection (SSI) is a health-threatening complication following caesarean section (CS); however, to the authors' knowledge, there is no worldwide estimate of the burden of post-CS SSIs. Therefore, this systematic review and meta-analysis aimed to estimate the global and regional incidence of post-CS SSIs and associated factors. Methods: International scientific databases were searched systematically for observational studies published from January 2000 to March 2023, without language or geographical restrictions. The pooled global incidence rate was estimated using a random-effects meta analysis (REM), and then stratified by World-Health-Organization-defined regions as well as by sociodemographic and study characteristics. Causative pathogens and associated risk factors of SSIs were also analysed using REM. Heterogeneity was assessed with I2. Results: In total, 180 eligible studies (207 datasets) involving 2,188,242 participants from 58 countries were included in this review. The pooled global incidence of post-CS SSIs was 5.63 95% confidence interval (CI) 5.18-6.11%. The highest and lowest incidence rates for post-CS SSIs were estimated for the African (11.91%, 95% CI 9.67-14.34%) and North American (3.87%, 95% CI 3.02-4.83%) regions, respectively. The incidence was significantly higher in countries with lower income and human development index levels. The pooled incidence estimates have increased steadily over time, with the highest incidence rate during the coronavirus disease 2019 pandemic (2019-2023). Staphylococcus aureus and Escherichia coli were the most prevalent pathogens. Several risk factors were identified. Conclusion: An increasing and substantial burden from post-CS SSIs was identified, especially in low-income countries. Further research, greater awareness and the development of effective prevention and management strategies are warranted to reduce post CS SSIs. 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Keywords: Surgical site infection Global incidence Caesarean section Meta-analysis risk-factors economic burden health prevalence surgery impact heterogeneity consequences prevention management Public, Environmental & Occupational Health Infectious Diseases
Page Range: pp. 82-92
Journal or Publication Title: Journal of Hospital Infection
Journal Index: ISI
Volume: 139
Identification Number: https://doi.org/10.1016/j.jhin.2023.05.019
ISSN: 0195-6701
Depositing User: خانم ناهید ضیائی
URI: http://eprints.mui.ac.ir/id/eprint/26367

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