Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/55715 https://orcid.org/0000-0003-0848-3740 |
Resumo: | Justification and objectives: Post-surgical site infection (SSI) is one of the major complications of cesarean section and preoperative antimicrobial prophylaxis is indicated before the incision or after umbilical cord clamping. The aim of this study is to compare the SSI rates and neonatal sepsis with two different prophylaxis protocols. Methods: Prospective observational study, carried out 2012 to 2015, at a reference maternity hospital for high obstetric risk patients. All pregnant women who underwent cesarean section and their newborns were included. Information was obtained when they were contacted by telephone call and by medical records. Infection criteria followed National Healthcare Safety Network and Agência Nacional de Vigilância Sanitária recommendations. Analysis was performed using the Statistical Package for Social Sciences. The study was approved by the Research Ethics Committee. Results: A total of 3230 pregnant underwent cesareansections. Of this total, 2,351 mother-newborn binomials (72.7%) were followed. When comparing infection events, considering the two different prophylaxis moments (before or after cord clamping), there was no statistical difference for SSI (X2 =1,98; p = 0.16) or neonatal sepsis (X2 = 0.94; p = 0.33). No analyzed variable was associated with maternal SSI. However, lower maternal age (p <0.003), lower gestational age (p <0.001), chorioamnionitis (p = 0.001), maternal hypertensive emergency (p < 0.001), centralization of blood flow (p = 0.02), ASA classification ≥ 3 (p = 0.02), dystocia or induction failure (p = 0.003) were significantly associated to neonatal sepsis. Only lower gestational age was significant in the multivariate analysis (p = 0.004). Conclusion: There was no negative impact on the clinical outcome of the newborn regarding the occurrence of sepsis. However, reduction in maternal SSI proportion was not observed and optimal time for antibiotic administration should be reevaluated. |
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2023-07-03T23:11:23Z2023-07-03T23:11:23Z20165123165324http://hdl.handle.net/1843/55715https://orcid.org/0000-0003-0848-3740Justification and objectives: Post-surgical site infection (SSI) is one of the major complications of cesarean section and preoperative antimicrobial prophylaxis is indicated before the incision or after umbilical cord clamping. The aim of this study is to compare the SSI rates and neonatal sepsis with two different prophylaxis protocols. Methods: Prospective observational study, carried out 2012 to 2015, at a reference maternity hospital for high obstetric risk patients. All pregnant women who underwent cesarean section and their newborns were included. Information was obtained when they were contacted by telephone call and by medical records. Infection criteria followed National Healthcare Safety Network and Agência Nacional de Vigilância Sanitária recommendations. Analysis was performed using the Statistical Package for Social Sciences. The study was approved by the Research Ethics Committee. Results: A total of 3230 pregnant underwent cesareansections. Of this total, 2,351 mother-newborn binomials (72.7%) were followed. When comparing infection events, considering the two different prophylaxis moments (before or after cord clamping), there was no statistical difference for SSI (X2 =1,98; p = 0.16) or neonatal sepsis (X2 = 0.94; p = 0.33). No analyzed variable was associated with maternal SSI. However, lower maternal age (p <0.003), lower gestational age (p <0.001), chorioamnionitis (p = 0.001), maternal hypertensive emergency (p < 0.001), centralization of blood flow (p = 0.02), ASA classification ≥ 3 (p = 0.02), dystocia or induction failure (p = 0.003) were significantly associated to neonatal sepsis. Only lower gestational age was significant in the multivariate analysis (p = 0.004). Conclusion: There was no negative impact on the clinical outcome of the newborn regarding the occurrence of sepsis. However, reduction in maternal SSI proportion was not observed and optimal time for antibiotic administration should be reevaluated.Justificativa e Objetivos: A infecção de ferida cirúrgica (IFC) é uma das principais complicações da cesariana e profilaxia pré-operatória antimicrobiana é indicada antes da incisão ou após o pinçamento do cordão umbilical. O objetivo deste estudo é comparar as taxas de IFC e sepse neonatal durante dois diferentes protocolos de profilaxia. Métodos: Estudo observacional, prospectivo, de 2012 a 2015, em maternidade de referência para assistência de alto risco obstétrico. Todas as mulheres grávidas submetidas à cesariana e seus recém-nascidos foram incluídos. As informações foram obtidas durante contato telefônico e em prontuário médico. Os critérios de infecção seguiram as recomendações do National Healthcare Safety Network e da Agência Nacional de Vigilância Sanitária. A análise foi realizada no Statistical Package for Social Sciences. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: Um total de 3.230 gestantes foi submetido à cesárea. Deste total, 2.351 binômios mãe-recém-nascidos (72,7%) foram seguidos. Ao comparar o evento infecção considerando os dois períodos de momento profilaxia diferente (antes ou depois da clampeamento do cordão), não houve diferença estatística para IFC (X2 = 1,98; p = 0,16) ou sepse neonatal (X2 = 0,94; p = 0,33). Nenhuma variável analisada foi associada com IFC materna. No entanto, menor idade materna (p <0,003), menor idade gestacional (p <0,001), corioamniotite (p = 0,001), emergência hipertensiva materna (p <0,001), centralização do fluxo sanguíneo (p = 0,02) classificação de ASA ≥ 3 (p = 0,02), distocia ou indução de falha (p = 0,003) foram significativamente associados à sepse neonatal. Apenas a idade gestacional permaneceu significativa em análise multivariada (p = 0,004). Conclusão: Não houve nenhum impacto negativo sobre o desfecho clínico do recém-nascido para a ocorrência de sepse. No entanto, não foi observada redução da IFC materna e tempo ideal para a administração antibiótico deve ser reavaliadoporUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE PEDIATRIAThe Journal of Infection ControlCesáreaSepse NeonatalCesareanNeonatal sepsisAntibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatalAntibiotic Prophylaxis in Cesarean section: Wound infection and Neonatal Sepsis risk factorsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://jic-abih.com.br/index.php/jic/article/view/156Roberta Maia de Castro RomanelliWanessa Trindade ClementeGabriela Mafra de OliveiraNatalia Pinto RibeiroCamila Yuri NakayaJoão Paulo SacramentoAna Raquel AlfenasRegina Amélia Lopes Pessoa de AguiarHenrique Vitor LeiteViviana RosadoDaniela Caldas Teixeirainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/55715/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALAntibioticoprofilaxia em cesariana Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal.pdfAntibioticoprofilaxia em cesariana Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal.pdfapplication/pdf381716https://repositorio.ufmg.br/bitstream/1843/55715/2/Antibioticoprofilaxia%20em%20cesariana%20Fatores%20de%20risco%20associados%20%c3%a0%20infec%c3%a7%c3%a3o%20de%20ferida%20cir%c3%bargica%20e%20sepse%20neonatal.pdf8cebacaaefe175781a7834ee5c7bf48dMD521843/557152023-07-11 17:10:20.736oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-07-11T20:10:20Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
dc.title.alternative.none.fl_str_mv |
Antibiotic Prophylaxis in Cesarean section: Wound infection and Neonatal Sepsis risk factors |
title |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
spellingShingle |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal Roberta Maia de Castro Romanelli Cesarean Neonatal sepsis Cesárea Sepse Neonatal |
title_short |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
title_full |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
title_fullStr |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
title_full_unstemmed |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
title_sort |
Antibioticoprofilaxia em cesariana: Fatores de risco associados à infecção de ferida cirúrgica e sepse neonatal |
author |
Roberta Maia de Castro Romanelli |
author_facet |
Roberta Maia de Castro Romanelli Wanessa Trindade Clemente Gabriela Mafra de Oliveira Natalia Pinto Ribeiro Camila Yuri Nakaya João Paulo Sacramento Ana Raquel Alfenas Regina Amélia Lopes Pessoa de Aguiar Henrique Vitor Leite Viviana Rosado Daniela Caldas Teixeira |
author_role |
author |
author2 |
Wanessa Trindade Clemente Gabriela Mafra de Oliveira Natalia Pinto Ribeiro Camila Yuri Nakaya João Paulo Sacramento Ana Raquel Alfenas Regina Amélia Lopes Pessoa de Aguiar Henrique Vitor Leite Viviana Rosado Daniela Caldas Teixeira |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Roberta Maia de Castro Romanelli Wanessa Trindade Clemente Gabriela Mafra de Oliveira Natalia Pinto Ribeiro Camila Yuri Nakaya João Paulo Sacramento Ana Raquel Alfenas Regina Amélia Lopes Pessoa de Aguiar Henrique Vitor Leite Viviana Rosado Daniela Caldas Teixeira |
dc.subject.por.fl_str_mv |
Cesarean Neonatal sepsis |
topic |
Cesarean Neonatal sepsis Cesárea Sepse Neonatal |
dc.subject.other.pt_BR.fl_str_mv |
Cesárea Sepse Neonatal |
description |
Justification and objectives: Post-surgical site infection (SSI) is one of the major complications of cesarean section and preoperative antimicrobial prophylaxis is indicated before the incision or after umbilical cord clamping. The aim of this study is to compare the SSI rates and neonatal sepsis with two different prophylaxis protocols. Methods: Prospective observational study, carried out 2012 to 2015, at a reference maternity hospital for high obstetric risk patients. All pregnant women who underwent cesarean section and their newborns were included. Information was obtained when they were contacted by telephone call and by medical records. Infection criteria followed National Healthcare Safety Network and Agência Nacional de Vigilância Sanitária recommendations. Analysis was performed using the Statistical Package for Social Sciences. The study was approved by the Research Ethics Committee. Results: A total of 3230 pregnant underwent cesareansections. Of this total, 2,351 mother-newborn binomials (72.7%) were followed. When comparing infection events, considering the two different prophylaxis moments (before or after cord clamping), there was no statistical difference for SSI (X2 =1,98; p = 0.16) or neonatal sepsis (X2 = 0.94; p = 0.33). No analyzed variable was associated with maternal SSI. However, lower maternal age (p <0.003), lower gestational age (p <0.001), chorioamnionitis (p = 0.001), maternal hypertensive emergency (p < 0.001), centralization of blood flow (p = 0.02), ASA classification ≥ 3 (p = 0.02), dystocia or induction failure (p = 0.003) were significantly associated to neonatal sepsis. Only lower gestational age was significant in the multivariate analysis (p = 0.004). Conclusion: There was no negative impact on the clinical outcome of the newborn regarding the occurrence of sepsis. However, reduction in maternal SSI proportion was not observed and optimal time for antibiotic administration should be reevaluated. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016 |
dc.date.accessioned.fl_str_mv |
2023-07-03T23:11:23Z |
dc.date.available.fl_str_mv |
2023-07-03T23:11:23Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/1843/55715 |
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23165324 |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0003-0848-3740 |
identifier_str_mv |
23165324 |
url |
http://hdl.handle.net/1843/55715 https://orcid.org/0000-0003-0848-3740 |
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por |
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por |
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The Journal of Infection Control |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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UFMG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
MED - DEPARTAMENTO DE PEDIATRIA |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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UFMG |
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