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Table 2 Analysis of risk factors for SSI in patients undergoing CS in the PRE-Int and POST-Int groups and Overall

From: Implementing a combined infection prevention and control with antimicrobial stewardship joint program to prevent caesarean section surgical site infections and antimicrobial resistance: a Tanzanian tertiary hospital experience

 Overall (n = 1040)PRE-Int (n = 467)POST-Int (n = 573)
SSI (n = 320)No SSI (n = 720)p-valueSSI (n = 225)No SSI (n = 242)p-valueSSI (n = 95)No SSI (n = 478)p-value
Age, years  0.403  0.561  0.009
  < 2058 (35.2)107 (64.8) 33 (43.4)43 (56.6) 25 (28.1)64 (71.9) 
 21–34220 (29.9)516 (70.1) 164 (48.4)175 (51.6) 56 (14.1)341 (85.9) 
  > 3439 (29.8)92 (70.2) 27 (52.9)24 (47.1) 12 (15.0)68 (85.0) 
 Not known   1 (100)0 2 (28.6)5 (71.4) 
BMI, median (range)27.8 (14–46)26.9 (16–66)0.03127.7 (19–46)26.7 (18–45)0.06027.8 (14–41)27 (16–66)0.224
Education  0.327  0.518  0.621
 No46 (35.1)85 (64.9) 34 (51.5)32 (48.5) 12 (18.5)53 (81.5) 
 Standard 7a165 (31.2)364 (68.8) 112 (46.5)129 (53.5) 53 (18.4)235 (81.6) 
 Form I-VIb88 (30.4)201 (69.6) 68 (51.5)64 (48.5) 20 (12.7)137 (87.3) 
 College/University16 (21.1)60 (78.9) 7 (33.3)14 (66.7) 9 (16.4)46 (83.6) 
 Not known5 (33.3)10 (66.7) 4 (57.1)3 (42.9) 1 (12.5)7 (87.5) 
HIV+  0.097  0.462  0.104
 Yes16 (44.4)20 (55.6) 10 (58.8)7 (41.2) 6 (31.6)13 (68.4) 
 No295 (30.4)676 (69.6) 211 (48.2)227 (51.8) 84 (15.8)449 (84.2) 
 Not known9 (27.3)24 (72.7) 4 (33.3)8 (66.7) 5 (23.8)16 (76.2) 
CS type  0.607  0.469  0.338
 Elective21 (27.6)55 (72.4) 18 (42.9)24 (57.1) 3 (8.8)31 (91.2) 
 Emergency299 (21.0)665 (69.0) 207 (48.7)218 (51.3) 92 (17.1)447 (82.9) 
Indication for CS  0.801  0.558  0.084
 Previously knownc133 (30.8)299 (69.2) 104 (49.5)106 (50.5) 29 (13.1)193 (86.9) 
 Not previously known187 (30.8)420 (69.2) 121 (47.3)135 (52.7) 66 (18.8)285 (81.2) 
Operator grade  0.006  0.038  1.000
 Junior229 (33.4)456 (66.6) 172 (51.0)165 (49.0) 57 (16.4)291 (83.6) 
 Senior87 (25.2)258 (74.8) 51 (40.2)76 (59.8) 36 (16.5)182 (83.5) 
Skin disinfection  < 0.001  0.410  1.000
 Dettol/Ethanol48 (50.0)48 (50.0) 47 (52.2)43 (47.8) 1 (16.7)5 (83.3) 
 Povidone-Iodine265 (28.7)658 (71.3) 172 (47.0)194 (53.0) 93 (16.7)464 (83.3) 
Type of incision  < 0.001  < 0.001  < 0.001
 Midline Vertical280 (38.0)457 (62.0) 198 (58.1)143 (41.9) 82 (20.7)152 (92.1) 
Pfannenstiel37 (15.0)210 (85.0) 24 (29.3)58 (70.7) 13 (7.9)314 (79.3) 
Skin suture  < 0.001  0.370  0.006
 Silk237 (34.2)456 (65.8) 167 (49.3)172 (50.7) 70 (19.8)284 (80.2) 
 Vicryl (absorbable)58 (21.9)207 (78.1) 40 (44.0)51 (56.0) 18 (10.3)156 (89.7) 
Suture type  < 0.001  < 0.001  < 0.001
 Interrupted268 (38.3)432 (61.7) 190 (58.1)137 (41.9) 78 (20.9)295 (79.1) 
 Continuous intradermic and semisubcutaneous45 (16.7)225 (83.3) 31 (32.3)65 (67.7) 14 (8.0)160 (92.0) 
Pre-Incision Prophylaxis  < 0.001  1.000  1.000
 No216 (47.3)241 (52.7) 215 (47.7)236 (52.3) 1 (16.7)5 (83.3) 
 Yes97 (17.0)475 (83.0) 5 (50.0)5 (50.0) 92 (16.4)470 (83.6) 
Timing of pre-Incision Prophylaxis  0.548  0.428  0.307
 Adequate25 (27.2)137 (31) 3 (100)2 (50) 22 (24.7)135 (30.8) 
 Not adequate67 (72.8)305 (69) 02 (50) 67 (75.3)303 (69.2) 
Post-CS ATB administration  < 0.001  1.000  0.220
 No64 (15.8)342 (84.2) 2 (50.0)2 (50.0) 62 (15.4)340 (84.6) 
 Yes253 (40.4)374 (59.6) 220 (47.9)239 (52.1) 33 (19.6)135 (80.4) 
  1. aPrimary education; bSecondary education; ccephalopelvic disproportion, bad obstetric history, previous CS
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Antimicrobial Resistance & Infection Control

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