Does surgical site infection after Caesarean section in Polish hospitals reflect high-quality patient care or poor postdischarge surveillance? Results from a 3-year multicenter study.

BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net. For each procedure, the following data were registered: age, American Society of Anesthesiologists score, procedure time, elective or emergency procedure, use of perioperative antibiotic prophylaxis, microbiology, the treatment used, and other information. RESULTS: SSI incidence was 0.5% and significant differences were noted among hospitals (between 0.1% and 1.8%), for different American Society of Anesthesiologists scales (between 0.2% and 4.8%) and different values of standardized SSI risk index (between 0.0% and 0.8%). In 3.1% of procedures, with no antibiotic prophylaxis, SSI risk was significantly higher. Deep infections dominated: 61.5% with superficial infections in only approximately 30% of cases and 2.6% of infections were detected postdischarge without readmissions. CONCLUSIONS: Results showed high incidence of SSI in Poland without perioperative antibiotic prophylaxis, and secondly, ineffective surveillance according to CS status, considering outpatient obstetric care. Without postdischarge surveillance, it is not possible to recognize the epidemiologic situation, and further, to set priorities and needs when it comes to infection prophylaxis, especially because such low incidence may indicate no need for improvement in infection control.

[Procedure in case of exposure of hospital's workers to HBV, HCV and HIV]. / Postepowanie w przypadku ekspozycji pracowników szpitala na HBV, HCV i HIV.

The aim of this study was to show our own experiences in the treatment our hospital's workers after the exposition of potentially infectious material. The register of the occupational exposition was established on 1st January 2001. 43 cases of occupational exposition to potentially infectious material were noted down, since the beginning of the observation to 31st October 2004. The persons who were injured, represented different professional groups: 9 physicians, 19 section nurses, 13 operative nurses and 3 maintenance workers. The exposition was caused by needle pricks during blood collection or injections (34 cases), as a result of a scalpel or other surgical instrument cut (2 cases), a splash of infectious material on the skin and conjunctivae (4 cases) and in the singular cases as a result of a bite by a stimulated patient, a medical waste cut in a rubbish bag or the hospital equipment. It was determined in the immunological examinations that among patients being the source of infection were: 1 person HBsAg(+), 5 persons anti-HCV(+), 37 persons HbsAg (-), 33 persons anti-HCV(-) and 5 persons HBsAg(?) and HCV(?). One medical unvaccinated worker was exposed to the HBsAg(+) blood. The specific treatment was administered by the application of 1 dose of anti-HBs immunoglobulin and realization of a series of protective vaccinations against HBV. 4 persons are being observed due to an exposition to HCV(+) blood. In all cases until now the treatment has been finished without a diagnosis of the occupational infection.