title: Surveillance of surgical site infection after cesarean section and time of notification.
abstract: BACKGROUND
  Cesarean section is a surgical procedure the main complication of which is surgical site infection (SSI), which is related to maternal morbidity and mortality.
  
  
  OBJECTIVE
  To evaluate active monitoring by telephone to identify infection and time of SSI report in postpartum women and associated risk factors.
  
  
  METHODS
  We conducted a prospective observational study from 2013-2014, at a referral service for high-risk pregnancies. Surveillance was conducted via telephone at least 30 days after cesarean delivery. Incidence ratio and time of infection occurrence (days) was analyzed. Survival analysis was conducted to assess the temporal distribution of the development of infection.
  
  
  RESULTS
  Of a total of 353 patients, 14 (4%) cases of SSI were reported, and 10 (7.4%) of the reported cases occurred within 15 days after cesarean and average time of infection was12.21 days. American Society of Anesthesiologists score was the only risk factor associated with SSI after cesarean section.
  
  
  CONCLUSIONS
  The prevalence of SSI after cesarean section via telephone is similar to several services with different methods of surveillance, considering it could be used by services with limited resources. Superficial incisional SSI was the most common type of infection, time of infection report was mainly before the 15th day postprocedure, and American Society of Anesthesiologists score of 2 or less was protective against SSI. Telephone calls can be a viable method to identify women with infection briefly after discharge, particularly at-risk patients.
authors.affiliation: Specialization in Prevention and Control of Hospital Infection, Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Faculdade Dinâmica do Vale do Piranga, Ponte Nova, Minas Gerais, Brazil.
authors.forename: Júnia Leonne Dourado de Almeida
authors.initials: JL
authors.lastname: Lima
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Regina Amélia Lopes Pessoa
authors.initials: RA
authors.lastname: de Aguiar
authors.affiliation: Department of Gynecology and Obstetrics, Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Henrique Vitor
authors.initials: HV
authors.lastname: Leite
authors.affiliation: Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Hercules Hermes Riani Martins
authors.initials: HH
authors.lastname: Silva
authors.affiliation: Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Werlley Meira
authors.initials: WM
authors.lastname: de Oliveira
authors.affiliation: Faculty of Medical Sciences of Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: João Paulo Tomaz da Cunha
authors.initials: JP
authors.lastname: Sacramento
authors.affiliation: Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Eduarda Almeida
authors.initials: EA
authors.lastname: Wakabayashi
authors.affiliation: Medical School of Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Helen Cristina
authors.initials: HC
authors.lastname: de Souza
authors.affiliation: Propedeutics Department, Medical School of Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Pediatrics Department, Medical School of Universidade Federal de Minas Gerais, Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Wanessa Trindade
authors.initials: WT
authors.lastname: Clemente
authors.affiliation: Pediatrics Department, Medical School of Universidade Federal de Minas Gerais, Universidade José do Rosário Vellano, Belo Horizonte, Minas Gerais, Brazil; Hospital Infection Control Committee, Hospital das Clínicas of Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address: rmcromanelli@gmail.com.
authors.forename: Roberta Maia de Castro
authors.initials: RM
authors.lastname: Romanelli
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects*; D003625:Data Collection / Q000379:methods; D004812:Epidemiologic Methods; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016019:Survival Analysis; D013997:Time Factors
keywords: Cross-infection; Epidemiologic surveillance; Infection Control