Paper on surgical site infections post cesarean section

Abstract

Background: Surgical site infections are among the most common hospital acquired infections. They make upto 14-16% of inpatient infections. Objective of present study was to evaluate the risk factors associated with surgical site infections in caesarian cases, the bacteria causing wound infections in obstetric operations, the antibiotic sensitivity and resistance pattern of the pathogens isolated. Methods: 100 women with wound infection during hospital stay or within 30 days following caesarean section were taken for the study. These case records were thoroughly studied and noted. Pus samples were collected from the wound site with help of sterile swabs under aseptic precautions and immediately transported to microbiology laboratory for culture and sensitivity. Results: Most of the patients belonged to the age group of 21-25 years, contributing to 55% of the cases. Majority of the women are from rural areas (71%). 57% of the cases were unbooked. 90% of the SSI were seen in emergency surgeries and 10% in elective surgeries. Anaemia (48%) was the most common medical risk factor followed by hypertensive disorders 25%. The risk of post operative infection has been found to be proportional to volume of blood loss during cesarean section and duration of surgery. Staphylococcus aureus was found to be predominant organism of wound infection of which 21% were MRSA followed by Klebsiella and E.coli.Conclusions: Proper assessment of risk factors that predispose to SSI is critical for the development of strategies for reducing the incidence of SSI and for identifying high risk patients requiring intensive postoperative surveillance. We can conclude that reduction in intraoperative blood loss and duration of surgery can reduce the incidence of Postoperative infections.Also Pre operative antibiotics should not be made mandatory in all lower segment caesarean section as no significant difference has been found in the infection rate inspite of giving preoperative antibiotics.