Incidence of post cesarean section wound infection and its associated risk factors in Orrota national referral maternity hospital between January and June 2015.

Abstract

Introduction

Cesarean section (CS) is a common mode of delivery now and post caesarean section wound infection (PCSWI) is becoming common infectious complication. This study was planned with the objective to determine the incidence rate and its risk factors of PCSWIs following CS at Orotta National Referral Maternity Hospital (ONRMH) in Asmara-Eritrea from January 1 to June 30, 2015.

Methods

A total of 410 consecutive pregnant women from Zoba Maekel undergoing CS, irrespective of indication, were studied. Women who died before the 3rd day of postoperative period were excluded. A questionnaire was developed to assess the risk factors associated with development of PCSWIs. All the subjects were followed from day one of surgery till discharge and then till the postoperative 30th day after discharge.

Results

PCSWI was identified in 28 (6.8%) out of 410 subjects. Nine types of microorganisms were isolated in 20 (71.4%) samples. The predominant isolated microorganism was Staphylococcus Coagulase negative 26.1% followed by Staphylococcus aureus 21.7%, and E. coli 17.4%. The isolated organisms were 100% sensitive to Clindamycin, Erythromycin, and Rifampcin but 100 % resistant to Ampicillin, Penicillin, and Oxacillin. Prolonged labor, prolonged rupture of membrane, multiple vagina examination, lack of administration of antibiotics prophylaxis, early stitch removal, early discharge from the hospital, and obesity showed strong association with PCSWI statistically significant with p value < 0.05.

Conclusions

The study revealed 6.8% PCSWIs rate. Development of PCSWI was related to multi-factorial. Nine different types of microorganisms were isolated. The degree of sensitivity and resistance of the microorganisms varied significantly.

Recommendation

The results of this study emphasized the need to implement on time effective antibiotic prophylaxis, avoid multiple vaginal examinations and shorten prolonged labour.