Risk factors and microbiological pattern of post caesarean wound infection in Federal Medical Centre Owerri

Abstract

Background: Delivery by caesarean section has been reported as the single most important risk factor for maternal infection. Post caesarean wound infection continues to be a source of maternal morbidity and mortality in developing countries despite the recent advances in aseptic techniques. Wound infection is not only a leading cause of prolonged hospital stay, but also a major cause of widespread aversion to caesarean delivery in developing countries. In order to control and prevent post caesarean wound infection in our environment, there was a need to evaluate the relative contribution of each aetiological factor and the microbiological pattern as these will help to ensure better management of the patient.
Objectives: The study determined the incidence of and predisposing factors to wound infection in elective versus emergency caesarean sections, and the associated micro-organisms.
Design: This was a prospective comparative cohort study
Setting: The study was carried out at the ward 4 obsterics, ward 4 extension and Microbiology department of the Federal Medical Centre, Owerri between February and April 2015.
Methodology: A total of 276 patients who underwent caesarean sections (138 elective and 138 emergency) and who met the inclusion criteria were recruited longitudinally for the study. Swabs taken from infected wounds were subjected to gram staining and culture and results were analysed using the computer Software Package for Social Sciences (SPSS) version 20.
Results: The outcome of the study showed that the incidence of post caesarean section wound infection in elective and emergency caesarean section was 9.4% and 17.4% respectively, giving an overall incidence of 13.4%. Additionally, only 3 risk factors out of the seventeen (17) risk factors studied were found to be independent variables for post caesarean wound infection.
Conclusion: The study showed conclusively that prolonged rupture of membranes, post-operative anaemia and a midline sub-umbilical incision were independent risk factors contributing directly to a higher incidence of post-caesarean wound infection with Staphylococcus aureus being the single most common organism implicated.