Post Caesarean Section Wound Infection and Microbiological Pattern at the University of Port Harcourt Teaching Hospital, Southern Nigeria

摘要

Background: Caesarean section is the commonest surgery done in modern obstetric practice. As safe as this procedure may be, it is associated with varying degree of morbidities and sometimes mortality including post-operative wound infection. Wound infection is a very important cause of physical and psychological stress leading to prolonged hospital stay. Objectives: The objective of this study was to determine the prevalence of post caesarean section wound infection, the common microbiological agents and the antibiotic sensitivity of the causative organisms at the University of Port Harcourt Teaching Hospital. Material and Methods: This was a prospective cross sectional study of 88 women with wound infection following caesarean sections at the University of Port Harcourt Teaching Hospital. Swabs were obtained from infected wounds over a period of 24 months. A structured Proforma designed for this purpose was used to obtain socio-demographic information and risk factors. Data collected was entered into a spread-sheet. Statistical analysis of results was done using SPSS 20.0 for windows? statistical software. Chi-square test was used to explore proportional relationship between groups. The level of statistical significance was set at P value <0.05 (providing 95% confidence interval). Results: The mean age of the women was 29.4years ± 5.6 and the mean parity was 1.73 ± 1.8. The wound infection rate was 6.7%. Unbooked status, multiple vaginal examinations, prolonged labour and prolonged rupture of membranes were all significantly associated with wound sepsis (P value <0.05). Majority 29 (33.3%) of the wound swab specimen yielded Staphylococcus aureus, all the microorganisms isolated were sensitive to ciprofloxacin and ofloxacin and least sensitive to cephtazidine and cefuroxime. Conclusion: This is the first published study to examine post caesarean section wound infection and microbiological pattern in our center and it will serve as a benchmark for the review of the current protocol for prophylactic antibiotics following caesarean section and for further research. Efforts should be made to reduce nosocomial infection in obstetric patients in order to decrease the incidence of wound infection following caesarean section especially in booked patients.