INVESTIGATION OF POST CAESAREAN SECTION WOUND INFECTIONS AT KAUSAR HOSPITAL KHAIRPUR MIR'S: RISK FACTORS, INCIDENCE RATES, BACTERIAL PROFILE & ANTIMICROBIAL RESISTANCE PATTERN

Abstract

Caesarean section, also commonly referred to as C-section, is a medical operation that entails cutting of the abdomen and uterus of a mother.  Failure to keep proper care after discharge may result in the development of infected surgical wounds.  This study was aimed at determining the prevalence, risk factors, incidence, type of bacteria involved and trend of resistance to antibiotics in C-section wound infections in patients of Kausar Hospital, Khairpur Mir, Sindh, Pakistan.

Sample pus was collected on sterilized swabs of the various hospital units under the use of sterilized Arnie.  Furthermore, the information about possible risk variables was obtained with the help of the standardized questionnaire.  The gathered samples were cultivated selectively and differentially using the media.  Colony morphology and biochemical testing were used to identify the bacteria, and when necessary, a Micro Scan system was used for confirmation.  Clinical and laboratory standards Institute (CLSI) guidelines were observed in carrying out antibiotic and antiseptic susceptibility testing.

The most important risk factor was ignored personal hygiene (87%), then there was improper medication adherence (70%), and low socioeconomic status (68%). The rates of the infection were recorded in 97 cases and the maximum number was in the period of June-August during a year.

Six different bacterial species were isolated: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus epidermidis. Findings on the antibiotic sensitivity revealed that the isolates were broadly resistant.  It was however found that gram-negative bacteria were susceptible to gentamicin and Augmentin, gram-positive bacteria were susceptible to cefoxitin and Augmentin.  Spirit was the second-best antiseptic among the ones tried corresponding to Dettol and Pyodine.

Based on findings, post C-section wound infection is not uncommon and most of the agents that cause it are becoming resistant to conventional medicines.  These results demonstrate the need of clinicians to use careful antibiotic stewardship and do further studies to identify new therapeutic drugs to curb this problem.