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 in spite of
giving preoperative antibiotics.