Surgical Site Infection Following Cesarean Section: A Hospital-Based Cross-Sectional Study

Abstract

Introduction: Cesarean section (CS) is one of the most commonly performed surgical procedures in the obstetrics and gynecology department.  After urinary tract infection, surgical site infection (SSI) is the most frequent infection found in post cesarean section patients. Optimizing maternal co-morbidities and using evidence-based surgical procedures are both essential for lowering the risk of SSI. This study was carried out to study the prevalence of surgical site infections following cesarean section.

Methods: This was a descriptive observational study in patients who had undergone cesarean sections from Baishak 2079 to Chaitra 2079 at Pokhara Academy of Health Sciences. Following surgery patients were put on  regular follow up visits during which signs of infection were noted. Swabs from infected surgical sites were then further sent for microbiological investigations.  Data collection was done and were analyzed using SPSS. 

Results: Among 315 cases,306 cesarean section  cases were included in the study and 9 cases were lost to follow up. In this study post LSCS SSI rate was 12.43%(n=35), of which SSI in elective LSCS was found in 4 cases i.e., 5.06% whereas in emergency LSCS SSI was found in 31 cases i.e., 13.65%.  Overall prevalence of SSI was higher in emergency LSCS with obesity being a major risk factor (31.42%). Among culture positive SSI, Staphylococcus (n=11/61.11%) was the most common microorganisms detected followed by Pseudomonas (n=5/27.78%). 

Conclusion: Prevalence of surgical site infection in cases of emergency LSCS is high, increasing maternal morbidity. The recognition and correction of associated medical complications in the antenatal period is vital. Staphylococcus being the most common and Pseudomonas the second most commonly isolated organisms.