%0 Journal Article
%T Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section
%A Devjani De
%A Sonal Saxena
%A Geeta Mehta
%A Reena Yadav
%A Renu Dutta
%J International Journal of Antibiotics
%D 2013
%R 10.1155/2013/283025
%X Background. Lower segment caesarean section (LSCS) is a common mode of delivery now and surgical site infection is the second most common infectious complication in these patients. This study was planned with this background to have a comprehensive approach to SSI following LSCS. Methods. 500 consecutive patients undergoing LSCS, irrespective of indication, were studied. A questionnaire was developed to assess the risk factors associated with development of SSI. All patients were followed up from day one of surgery till discharge and then up till the postoperative day 30 after discharge. Results. SSI was identified in 121 (24.2%) out of 500 patients. In all age groups, Gram-negative bacilli were the commonest finding. The commonest isolate was Acinetobacter species (32.03%) followed by Staphylococcus aureus and coagulase negative Staphylococcus (21.09%). 23.8% of Staphylococcus aureus strains were MRSA. By multivariate logistic regression premature rupture of membrane (PROM), antibiotics given earlier than 2 hours and increased duration of stay in the hospital were found to be significant. Conclusions. A proper assessment of risk factors that predispose to SSI and their modification may help in reduction of SSI rates. Also, frequent antimicrobial audit and qualitative research could give an insight into the current antibiotic prescription practices and the factors affecting these practices. 1. Introduction Surgical site infection (SSI) is a common, generic postoperative event that causes considerable morbidity but seldom leads to death. Surveillance of SSI is an important infection control activity [1]. Most of the studies on surgical site infections in lower segment caesarean section patients have been conducted outside India. As a result not much data is available on the incidence rates of SSI following lower segment cesarean section (LSCS) in Indian hospitals. The data is also lacking in the knowledge of common pathogens after LSCS. There exists a need to investigate intraoperative and postoperative risk factors for SSI after LSCS. In spite of the availability of antibiotics, SSIs are still responsible for much morbidity and far reaching socioeconomic consequences for both patients as well as health care systems. Reduction in surgical site infections while minimizing antibiotic resistance still remains a challenge for many health care institutions. 2. Materials and Methods The study was carried out prospectively in the Department of Microbiology and Department of Obstetrics and Gynaecology, Lady Hardinge Medical College and Smt. Sucheta Kriplani
%U http://www.hindawi.com/journals/ijan/2013/283025/