Surgical site infection in puerperal women with caesarean

Abstract

Introduction: Puerperal infection as an expression of infection associated with healthcare is one of the major complications of obstetric patients.
Objective: Characterize microbiological and epidemiologically patients with caesarean section wound infection and positive bacteriological culture.
Methods: A descriptive, prospective and cross-sectional study was conducted at, "Dr. Juan Bruno Zayas Alfonso" Hospital from November 2013 to November 2014. The study sample consisted of 69 caesarean postpartum women, infected wounds and performed bacteriological studies. The sample comprised 62 patients in which the infectious agent was isolated. Ethological agents and their antimicrobial resistance were identified. Epidemiological variables were operationalized.
Results: The study revealed wound infection in 4.9 % of caesarean sections performed. It prevailed monomicrobial infections (88.7 %), by Gram-positive bacteria (59.4 %). Staphylococcus aureus was the predominant organism (42.02 %). The presence of multidrug-resistant agents was showed: methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and beta-lactamase producing Enterobacteriaceae. Anemia (87.1 %), preoperative stay more than three days (82.3 %), insufficient weight gain (33.9 %) and diabetes mellitus (27.4 %) were the main risk factors identified. Urgent caesarean sections predominated (91.9 %), with clean contaminated wounds (93.5 %) and superficial incisional infections (53.2 %). The wound dehiscence was observed in 74.2 % of patients.
Conclusions: The presence of modifiable and controllable risk factors in pregnant women conditions the occurrence of infections, which imposes adequate prenatal care, the compliance of protocols for infection prevention and continuous epidemiological surveillance, allowing accurate diagnosis and early treatment.