Dhar Hansa, Al-Busaidi Ibrahim, Rathi Bhawna, Nimre Eman A, Sachdeva Vibha, Hamdi Ilham
Department of Obstetrics & Gynaecology, Nizwa Hospital, Oman;
Ministry of Health, Oman.
Sultan Qaboos Univ Med J. 2014 May;14(2):e211-7. Epub 2014 Apr 7.
The aim of this study was to determine the incidence of surgical site infections (SSI) in patients undergoing a Caesarean section (CS) and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient's quality of life by increasing morbidity and extending hospital stays.
A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS) SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220) were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection.
The total number of PCS wound infections was 211 (2.66%). There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53%) and a three-fold higher incidence of diabetes (32, 15.16%) in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27%) and the Gram-negative Escherichia coli group (40, 18.95%). The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%), while 47 (22.27%) yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted.
Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques.
本研究旨在确定剖宫产患者手术部位感染（SSI）的发生率，并识别危险因素、常见细菌病原体及抗生素敏感性。手术部位感染通过增加发病率和延长住院时间，显著影响患者的生活质量。
在阿曼尼兹瓦医院进行了一项回顾性横断面研究，以确定2001年至2012年剖宫产术后（PCS）手术部位感染的发生率。随后对211例发生手术部位感染的剖宫产病例进行了病例对照研究。对照组（220例）为同期在同一医院接受剖宫产且未发生任何手术部位感染的随机选取病例。收集了剖宫产类型、危险因素、人口统计学资料、病原体类型、药物敏感性及感染日期等数据。
剖宫产伤口感染总数为211例（2.66%）。与对照组相比，剖宫产病例中胎膜早破的发生率高4倍（37例，17.53%），糖尿病的发生率高3倍（32例，15.16%）。导致手术部位感染最常见的病原体是金黄色葡萄球菌（66例，31.27%）和革兰氏阴性大肠杆菌属（40例，18.95%）。最敏感的抗生素是氨基糖苷类和头孢菌素类。42例（19.90%）为混合感染，47例（22.27%）未培养出细菌。观察到肥胖、高血压、贫血和伤口血肿等相关危险因素的高发生率。
建议采取措施降低手术部位感染的发生率，包括实施感染预防措施以及采用严格的手术技术进行抗生素预防。
