DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20214309
Published: 2021-10-27

Risk factors for surgical site infections after caesarean section at Yaounde, Cameroon

Pierre M. Tebeu, Aurelien Kamdem, Jean P. Ngou-Mve-Ngou, Esther Meka, Jesse S. S. Antaon, Meukem Tegue Loic, Jeanne Fouedjio

Abstract


Background: Surgical site infection is the invasion by microorganisms of the tissue layers affected by the surgical procedure. Maternal morbidity from infections has been shown to be higher after caesarean section compared to the vaginal delivery. Objective of the research was to analyze the risk factors associated with surgical site infections after caesarean section.

Methods: This was a cross sectional (affected/non affected) study approved by the institutional committee for ethics and research of the faculty of medicine and biomedical sciences. A total of 310 medical files were assessed, 62 files from patients with surgical site infections and 248 files from patients without any complications. The data was collected using a pretested questionnaire and analyzed using the statistical package for the social sciences (SPSS) software version 22.0. The Chi squared and the Fisher exact tests were used to assess homogeneity between the 2 groups. Odd ratio 95% confidence interval was used to assess the association between the variables.

Results: The proportion of surgical site infections during the study was 1.81%. Factors associated with surgical site infections were premature rupture of membranes (OR: 2.065; 95% CI 1.051-4.05; p=0.035); the vertical midline incision (OR=5.26; 95% CI; 1.41-19.57; p=0.013) and a operation by a resident physician doctor (OR=1.98; 95% CI 1.09-3.59; p=0.02).

Conclusions: A factors associated with surgical site infections after caesarean section are a premature rupture of membranes, vertical midline incision and the qualification of the practitioner.


Keywords


Risk factors, Frequency, Infection, Cesarean section

Full Text:

PDF

References


U.S. National librery of medicine. Cesarean Section - A Brief History: Part 1. Available at: https://www.nlm.nih.gov/exhibition/cesarean/part1.html. Accessed on 10 November 2017.

Lurie S, Glezerman M. The history of cesarean technique. Am J Obstet Gynecol. 2003;189(6):1803-6.

Deneux-Tharaux C. Utérus cicatriciel: aspects épidémiologiques. J Gynécologie Obs Biol la Reprod. 2012;41(8):697-707.

Nkwabong E, Kouam L. Indication des cesariennes a la maternite du CHU de Yaounde de 2000 A 2004. Clin Mother Child Heal. 2006;3(1):453-5.

Monitoring report of 100 key health indicators in Cameroon in 2017. 2018. Available at: http://cdnss.minsante.cm/?q=fr/content/rapport-de-suivi-des-100-indicateurs-cles-de-sante-au-cameroun-en-2017. Accessed on 10 November 2017.

Leke R. Mortalite Maternelle. Postgrad Res Train Reprod Heal. 2004. Available from: https://www.gfmer.ch/Medical_education_En/Cameroon/Pdf/Mortalite_maternelle_Leke.pdf. Accessed on 20 November 2017.

Vitenskap M. Infections after caesarean sections. J Nor Med Assoc. 2009;(1):2-6.

Gong S, Guo H, Zhou H, Chen L, Yu Y. Morbidity and risk factors for surgical site infection following cesarean section in Guangdong Province , China. J Obstet Gynaecol Res. 2012;38(3):509-15.

Mitt P, Lang K, Peri A, Maimets M, National P. Surgical -site infections following cesarean section in an estonian u niversity hospital: postdischarge surveillance. Infect Control Hosp Epidemiol. 2005;26(5):449-54.

Jido T, Garba I. Surgical-site infection following cesarean section in Kano, Nigeria. Ann Med Health Sci Res. 2012;2(1):33-6.

Ngowa JDK, Ngassam A, Fouogue JT, Metogo J, Medou A, Kasia JM. Complications maternelles précoces de la césarienne: A propos de 460 cas dans deux hopitaux universitaires de Yaoundé, Cameroun. Pan Afr Med J. 2015;21:265.

Vijayan CP, Mohandas S, Nath AG. Surgical Site Infection Following Cesarean Section in a Teaching Hospital. Intern Journ Sci Study. 2016;3(12):97-101.

Goderel I, Lejeune V, Milliez J. Travail original Infections de site opératoire chez les patientes. J Gynecol Obs Biol Reprod. 2011;33:487-96.

Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section. Infect Control Hosp Epidemiol. 2008;29(06):477-84.

Killian CA, Graffunder EM, Vinciguerra TJ, Venezia RA. risk factors for surgical-site infections. Infect Control Hosp Epidemiol. 2014;22(10):613-7.

Wodajo S, Mehretu Belayneh SG. Magnitude and Factors Associated With Post-Cesarean Surgical Site Infection at Hawassa University Teaching and Referral Hospital, Southern Ethiopia: A Cross-sectional Study. Ethopian J Heal Sci. 2017;27(3):283-90.

Wloch C, Wilson J, Lamagni T, Harrington P, Charlett A, Sheridan E. Risk factors for surgical site infection following caesarean section in England: Results from a multicentre cohort study. BJOG An Int J Obstet Gynaecol. 2012;119(11):1324-33.

Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control. 2014;3(25):1-10.

Thornburg LL, Linder MA, Durie DE, Walker B, Pressman EK, Glantz JC. Risk factors for wound complications in morbidly obese women undergoing primary cesarean delivery. J Matern Neonatal Med. 2012;25:1544-8.