ABSTRACT
Background: Surgical site infection (SSI) after a Cesarean section (CS) increases maternal morbidity and medical costs. No data regarding the epidemiology of SSI after CS are available in settings operated by Médecins Sans Frontières.
Objectives: To determine incidence and independent risk factors for SSI after CS, as well as pathogens associated with infections.
Methods: A prospective data collection among women undergoing CS was conducted in a 43-bed maternity ward hospital in Haiti. Infections were identified during hospital stay or by post-discharge survey using a combination of telephone calls, healthcare worker questionnaires and outpatient medical records review for 30 days after surgery. Surgical site infection was defined according to the International Nosocomial Infection Surveillance system criteria.
Results: From 1st of May to 30th of November 2014, 523 women were included in the study. Eight SSI were identified, yielding an SSI rate of 1.5 infections/100 (95% CI 0.5-2.6). All of them were detected during post-discharge surveillance. Mean hospital stay was four days, while mean time between CS and SSI diagnosis was 12 days. Lost to follow-up rates were 39%, 57%, 89% after seven days, 15 days, and 30 days, respectively. The most common pathogen isolated was methicillin-resistant Staphylococcus aureus (MRSA).
Conclusions: Post-discharge surveillance system is crucial to detect and treat SSI. Efforts should be made to optimize post-operative follow-up and measures should be taken to mitigate the spread of MRSA.
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