Bacterial etiology, antibiotic susceptibility pattern, and treatment modality of surgical site infections among post-caesarean delivery women: A 2019 cross-sectional study conducted in Iringa, Tanzania

Alphonce Alphonce Moyo 1, Alex Ernest 1, Athanase Lilungulu 1, Peter D Simchimba 2, Kornel Izidory Matheo 2 and Ipyana Mbaga Kajembula 2, *

1 Department of Obstetrics and Gynecology, Tumbi Regional Referral Hospital, Pwani, Tanzania.
2 School of Nursing, Muhimbili University of Health and Allied Sciences Dar es Salaam, Tanzania.
 
Research Article
International Journal of Science and Research Archive, 2024, 13(01), 2690–2701.
Article DOI: 10.30574/ijsra.2024.13.1.1938
Publication history: 
Received on 02 September 2024; revised on 13 October 2024; accepted on 16 October 2024
 
Abstract: 
Background: Surgical site infection (SSI) is a common complication after cesarean section in Tanzania, with high rates of infection and multidrug-resistant isolates reported. Understanding bacterial etiology and antibiotic susceptibility patterns is crucial for effective treatment and prevention. Therefore, this study aimed to determine the bacterial etiology, antibiotic susceptibility patterns, and treatment modalities of SSI among post-cesarean delivery women in the Iringa region.
Methods: A cross-sectional study involving 162 women with SSI was conducted across five hospitals in Iringa. Data on demographics were collected using a structured questionnaire, and wound discharge samples were taken for culture and sensitivity testing. Definitive treatment modalities were identified from patients’ files. Data analysis was performed using SPSS version 20, with chi-square tests used to identify associations, and a p-value < 0.05 considered significant.
Results: Among 162 participants, 59.7% had superficial SSIs and 35.2% had deep SSIs. Culture positivity was 96.3%, with 53.2% being gram-positive and 37.2% gram-negative. Staphylococcus aureus was the most commonly isolated pathogen (40.1%), with 64.6% of cases being methicillin-resistant (MRSA). Resistance to vancomycin and chloramphenicol among gram-positive isolates was 3.1% and 13.8%, respectively. Non-surgical management was provided to 58% of the participants, while Staphylococcus aureus infections were significantly associated with surgical intervention (OR = 1.38, p = 0.001).
Conclusion: Staphylococcus aureus, particularly MRSA, was the most prevalent pathogen in post-cesarean SSIs. Antibiotic resistance was common, and surgical intervention was significantly associated with Staphylococcus aureus infections.
 
Keywords: 
Surgical site infection; Caesarean section; Wound Infections; Resistance
 
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