Prevalence, Bacterial Profiles and Factors Associated with Surgical Site Infection among Post-Operative Mothers at Kawempe National Referral Hospital, Uganda

Abstract

Muyingo Yusuf, Nakijoba Jawuhala, Nakwagala Frederick Nelson, Byaruhanga Emmanuel, Hassan Muhammad, Angwiunzi Alfred Koma, Enoch Muwanguzi, Olwee Isaac Eluma, Sempijja Fred, Buga Rudolf, Gumisiriza Robert, Nyiramahoro Salome, Ocan Moses, Abaasa Catherine and Rogers Kalyetsi

Background: Surgical Site Infections (SSI) pose a global threat of morbidity and mortality in patients undergoing all types of operations and account for a fifth of all healthcare-associated infections and about 12% of maternal deaths in developing countries Uganda inclusive, Due to this outrageous increased number of mothers failing to heal-off their surgical site, therefore the study focused on determining the prevalence of Surgical site infections, commonest pathogens causing sepsis, the associated factors and the antimicrobial susceptibility at Kawempe National referral hospital.

Methods: Across-sectional study conducted from Jan - April 2023, with 202 consented participants using purposive sampling were administered with Structured questionnaires to collect data on associated factors. Swabs were collected, transported at 2-8oc and inoculated on Blood Agar and CLED Agar microbial plates, incubated in carbon dioxide at 37°C for 18-24 hours and examined macroscopically for potential pathogens. Gram staining followed by suitable biochemical tests and susceptibility testing on Meuller Hinton Agar (incubated at 370c for 18-24hrs) of the fresh isolates were done. Zones of inhibitions were measured in millimeters using a ruler and interpreted according to the inhibition zone sizes against the standard chart.

Results: The prevalence of surgical site infection was 30.7%. Having multiple parities (p-value 0.013), being over weight (p-value <0.001), more than two Vaginal examinations (p-value 0.011), vertical type of incision (p-value 0.026), and failure to administer antibiotics before surgery (p-value 0.020) all had p-value <0.05. The most common organism was Staphylococcus aureus and was most susceptible to Clindamycin and Vancomycin.

Conclusions: The prevalence of post-Caesarean wound sepsis was 30.7% mostly attributed to by Staphylococcus aureus. Having multiple parities, being overweight, more than two Vaginal examinations, vertical type of incision, and failure to administer antibiotics before surgery were all significantly and positively associated with post-Caesarean wound sepsis.

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