Microbial and Antibiogram of Post Caesarean Section Puerperal and Wound Sepsis at a Teaching Hospital in Southern Nigeria

Abstract

Background: Post caesarean section puerperal sepsis is a very challenging condition to the parturient and health care system. When this occurs in combination with wound sepsis, the burden can be devastating. Aims: To identify the microorganisms involved in post caesarean section puerperal and surgical site wound sepsis as well as to determine their antibiotics susceptibility at the University of Port Harcourt Teaching Hospital. Methodology: This was a prospective cross-sectional study of 50 parturients whose caesarean sections were complicated by puerperal and wound sepsis at the University of Port Harcourt Teaching Hospital. The study population was made up of booked, unbooked, as well as referred patients whose caesarean sections were complicated by puerperal and wound sepsis. Wound and intracervical swabs were taken from each participant once a clinical diagnosis was made. A data collection tool was used to obtain socio-demographic information and risk factors for post caesarean section puerperal and wound sepsis. Data was analyzed with Statistical Package for Social Sciences version 25. Continuous variables were summarized using means and standard deviations. Statistical significance was set at p ≤ 0.05. Results: Staphylococcus aureus was the predominant pathogen responsible for post-caesarean section puerperal and wound sepsis in both intracervical and wound swabs, with a prevalence of 44% and 36%, respectively. Sensitivity pattern revealed that gentamicin was sensitive to both intracervical and wound swab cultures accounting for 44 (88%) and 26 (52%) respectively. Unbooked status and prolonged rupture of membranes were significantly associated with post caesarean section puerperal and wound sepsis accounting for 42 (84%) and 32 (64%) respectively. Conclusion: The study demonstrated a significant relationship in the microbial and antibiogram in post caesarean puerperal and wound sepsis. The predominance of S. aureus and K. pneumoniae, and the high sensitivity to gentamicin and ciprofloxacin, highlights the need for targeted empirical therapy in this population.