Predictors bacterial isolates, and antibiotic susceptibility among women with surgical site infection following caesarean section at Amana regional referral hospital
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Date
2025
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Kairuki University
Abstract
Background:
Surgical site infection following cesarean section remain a common problem
contributing to significant morbidity and mortality, attributed partly to the emergency
nature of the surgical intervention and an increase in antimicrobial resistance among
the etiological agents. This study was done to explore the predictors, bacterial pattern
and antibiotics susceptibility among women giving birth by cesarean section at Amana
Regional Referral Hospital.
Methodology:
This was a prospective cohort study which included 151 women who underwent
cesarean section within 48 hours at Amana Regional Referral Hospital from March to
May 2025 who were then followed up for 30 days to see if they develop SSI.
Preoperative, intraoperative and postoperative data were collected by using a
structured questionnaire. Wound swab was collected and sent to the laboratory for
culture and sensitivity by following the standard operating procedures. Susceptibility
testing was carried out by using Kirby-Bauer disc diffusion technique. Data obtained
were analyzed using the SPSS version 26. Mean and standard deviation were used to
summarize continuous variables while categorical variables were summarized as
proportions. Both univariate and multivariate analyses were done and a p-value of less
than 0.001 was considered statistically significant.
Results:
This study found that 19.9% (30 patients) developed surgical site infections, with
superficial infections accounting for the majority—63.3% (19 cases) of all SSIs.
The study identified key risk factors for surgical site infections (SSI), including age
above 35 years (82.6%), BMI> (37.5%), and cesarean sections lasting more than one
hour (63.3%). Staphylococcus aureus (46.7%) was the most commonly isolated
pathogen, followed by coagulase-negative staphylococcus (23.3%). Among antibiotics
tested, Meropenem (71.4%) and Vancomycin (57.1%) were the most effective against
the isolates, while Ceftriaxone (85.7%), Amoxicillin (64.3%), and Ampicillin and
Cloxacillin (42.8%) showed poor effectiveness.
Conclusion:
The study identified several significant risk factors for surgical site infections (SSI),
including age above 35 years, multigravidity, and prolonged cesarean sections (lasting
more than one hour). The most frequently isolated pathogens were Staphylococcus
aureus and coagulase-negative staphylococci. Antibiotic susceptibility testing revealed
that Meropenem and Vancomycin were the most effective against the bacterial isolates,
whereas Ceftriaxone, Amoxicillin, and Ampicillin-Cloxacillin demonstrated poor efficacy.
Description
A dissertation submitted in partial fulfilment of the requirements for Master of Medicine in obstetrics and gynaecology of Kairuki university.
Keywords
surgical site infection, cesarean section, antibiotic susceptibility
Citation
Kullaya, Titus B. 2025. Predictors bacterial isolates, and antibiotic susceptibility among women with surgical site infection following caesarean section at Amana regional referral hospital. Dissertation. Kairuki University