Factors Associated with Acquired Infections Caesarian Wounds in Maternity Mbuji-Mayi/DR Congo

Jean Christophe Bukasa^1*, Augustin Kadiata¹, Andre Guillaume Kabongo¹, Didier Lepelletier², Decas Blood Banza¹, Jean Jacques Bukasa¹, Félicien Ilunga³, Andre Mutombo⁴, Senghor Ngoyi Mbo⁵, Angelique Bandimuna⁵, Sébatien Kashimpo⁵, Alexis Ntambwe⁶, Stany Wembonyama⁷

¹Higher Institute of Medical Techniques of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo.
²Emerging Laboratory MiHAR, Faculty of Medicine, University of Nantes, Nantes, France.
³Higher Institute of Medical Technologies of Kinshasa, Kinshasa, Democratic Republic of the Congo.
⁴Official University of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo.
⁵Higher Institute of Medical Technologies of Kabinda, Kabinda, Democratic Republic of the Congo.
⁶Higher Institute of Kabinda, Kabinda, Democratic Republic of the Congo.
⁷School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.

DOI: 10.4236/oalib.1104437                

Abstract

Introduction: The purpose of this study is to analyze the factors associated with nosocomial infections of caesarean section wounds in the maternity hospitals of the city of Mbuji-Mayi. Methods: This study was conducted in 25 maternities of general referral hospitals, clinics and hospitals in the city of Mbuji-Mayi during the period from 1 February to 1 June 2017, out of 171 parturients cesarized that were followed during a period of 4 months. A survey questionnaire was used to collect the data. Results: Out of 171 parturients monitored, surgical site infection developed 52 (SSI), an incidence of 30.4%. After analysis, nine factors were identified as associated post-caesarean SSI in Mbuji-Mayi city (p ≤ 0.05): age (p = 0.000), anemia (p = 0.000), prolonged duration of labor delivery (p = 0.001), premature rupture of the membranes before caesarean section (p = 0.044), prolonged duration after-rupture of the membranes (p = 0.000), preparation of the operative site by shaving (p = 0.029), surgery by general practitioner (p = 0.023), duration of operation greater than 60 minutes (p = 0.040), non-compliance with asepsis during dressing (p = 0.000). Conclusion: The fight against nosocomial infections must be a permanent concern: the prevention and regular monitoring of these infections must be the control strategies of each hospital structure, under the watchful eye of a coordination center for the fight nosocomial infections.

Keywords

Factors, Nosocomial Infections, Caesarean Section Wounds

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Assawapalanggool, S., Kasatpibal, N., Sirichotiyakul, S., Arora, R. and Suntornlimsiri, W. (2016) Risk Factors for Cesarean Surgical Website Infections at Thai-Myanmar Border Hospital. American Journal of Infection Control, 44, 990-995. https://doi.org/10.1016/j.ajic.2016.01.031
[2]	Biltery, R. and Milord, F. (2008) Prevention of Nosocomial Infections, Also a Hot Topic in Developing Countries. Perceptive Nurse, 3, 20-26.
[3]	Borq, T.F., Ali, K.K., Salahaldeem, A.S. and Alkallaf, A.S. (2016) Impact and Risk Factors for Surgical Site Infection Following Cesarean Section in a Tertiary Care University Hospital. Journal of Evidence-Based Women’s Health, 6, 51-57. https://doi.org/10.1097/01.EBX.0000481362.51250.6c
[4]	Chu, K., Maine, R. and Trelles, M. (2015) Cesarean Section Surgical Infection Site in Sub-Saharan Africa: A Multi Country Study from Doctors without Frontiers. World Journal of Surgery, 39, 350-355. https://doi.org/10.1007/s00268-014-2840-4
[5]	De, D., Saxena, S., Mehta, G., Yadav, R. and Dutta, R. (2013) Risk Factor Analysis and Microbial Etiologies’ of Surgical Infection Site Following Lower Segment Caesarean Section. International Journal of Antibiotics, 2013, Article ID: 283025, 6 p.
[6]	Dupont, J., Ngowa, K., Ngassam, A., Tsuala Fouogue, J., Metogo, J., Medou, A. and Kasia, J.M. (2015) Early Complications of Cesarean Section: About 460 of These in Teaching Hospitals of Yaounde. Pan African Medical Journal, 21. http://www.panfarican-med-journal.com/article/21/165/fu
[7]	Césarine, L. (2016) The Consequences of Caesarean Section for the Mother: Risk of Surgical Site Infection. The Journal Obstetrics and Gynecology Research, 38, 509-515.
[8]	Jido, T.A. and Garba, I.D. (2012) Surgical Site Infection Following Cesarean Section in Kano. Annals of the Medical and Health Sciences Research, 2, 33-36. https://doi.org/10.4103/2141-9248.96934
[9]	Kabua, M. (2014) Incidence Year Determinants of Surgical Infection After-Site Caerean Delivery at Kenya National Hospital. Dissertation, University of Nairobi, Nairobi.
[10]	Mpogoro, F.J., Mshama, S.E., Mirambo, M.M., Kindenya, B.R., Gumodoka, B. and Imizalioglu, C. (2014) Incidence and Predictors of Surgical Site Infection Following Caesarean Section at Bugando Medical Center, Mwanza, Tanzania. Antimicrobial Resistance & Infection Control, 3, 25.
[11]	Opoien, H.K., Valbo, A., Grinde-Andersen, A. and Walberg, M. (2007) Post-Cesarean Surgical Website Infections to CDC Occording Standars: Rates and Risk Factors. Acta Obstetricia et Gynecologica Scandinavica, 86, 1097-1102.
[12]	Dahiya, P., Gupta, V., Prindir, S. and Chawla, D. (2016) Study of Impact and After-Risck Factors for Surgical Cesarean at First Referral UNIT. International Journal of Contemporary Medical Research, 3, 1102-1104.
[13]	Cunningham, F.G. (2002) Post Operative Complication in Operative Obstetrics. 2nd Edition, McGraw Hill, New York, 293-309.
[14]	Vincent, A. (2014) Nosocomial Infections in Women Delivered by Caesarean Section. http://cclinsudest.chulyon.fr/Reseaux/MATER/Journee/2014/CR_14
[15]	Malik, A.Z. and Ali, Q. (2014) Surgical Site Infections after Elective Surgery. Journal of Rawalpindi Medical College, 19, 209-214.
[16]	18Dhar, H., Al-Busaidi, I., Rathi, B., Nimre, E.A., Sachdeva, V. and Hamdi, I. (2014) A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital Oman. Sultan Qaboos University Medical Journal, 14, e211-e217.
[17]	Smail, F.M. and Mgrivel, R. (2014) Antibitic Prophylaxis versus No Prophylaxis for Infection Preventing After-Cesearen Section. Cochrane Data Base of Systemic Reviews, No. 10, CD007482. http://www.cochranelibrary.com
[18]	Tita, A.T., Stam, O.J., Grimes, A.M., Hauth, A. and Andrews, C.J. (2008) Impact of Extended-Spectrum Antibiotic Prophylaxis of Cesarean Incidence of Post Surgical Wound Infection. American Journal of Obstetrics and Gynecology, No. 199, 303-306. http://www.Ajog.org
[19]	Gong, S.P., Guo, H.X., Zhou, H.Z., Chen, L. and Yu, Y.H. (2012) Morbidity and Risk Factors for Surgical Site Infection Following Cesarean Section in Guangdong Province, China. The Obstetrics and Gynecology Research, 38, 509-515. https://doi.org/10.1111/j.1447-0756.2011.01746.x
[20]	Wloch, O., Wilson, J., Lamagni, T., Harrington, P., Charlett, A. and Scheridan, E. (2012) Risk Factors for Surgical Site Infection Following Caesarean Section in England: Results from a Multicenter Cohort Study. International Journal of Obstetrics and Gynecology, 119, 1324-1333.
[21]	Conroy, K., Yu, Y.H., Courtney, A., Lee, H.J. and Norwitz, E.R. (2012) Infectious Morbidity After-Cesarean Delivery 10 Strategies to Reduce Risk. Obstetric and Gynecology Reviews, 5, 69-77.