Post-Caesarean Wound Infections: Incidence, Bacterial Profiles, Antimicrobial Susceptibility Patterns and Associated Factors in Public Hospitals, Southern Ethiopia

Abstract

Post-caesarean wound infections are a maternal health concern associated with increased morbidity and extended hospital stays, mainly caused by drug-resistant pathogens. A prospective cross-sectional study was undertaken in the title public hospitals among pregnant women who had undergone Caesarean section (CS). All women were followed up for 30 days, and those who developed a clinically infected wound (i.e., 204) were included in the bacteriological analysis. A pre-tested questionnaire was used to collect the data. Wound samples were collected to identify bacteria as per the microbiological guidelines. Antimicrobial susceptibility profiles were determined by the Kirby–Bauer disk diffusion method. Of the 204 samples, 85.78% (175/204) were culture-positive, yielding 203 bacteria. Staphylococcus aureus predominantly caused wound infections (n = 65, 32.01%), followed by Klebsiella pneumoniae (n = 54, 26.6%). Gram-negative bacilli were highly resistant to piperacillin, ceftriaxone, cefotaxime, and co-trimoxazole (> 85%), whereas Gram-positive cocci were highly resistant to penicillin and tetracycline (> 90%). Overall, 70.44% (n = 143) of isolates were multidrug-resistant. Parity [P = 0.01, AOR: 4.4, (CI: 1.40, 13.87)], previous CS [P = 0.0, AOR: 6.3, (CI: 3.10, 13.01)], diabetes mellitus [P = 0.05, AOR: 3.2, (CI: 2.1, 5.8)], and emergency CS [P = 0.05, AOR: 2.07, (CI: 1.06, 2.63)] were significantly associated with post-caesarean wound infections.