Profile of Aerobic Bacteria in Surgical Site Infection Following Caesarean Section and Antibiotic Susceptibility Pattern in Silchar Medical College, India

BACKGROUND Caesarean section is one of the most common surgeries performed in women of reproductive age group. Postoperative surgical site infection (SSI) is the third most frequently reported nosocomial infection. Recovery after caesarean section can be more demanding for a woman who develops a post-operative surgical site infection that can even lead to death. Surveillance of surgical site infection is an important infection control activity. A better understanding of the spectrum of pathogens causing SSI as well as their susceptibility pattern is important for prompt management of patients. The main objectives of this study were to identify the bacterial agents causing postoperative wound infection in caesarean section, as well as determine the in-vitro antimicrobial susceptibility pattern of different bacterial isolates and also to examine the risk factors of postoperative caesarean infection. METHODS This is an observational (cross sectional study) where 100 cases of postoperative caesarean section wound infection admitted in the Department of Obstetrics & Gynaecology ̦ Silchar Medical College were studied. Pus samples were collected and cultured, and the pathogenic isolates were tested against different antimicrobial agents by standard disc diffusion method (Kirby-Bauer method) as per the recommendation of Clinical and Laboratory Standard Institute (CLSI) guidelines. RESULTS The study revealed Staphylococcus aureus 38.1 % of which 21.9 % were methicillin resistant (MRSA), as the most common organism responsible for SSI followed by Escherichia coli 23.8 % and Klebsiella pneumoniae 16.7 %. Staphylococcus aureus was 100 % sensitive to vancomycin and linezolid 78.1 % and 71.9 % sensitive to erythromycin and ciprofloxacin respectively. The most sensitive antimicrobials for Gram negative isolates were polymyxin B 96.2 %, imipenem 94.2 % and ciprofloxacin 76.9 %. Emergency C-section (83 %), premature rupture of membranes (PROM) 30 %, prolong labour 26 %, history of previous caesarean section 22 %, anaemia 15 % cases and BMI ≥ 25 (16 %) were found to be risk factors. CONCLUSIONS The findings of preponderance of Staphylococcus aureus and Gram negative bacilli in this study with good antibiotic sensitivity against the fluoroquinolone and aminoglycosides is of local clinical relevance. KEY WORDS Caesarean Section, Surgical Site Infection, Antimicrobial Susceptibility Pattern, Bacterial Isolates, MRSA Strains