2016, Number 1
Surgical site infection in puerperal women with caesarean
Language: Spanish
References: 21
Page:
PDF size: 281.40 Kb.
ABSTRACT
Introduction: Puerperal infection as an expression of infection associated with healthcare is one of the major complications of obstetric patients.Objective: Characterize microbiological and epidemiologically patients with caesarean section wound infection and positive bacteriological culture.
Methods: A descriptive, prospective and cross-sectional study was conducted at, "Dr. Juan Bruno Zayas Alfonso" Hospital from November 2013 to November 2014. The study sample consisted of 69 caesarean postpartum women, infected wounds and performed bacteriological studies. The sample comprised 62 patients in which the infectious agent was isolated. Ethological agents and their antimicrobial resistance were identified. Epidemiological variables were operationalized.
Results: The study revealed wound infection in 4.9 % of caesarean sections performed. It prevailed monomicrobial infections (88.7 %), by Gram-positive bacteria (59.4 %). Staphylococcus aureus was the predominant organism (42.02 %). The presence of multidrug-resistant agents was showed: methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and beta-lactamase producing Enterobacteriaceae. Anemia (87.1 %), preoperative stay more than three days (82.3 %), insufficient weight gain (33.9 %) and diabetes mellitus (27.4 %) were the main risk factors identified. Urgent caesarean sections predominated (91.9 %), with clean contaminated wounds (93.5 %) and superficial incisional infections (53.2 %). The wound dehiscence was observed in 74.2 % of patients.
Conclusions: The presence of modifiable and controllable risk factors in pregnant women conditions the occurrence of infections, which imposes adequate prenatal care, the compliance of protocols for infection prevention and continuous epidemiological surveillance, allowing accurate diagnosis and early treatment.
REFERENCES
Calderón León MF, Calle Morillo LV, Jaña Lozada JR, Parodi R, Hidalgo L. Infección puerperal poscesárea vsinfección puerperal posparto en el hospital ginecoobstétrico Enrique C. Sotomayor. Rev Med FCM-UCSG. 2011 [citado 2014 Mar 22];17(4):238-43. Disponible en: https://www.google.com.cu/search?sclient=psyab& site=&source=hp&q=Rev.+Med.+FCM-UCSG.2011%3B+17+%284%29%3A238- 243&btnG=Buscar
Cruz Briz EF. Características clínicas de las pacientes obstétricas con infección de heridas quirúrgicas en el Hospital de la Mujer. 2010. Tesis para optar por el título de especialista en Ginecología y Obstetricia. [Artículo en Internet]. 2010[citado 2014 Oct. 8]. Disponible en: http://bdigital.dgse.uaa.mx:8080/jspui/bitstream/123456789/51/1/329248.pdf
Aguiar da Cruz L, Vieira Freitas L, Moura Barbosa RC, De Souza Gomes LF, Teixeira Vasconcelos CM. Infección de herida operatoria tras cesárea en un hospital público de Fortaleza. Rev Electrón Trimestral Enferm. 2013[citado 2014 Mar 15];(29):105-17. Disponible en: http://www.repositorio.ufc.br/bitstream/riufc/6759/1/2013_art_ctmvasconcelos1.p df
Padgett D, Tulio Luque M, Rivera DM, Zepeda LM, Hernández AL. Vigilancia de infecciones nosocomiales: experiencia en hospital de especialidades del Instituto Hondureño de Seguridad Social, 2006-2012. REV MED HONDUR. 2013[citado 2014 Mar 15];81(2-4):68-72. Disponible en: http://www.google.com.cu/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rj a&uact=8& ved=0CBwQFjAA&url=http%3A%2F%2Fwww.bvs.hn%2FRMH%2Fpdf%2F2013%2Fpdf %2FVol81-2-4-2013- 3.pdf&ei=H0jKVNuQMYP2yQS20oH4Dg&usg=AFQjCNFtdrWSETPtYQTHUwOm95XzJ61A yA&bvm=bv.84607526,d.aWwArial, Helvetica, sans-serif" size="2">
Pérez Tapia AG, Sánchez Vázquez M, Bautista Mata DC, Mendosa Charcas R, Fragoso Morales LE, Velarde del Río LT, et al. Prevalencia de infección de herida quirúrgica, causas y resistencia a los fármacos en el hospital General de zona núm. 2 del IMSS, San Luis Potosí. Rev Esp Méd Quir. 2012 [citado 2014 Mar 15];17(4):261-5. Disponible en: http://www.redalyc.org/articulo.oa?id=47325181004
Gádor Manrique MF, González A, Aceituno l, González V, Redondo R, Mauro Aisa l, et al. Incidencia de infección nosocomial quirúrgica en ginecología y obstetricia en un hospital comarcal. Rev Chil Obst Ginecol. 2013[citado 2014 mar 26];78(5):344-5. Disponible en: http://www.scielo.cl/scielo.php?pid=s0717- 75262013000500003&script=sci_arttext
Martínez Martínez L, Calvo J. El problema creciente de la resistencia antibiótica en bacilos gramnegativos: situación actual. Enferm Infecc Microbiol Clin. 2010 [citado 2014 mar 26];28(2):25-31. Disponible en: http://www.elsevier.es/es-revistaenfermedades- infecciosas-microbiologia-clinica-28-articulo-el-problema-crecienteresistencia- antibiotica-bacilos-gramnegativos-13188591
Ángeles Garay U, Morales Márquez LI, Sandoval Balanzarios MA, Velázquez García JA, Maldonado Torres L, Méndez Cano AF. Factores de riesgo relacionados con infección del sitio quirúrgico en cirugía electiva. Cir. 2014 [citado 2014 Dic 26];82(1):48-62. Disponible en: http://www.google.com.cu/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rj a& uact=8&ved=0CBwQFjAA&url=http%3A%2F%2Fwww.medigraphic.com%2Fpdfs%2Fcir cir%2Fcc2014% 2Fcc141g.pdf&ei=T03KVO_TN5ScyQTKkoHQAw&usg=AFQjCNFywYHrKATMLV06 AZIRzjnR6ARAIw& bvm=bv.84607526,d.aWw