The Causes of sepsis after Caesaråan section and determination of antibiotic sensitivity / Монголын Анагаах Ухаан

ABSTRACT

Background. Puerperal infection following caesarean section remains a major cause of maternalmorbidity and mortality. It is still one of actual problems in Obstetrics and has incidence rate 2-10%. It isestimated 150 000 maternal deaths due to infection worldwide, despite tendency to decline septicemiaafter C-section due to wide usage of antibiotics in the obstetric practice, postpartum infection hasincreased last decade. Post-Caesarean sepsis incidence rate is above 20%. An assortment of pathologicagents may cause puerperal infection including bacteria, virus and parasites. In 30-40s of last centurymain reason of infection was Streptococcus, then in 40-60s major role was played by Staphylococcus,later in 70-80s Gram-Negative Aerobic Bacteria took its place.Objective. To improve prevention and treatment of post-caesarean sepsis by detection of its causes andantibiotic sensitivity. Materials and methods: We reviewed patients admitted to First Maternity Hospitaland National Center for Maternal and Child Health and who had post-caesarean sepsis between 2011-2013. Statistics analysis had been performed by SPSS-17 software programme, whereas statisticsprocess by X2 test, Fisher test, and t-test. Confi rmation rate was 95%. P<0, 05.Results. The clinical course of 361 post-caesarean patients with septicemia was reviewed prospectively.Primary dysfunctional labour (P<0.033), preterm rupture of the membranes (P<0.0001), ineffectivelabour induction (P<0.001) are risk factors for infectious morbidity. Considerations should be given toprophylactic antibiotic therapy by choosing correct medicine at the correct time. E.coli 29,4%, Intestinalbacteria 9,1%, Staphylococcus epidermis’s 8,9%, Staphylococcus aureus 7,2%, Gram-NegativeBacteria 6,6%, Streptococcus 5,3%, Gram-Positive Bacteria 2,8%, Candida albicans 1,4%, Micoplasma1,1% were responsible for bacteremia, respectively.Conclusion. Bacteriology of all patients diagnosed with post-caesarean sepsis in 74, 7% was positivefor pathologic bacterial cultures. Infection caused by 1 bacteria in 141 cases (39, 1%), by 2 bacteria in 56cases (15, 5%), by 3 bacteria in 2 cases (0, 6%), without any detection of bacteria 162 cases (44, 9%).