[Controlling caesarean-site infection. Collaboration between the obstetric and hospital hygiene departments]

In 1998, the isolation of Staphylococcus aureus resistant to methicillin (MRSA) from a sample taken from a post-caesarean surgical site infection (SSI) led the obstetrics department to call upon the hospital hygiene team for assistance. A retrospective investigation of incidence in the files of 24 women with caesarean deliveries showed a SSI rate of 24%. These abnormally high figures led to an audit of hygiene practices during these deliveries.

To reduce the incidence of post-caesarean SSIs at Dreux Hospital Centre.

From 1999 through 2005, SSIs have been monitored according to the methods of the western France Coordinating Centre for Nosocomial Infections and the guidelines of ANAES in France and the U.S. CDC. The data were analysed by Epi Info 6, retrospectively.

Files of 1972 caesareans performed over a 6-year period were analysed. The SSI rate was 24% in 1999; it fell to 7.4% in 2000 and stabilized from 2003 through 2005 in the neighbourhood of 2.6%. More than 70% of our patients are re-examined within 2 weeks of delivery.

Close cooperation between the Obstetrics and Hospital Hygiene departments led to a dramatic reduction in SSI rates, to 2.6% (similar to the national rate), and its maintenance over a 3-year period. Implementation of the caesarean hygiene protocol has continued since 2006.