Analysis of Risk Factors for Surgical Site Infection in Obstetric Surgeries at a Tertiary Care Hospital in South...

Surgical site infections (SSIs) are among the most common postoperative complications, contributing significantly to maternal morbidity and healthcare burden worldwide. Obstetric procedures, particularly cesarean sections, are prone to SSIs due to exposure to vaginal and enteric flora, patient comorbidities, and procedural factors. This study aimed to assess the incidence, risk factors, comorbidities, and microbiological characteristics of SSIs in obstetric surgical patients.

An observational, cross-sectional study was conducted over 12 months in the Department of Obstetrics and Gynaecology at Sree Balaji Medical College and Hospital, Chennai, India. A total of 300 women undergoing obstetric surgery were enrolled using a convenience sampling technique. Detailed demographic, clinical, and surgical data were collected. SSIs were defined according to the Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) criteria as infections occurring within 30 days postoperatively. Wound swabs from suspected SSIs were cultured, and antimicrobial susceptibility was determined. Statistical analysis was performed using chi-square tests, with p < 0.05 considered significant.

The overall incidence of SSIs was 20/300 (6.7%). Infection rates were higher in emergency surgeries, 16/222 (7.2%), compared to elective procedures, 4/78 (5.1%). Significant risk factors included age 30-40 years 10/80 (12.5%, p = 0.020), obesity 12/50 (24%, p = 0.001), diabetes mellitus 12/50 (24%, p < 0.001), preoperative vaginal discharge 7/23 (30.4%, p = 0.001), multiple vaginal examinations (>5) 12/50 (24%, p = 0.001), prolonged hospital stay (>14 days) 5/30 (16.7%, p = 0.008), and use of interrupted sutures 12/100 (12%, p = 0.018). The predominant microbial isolates were Escherichia coli 5/20 (25%) and MRSA 4/20 (20%), with 7/20 (35%) of cases showing no growth. Linezolid, amikacin, and gentamicin demonstrated the highest susceptibility.

SSIs remain a significant complication of obstetric surgery, particularly in high-risk patients and emergency settings. Optimizing maternal comorbidities, adhering to aseptic techniques, judicious antibiotic use, and implementing robust infection control strategies are essential to reduce SSI incidence and improve maternal outcomes.