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| Analysis of the risk factors of nosocomial infection of puerpera after cesarean section and the distribution and the drug-resistance of the pathogenic bacteria in susceptibility testing |
| 1. Ding 'an County People's Hospital, Ding 'an, Hainan Province, 571200；2. Hainan Provincial People's Hospital (Affiliated Hospital of Hainan Medical College), Haikou |
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Abstract To investigate the status and the risk factors of nosocomial infection of puerpera after cesarean section, and to provide the preventive measures for nosocomial infection. Methods: The clinical data of 3538 puerpera delivered by cesarean section from June 2018 to June 2022 were collected retrospectively. The puerpera were divided into group A (parturients with nosocomial infection)and group B (parturients without nosocomial infection)according to the situation of the nosocomial infection. The infection sites of the parturients were counted. And the pathogenic bacteria of the infection of the puerpera were cultured and analyzed, and the susceptibility testing of the pathogenic bacteria was conducted. The differences of the clinical data of the puerpera were compared between the two groups. And the influencing factors of the nosocomial infection of the puerpera after cesarean section were analyzed. Results: There were 274 (7.7%)puerpera with nosocomial infection after cesarean section. The main infection sites of the puerpera were surgical incision (31.8%), genitourinary system (29.6%), and upper respiratory tract (21.2%). The pathogenic bacteria of the infection of the puerpera were mainly gram-negative bacteria, such as Escherichia coli (29.5%), pseudomonas aeruginosa (23.4%), and Klebsiella pneumoniae (22.6%), and which all were sensitive to quinolones antibiotics. Multiple logistic regression analysis showed that the vaginal examination during labor ≥3 times, the hospital stay ≥7d, the pregnancy complications, the anemia, the gestational diabetes mellitus, the catheter used time ≥24h of the puerpera were all the independent risk factors of their nosocomial infection after cesarean section (P＜0.05). The high education level of the puerpera was an independent protective factor of their nosocomial infection after cesarean section (P＜0.05). Conclusion: The incidence of nosocomial infection of the puerpera after cesarean section is 7.74% in this investigation. The infection sites are mainly located in the surgical incision, urogenital system, and upper respiratory tract. The pathogenic bacteria of the nosocomial infection are mainly caused by gram-negative bacteria, and which are sensitive to quinolones. The frequency of vaginal examination during labor, the duration of hospitalization, the pregnancy complications, the anemia, and the gestational diabetes mellitus, the time of catheter used, and the educational level of the puerpera are all the factors influencing their nosocomial infection after cesarean section.
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