Distribution of pathogens isolated from cesarean section puerpera with postoperative infection and influencing factors
OBJECTIVE To explore the distribution of pathogens and influencing factors for postoperative infection in the cesarean section puerpera.METHODS The clinical data were retrospectively collected from 2 048 cesarean section puerpera who were treated in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and Yiyang Maternal and Child Health Hospital from Jan 2020 to Dec 2022.The enrolled puerpera were divided into the infection group with 102 cases and the non-infection group with 1 946 cases according to the status of postoperative infection.The prevalence of postoperative infection,infection sites and species of pathogens were statistically analyzed.Multivariate logistic regression analysis was performed for the influencing factors for the postoperative infection.The levels of inflammatory factors and stress indexes were observed and compared be-tween the two groups before the surgery and after the surgery for 72 hours.RESULTS The incidence of postopera-tive infection was 4.98％among the cesarean section puerpera.The puerpera with incision infection accounted for 47.06％,the puerpera with urinary system infection 24.51％,the puerpera with respiratory system infection 18.63％,the puerpera with genital system infection 8.82％,the puerpera with abdominal infection 9.80％.To-tally 133 strains of pathogens were isolated;Escherichia coli,Pseudomonas aeruginosa,Enterococcus and Staph-ylococcus epidermidis were the major species of pathogens causing the infection.Body mass index(BMI),prema-ture rupture of membranes,amniotic fluid contamination,complication with gestational diabetes mellitus,anes-thesia duration no less than 1 hour and intraoperative blood loss volume were the independent risk factors for the postoperative infection in the cesarean section puerpera(P＜0.05),preoperative prophylactic use of antibiotics was the protective factor for the postoperative infection(P＜0.05).The levels of serum interleukin(IL)-6,IL-10,no-radrenaline(NE)and cortisol(COR)of the two groups were higher after the surgery for 72 hours than before the surgery,and the levels of abode indexes of the infection group were higher than those of the non-infection group(P＜0.05).CONCLUSION The incidence of postoperative infection is relatively high among the cesarean section puerpera.The infection sites include the incision,urinary system,respiratory system,genital system and abdomi-nal cavity.E.coli,P.aeruginosa,Enterococcus and S.epidermidis are the predominant species of pathogens causing the infection.There are a variety of influencing factors for the infection.The postpartum infection may lead to the rise of levels of inflammatory factors and stress indexes and affect the prognosis.
NETL
NSTL
万方数据
维普
