[Incidence and risk factors of surgical site infection following caesarean section in a Tunisian maternity unit].

INTRODUCTION: Surgical site infection (SSI) is a major health concern and is one of the most common complications following caesarean section, with an incidence of 3%-15%. With the worldwide increase in caesarean section rates, the incidence of SSI is expected to increase in parallel. This study was designed to estimate the incidence and determine the risk factors of SSI after caesarean section in an Obstetrics and Gynaecology department in the Kairouan region in Tunisia.

METHODS: A prospective cohort study of all patients who delivered by caesarean section between December 2015 and February 2016 was conducted in the Kairouan Obstetrics and Gynaecology department. The clinical status of these women was monitored during the 30-day postoperative period (in the outpatients department, emergency room or they were contacted by phone). A multivariate logistic regression model was used to identify risk factors.

RESULTS: Of the 714 patients admitted for caesarean delivery, 636 (89%) were monitored for 30 days. Thirty-two of these women were diagnosed with SSI, corresponding to an incidence of 5% (95% CI = 3.3%; 6.6%). 87.5% (n = 28) of SSI were superficial and 12.5% (n = 4) were complex (deep and organ/space). Multivariate logistic regression analysis identified the woman's age as a risk factor of SSI (RR = 1.07 for every year increment, 95% CI = 1.007; 1.17), whereas drainage was identified as a protective factor (RR = 0.16, 95% CI = 0.05; 0.48).

CONCLUSION: This study identified the incidence and risk factors of postoperative infection following caesarean section. Prevention of these infections should be a public health priority.