Etude comparative des infections du site opératoire : césarienne systématique versus césarienne itérative au centre de sante de référence de la commune V du district de Bamako/Mali

Aim: The objective of this study was to determine the frequency, clinical and therapeutic aspects of surgical site infections (SSI) in iterative caesareans (cicatricial uteri) versus systematic caesareans (healthy uteri). Material and method: A retrospective and comparative study was performed from January 1, 2013 through December 31, 2017. All cases of iterative and systematic cesarean section with surgical site infections were included. The data analysis was performed on the SPSS software. Chi Square with a significant threshold of p <0.05 was used. Results: Among a total of 10281 Caesareans, 4318 were iterative and 5923 systematic. Surgical site infections were found in 540 (5.25%) including 180 iterative and 360 systematic (p = 0.0000). The mean age was 26 years. In accordance with the policies, standards and procedures in force in Mali, all patients with caesarean have systematically received amoxicillin on antibiotic prophylaxis. Superficial suppuration was found in 115 (64%) cicatricial uteri versus 192 (53.33%) healthy uteri (p = 0.019). Altemeier risk class II was present in 170 (94.44%) cicatricial uteri and 304 (84.44%) healthy uteri with p = 0.000. These same cases had zero score of NNISS. Staphylococci sp and Escherichia coli were isolated, respectively, in 31.44% (77) and 16.94% (53). Antibiotic therapy was adapted to the susceptibility test result. The mean time of hospitalization was 17.5 days. No maternal death related to SSI was recorded. Conclusion: The post-cesarean SSI remains high in commune V of Bamako