Surgical-site infections (SSIs) following caesarean sections (CS) represent a significant health complication with a global prevalence between 5 and 10 percent. This issue is particularly prevalent in low- and middle-income countries (LMICs) due to limited access to medical surveillance and routine microbiology, often resulting in largely empirical antibiotic treatments. LMICs are disproportionately impacted, necessitating further research on common pathogens and resistance patterns.
The need for research is especially heightened when considering the rising trend of antimicrobial resistance (AMR), prominently in sub-Saharan Africa. This article is based on a prospective observational study examining bacterial pathogens, resistance profiles, and clinical outcomes of post-CS SSIs in Kampala, Uganda’s largest maternity hospital. A total of 66 women were enrolled for the study, which took place from May 2021 to January 2022.
Deep wound swabs discovered the majority of bacteria in these infections were multidrug resistant Gram-negative pathogens. This high proportion of carbapenem-resistant Acinetobacter spp. could indicate hospital-acquired infections, highlighting the need for stronger infection prevention and control measures.
Additionally, the World Health Organization’s (WHO) data show an upward trajectory of CS, contributing to an increased risk of SSIs. This risk is compounded by the reality that numerous factors—specific patient-related conditions, limited resources for perioperative and postoperative infection control, or the lack of adequate antibiotic prophylaxis—can exacerbate the occurrence and severity of these infections. The situation is further aggravated by an alarming surge in AMR, a predicament fuelled by the inappropriate usage of antimicrobials, coupled with insufficient infection prevention and control measures resulting in a reported 5 million deaths associated with AMR, predominantly in sub-Saharan Africa.
Consequently, understanding and identifying the bacterial pathogens and antibiotic resistance patterns involved in post-CS SSIs is critical for the development of an effective response to this health crisis, thus better informing treatment strategies and ultimately reducing associated morbidity and mortality.
Source: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-025-04101-7