Pathogenic bacteria distribution and related factors of incision infection after lateral perineal incision of parturients

Abstract

Objective To investigate the distribution characteristics of pathogenic bacteria of perineal incision infection in parturients, and to analyze the risk factors of perineal incision infection in parturients, to provide guidance for the prevention and treatment of perineal incision infection. Methods Total of 461 parturients who underwent lateral perineal incision in Kaizhou District People’s Hospital from March 2014 to October 2018 were selected for retrospective analysis. According to the results of bacterial culture, the parturients were divided into infection group (46 cases) and uninfected group (415 cases). The types and proportion of pathogenic bacteria in incision infection after lateral perineal incision were analyzed. The risk factors affecting the infection of lateral perineal incision were analyed by Logistic unconditional regression analysis. Results The infection rate of lateral episiotomy incision was 9.98% (46/461). A total of 43 strains were detected. Gram-negative bacteria accounted for 53.49% (23/43), Gram-positive bacteria accounted for 39.53% (17/43). Escherichia coli and Staphylococcus epidermidis were the main pathogens of lateral episiotomy incision infection. The detection rates were 25.58% and 23.26%. There were 54.35% (25/46) of parturients had two or more pathogenic bacteria infection. Univariate analysis showed that maternal BMI, number of vaginal examinations, premature rupture of membranes, labor process, incision length, length of midwives’ working life, hospital stay after operation, gestational diabetes mellitus and genital tract infection were related (all P 0.05). Logistic regression analysis showed BMI (OR = 2.282, 95%CI: 1.958-8.265, P < 0.001), number of vaginal examinations (OR = 1.855, 95%CI: 1.065-4.682, P = 0.002), premature rupture of membranes (OR = 2.085, 95%CI: 1.730-7.165, P < 0.001), reproductive tract infection (OR = 2.732, 95%CI: 2.015-10.562, P = 0.015), gestational diabetes mellitus (OR = 3.337, 95%CI: 2.356-12.526、P < 0.001), labor process (OR = 1.714, 95%CI: 1.305-4.928, P < 0.001) were independent risk factors for perineal incision infection. Conclusions Infection rate of perineal incision is higher in parturients affected by many factors, Escherichia coli and Staphylococcus epidermidis were the main pathogens.Clinical targeted measures should be taken to increase the risk factors of incision infection in order to reduce the rates of incision infection after perineal lateral resection. Key words: Lateral perineal incision; Incision infection; Pathogenic bacteria; Influencing factors