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The most important source of micro-organisms responsible forpost-cesarean section infection is the genital tract, particularly if the membranes are ruptured. Even in the presence of intact membranes,microbial invasion of the intrauterine cavity is common,especially with preterm labour (Watts 1992). Infections are commonlypolymicrobial. Pathogens isolated from infected woundsand the endometrium include Escherichia coli and other aerobicgram negative rods, Group B streptococcus and other streptococcusspecies, Enterococcus faecalis, Staphylococcus aureus and coagulasenegative staphylococci, anaerobes (including peptostreptococcusspecies and Bacteroides species), Gardnerella vaginalis andgenital mycoplasmas (Watts 1991; Roberts 1993; Martens 1995).AlthoughUreaplasma urealyticumis very commonly isolated fromthe upper genital tract and infected wounds, it is unclear whetherit is a pathogen in this setting (Roberts 1993). Wound infectionscaused by Staphylococcus aureus and coagulase negative staphylococciarise fromcontamination of the wound with the endogenousflora of the skin at the time of surgery (Emmons 1988).
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