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Uncommon Bacteria Causing Inflammation of the Surgical Site of a Caesarean Section

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Uncommon Bacteria Causing Inflammation of the Surgical Site of a Caesarean Section Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 12561 - 12575 Received 25 April 2021; Accepted 08 May 2021. Uncommon Bacteria Causing Inflammation of the Surgical Site of a Caesarean Section *Nedaa Yaseen Taha *Laith Mosleh Najeeb * University of Anbar/college of science/department of biology, Anbar, Iraq. Abstract Lower segment caesarean section is a common mode of delivery now and surgical site infection is the second most common infectious complication in these patients. Surgical site infection plays an important role in the development of chronicity, delaying wound healing. This study aimed to identify the bacterial pathogens present in infected wounds and characterize their resistance profile to the most common antibiotics used in therapy. Definessurgical site infection as an infection occurring within 30 days from the operative procedure in the part of the body where the surgery took place. Incisional SSI is further divided into superficial, and deep Surgical site infection,(61) isolates were obtained from the study, and the common isolates occupied the largest number in our study by (54.1%). As for the uncommon isolates, 28 bacterial isolates were shown at a rate (45.9%), as it was found that Morganella morganaii, Streptococcus agalatica bacteria accounted for 7 isolates, at a rate of (25%), It was followed by Acinetobacter baumannii with 5 isolates (17.9%), Staphylococcus lugdunensis with 2 isolates (7.1%), Sphingomonas paucimobilis, Methylobacterium spp., Staphylococcus lentus, Staphylococcus homini, Staphylococcus haemolyticus, Bacillus cereus ,Burkholderia cepacia One at a rate of (3.6%).The results showed the sensitivity of most of the uncommon isolates to ciprofloxacin, Colistin , Levofloxacin, Amikacin, while most of them showed high resistance to Ampicillin / cloxacillin, Amoxicillin / clavulanic acid, cefixime, and the bacteria differed from their sensitivity to the antibioticsAzithromycin, Ceftriaxone,Piperacillin, Cefoxitin ,Trimethoprime/Sulfamethoxazole , The uncommon positive Gram stain is more resistant than the uncommon Gram-negative bacteria, especiallyStreptococcus agalatica, whose isolates showed high resistance to antibiotics. Introduction Cesarean section It is a procedure performed by obstetricians to remove the infant through the incision of the abdomen and the mother's womb instead of the vagina, and http://annalsofrscb.ro 12561 Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 12561 - 12575 Received 25 April 2021; Accepted 08 May 2021. it is one of the mostcommon operations in the world (Martin, 2017) . The rise in caesarean section rates has agreat effect on infection. Surgical sites (Osterman et al., 2015), are considered major surgeries as they come with the same risks,including inflammation of the surgical site asOther types of surgery, one-third to two-thirds of patients who undergo cesarean sections in low-income countries are infected with a surgical site infection, which is nine times higher than in high-resource countries(Lijaemiro et al., 2020) . Bacteria are one of the main and important causes of inflammation, and the bacteria vary between bacteria The common and uncommon bacteria (T Fernández & Hancock, 2012), and there is a low presence bacteria (which is not common), where bacteria have been found in some genera of uncommon aerobic bacteria that cause inflammation at the surgical site of caesarean section. -Morganella morganii, a Gram-negative bacillus(Al-Douri & Maaroof, 2018). It is an anaerobic facultative bacterium. It grows as flat and colorless colonies from 2 to 3 mm on MacoConkey agar and blood agar and Morganella morganii is considered an opportunistic pathogen. Due to the optional pressure of widely used antibiotics significantly accelerating bacterial development(Liu et al., 2016) (Fernández & Hancock, 2012), it causes postoperative wound infection and is a cause of hospital infection in adults. -Sphingomonas paucimobilis:- is a motile aerobic bacterium with polar flagella at 22 ° C and not moving at 37 ° C, non-fermented, Gram-negative bacillus, growing on blood agar and chocolate agar, and not growing on MacConkey agar or selective bacteria media Intestinal. With Oxidase positive and Catalase positive, Urease negative, Indole negative, DNAase negative(Mahon et al., 2018), they are found in the natural environment, they were isolated from water, soil and hospital equipment and cases of infection are due to contaminated solutions suchas distilled water and dialysis means(Maragakis et al., 2009). - Methylobacterium spp.:- It isaerobic bacteria a slow-growing compulsive aerial bacterium that takes 5-7 days. It grows best on medium dextrose agar sabouraud, buffered charcoal yeast extract agar, and it is a gram-negative bacterium, moving in the form of a rod and having a single polar flagellum, not fermented, CatalasePositive, oxidase positive weak, negative for the nitrate reductase test, positive for urease(Kovaleva et al., 2014). Itgrows in small colonies with a pinkish pigment and mucus on solid media such as solid blood medium and solid nutrient agar and does not grow onMacConkey agar. It is an opportunistic pathogen for humans and is a http://annalsofrscb.ro 12562 Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 12561 - 12575 Received 25 April 2021; Accepted 08 May 2021. cause of health care-related infections, especially in immunocompromised patients(Pathogens, 2020). - Acinetobacter baumanii:- is one of the opportunistic pathogens as one of the most dangerous pathogens in health care facilities,facultative anaerobic bacteria, the most common species that causes infection due to its possession of virulent factors results in hospital-acquired infections (Drummond, 2010), growing on solid blood and MacConkey agar In the form of mucous white-gray colonies with a diameter of 1.5 to 3 mm, it is a gram-negative bacillus bacteria in the form of nearly round rods, facultative non-fermented anaerobes of lactose sugar, oxidase negative , catalase positive, citrate positive, non-motile(Ahmad et al., 2020). - Burkholderia cepacia:- Gram-negative bacillus, aerobic, non-fermented lactose, Catalase positive, Oxidase positive weak, transported through a polar flagellum(Pollini et al., 2018), growing on the medium of MacConkey agar and the medium of, Burkholderia cepacia is an opportunistic pathogen in hospital patients(Tavares et al., 2020).. - Coagulase-negative staphylococci: - Its cells are arranged in clusters and can be seen single or double, and are positive for a chromium pigment, and the spores do not form, do not move, and do not form flagella growing in Optional anaerobic conditions (Baker et al. 2011). It consists of S. lugdunensis,S. epidermidis, S. lentus, S. hominis, S. haemolyticus and others called coagulase-negative staphylococci, which affect human diseases, especially in hospitals, they do not produce a free coagulase, where there is a bound factor. Coagulase is an extracellular fibrinogen binding protein and extracellular adhesion protein that binds fibrinogen or fibrin and does not cause coagulation (Argemi et al., 2017). - Streptococcus agalactiae :- It is a harmless,facultative anaerobic bacteria symbiotic bacteria that colonizes the gastrointestinal and genitourinary systems of up to 30% of healthy adults in colonial women. S. agalactiae is important because it precedes invasive diseases and spontaneous abortions(Cumley, 2012). And they appear under the microscope after staining Gram stain in the form of non-motile, spherical, gram- positive chains or pairs surrounded by a capsule that is not spores, Catalase test negative, positive CAMP test which is important for determining the synergy of each S. agalactiae with S. aureus(Carrillo-Ávila et al., 2018)as for GBS colonies in women who are at risk of miscarriage and premature labor during pregnancy(Esleem, 2017). http://annalsofrscb.ro 12563 Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 12561 - 12575 Received 25 April 2021; Accepted 08 May 2021. - Bacillus cereus:- is a facultative anaerobic bacteria that grow on solid blood medium, a beta-type hemolytic, and grow on an optional medium such as mannitol- egg yolk-polymyxin (MYP) (Griffiths & Schraft, 2017), are Gram-positive bacteria , bacilli, motile, Formed for citrate, positive for vogse-proskauer, positive for nitrate reduction, positive for citrate, causing skin infections(Wu et al., 2019). Antibiotics are known as organic compounds produced by certain types of microorganisms, naturally or synthesized and these materials, in small concentrations, can kill or inhibit other microorganisms, through the first two mechanisms, which impede the structural integration as it prevents the building of the plasma membrane and the cell wall, and the second metabolic structure such as the building of acids The nuclear industry and the various proteins that play a major role in the life of the bacterial cell(BALAT & HILL, 1999). In the study, antibiotics from different families were used to demonstrate the effect of antibiotics on bacterial growth, and large groups of antibiotics were used, including Beta-lactum. These groups share a Beta-lactum ring, including the family of cephalosporins and penicillin(Sader & Jones, 2005).. Materials and methods of work Sample collection:-And 140 patients were followed up for an extended period from August 2020 to January 2021, and it was found that 26 patients suffered from inflammation of the surgical site during the follow-up of the patients for 30 days
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