Inquiry report in Sivapriya’s death rules out hospital-acquired infection

A four-member inquiry committee which had been set up to investigate the death of a 26-year-old woman, Sivapriya, following post-partum sepsis has ruled out the possibility that the woman could have acquired the infection from the labour room at the SAT hospital.

The committee, headed by Sangeetha Menon, Head of the department of Obstetrics and Gynaecology at the Alapuzha Government Medical College Hospital, has reported that Sivapriya had died of sepsis due to bacterial infection caused by Staphylococcus aureus.

The committee has reported that there is no chance that the infection was hospital-acquired and that it had to be community-acquired.

The report was submitted to the Director of Medical Education on Friday, to be forwarded to the Health Minister.

Sivapriya, who had a normal delivery on October 22 at SAT, was discharged on October 24 and had been re-admitted with high fever, diarrhoea and in a state of septic shock on October 26th evening. Her death following sepsis on November 5 had triggered the allegation that the infection was hospital-acquired. This had been denied by SAT hospital authorities, who pointed out that there had been 17 deliveries on the same day as Sivapriya’s and several more in the days that followed and that none of the mothers had developed any health issues.

The committee report has validated what the SAT hospital authorities had maintained, that as a hospital with LaQshya quality accreditation (a labour room quality certification from National Quality Accreditation Standards), infection control protocols were maintained strictly by the SAT hospital. All surface culture swabs taken from the labour room by the Microbiology department as part of infection control protocols just two days before Sivapriya’s delivery had certified the labour room as sterile.

Doctors at the SAT hospital said that hygiene in the post-partum period was extremely important to prevent infections, especially when the wound ( episiotomy) was fresh. The case sheets at the time of her re-admission to the hospital notes that she had fever and diarrhoea. While it is possible that the wound could have been infected through soiling, there was no way to pinpoint anything.

Doctors said that though blood culture reports had initially not yielded any results, the blood culture report on November 4 had confirmed Staphylococcus aureus infection (pus samples from the episiotomy site on culture had earlier showed the presence of Acinetobacter).

“Practising good hygiene is important in the post-partum period to prevent infections. Staphylococcus infection can present as diarrhoea. Host immunity is an important factor that can affect the outcome,” a senior doctor said.