Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis
Öz
Objective: The aim of this study is to evaluate the C-reactive protein (CRP) levels in vaginal washing fluid (VWF) in women with a history of recurrent and/or treatment resistant vaginitis. Methods: This prospective case control study was conducted in the gynecology clinic of the current hospital. A total of 64 women (33 with a history of recurrent and/ or treatment resistant vaginitis as study group and 31 healthy women as control group) were enrolled in the study. The recorded parameters were; age, presenting symptom, educational level, socioeconomic status, frequency of vaginal douching (VD), peripheral blood leukocyte count, CRP levels in VWF, vaginal culture, fresh vaginal smear and urinalysis. Results: The study group had statistically significantly lower educational level and socioeconomic status than the control group (p<0.05). The mean levels of peripheral blood leukocyte count and leukocyte count on the fresh vaginal smear, leukocyturia and VWF CRP levels were statistically significantly higher in the study group (p<0.05). In patients who had ≥ 3 times a week VD had also statistically significantly higher VWF CRP levels (p=0.012). Conclusion: According to this study, recurrent and/or treatment resistant vaginitis is more common in women who have lower socioeconomic status/educational level and who perform more frequently VD, and VWF CRP levels may be a good marker for the diagnosis of disease. J Clin Exp Invest 2015; 6 (1): 5-9 Key words: C-reactive protein, recurrent vaginitis, treatment resistant vaginitis, vaginal washing fluid
Anahtar Kelimeler
C-reactive protein recurrent vaginitis treatment resistant vaginitis vaginal washing fluid
Kaynakça
- Ramírez SA, Pereiro MJ, Toribio J. Recurrent vulvovaginitis:
- diagnostic assessment and therapeutic management.
- Actas Dermo-Sifiliográficas 2008;99:190-198.
- Sivaranjini R, Jaisankar T, Thappa D.M, et al. Spectrum of
- vaginal discharge in a tertiary care setting. Trop Parasitol
- ;3:135-139.
- Guzel AI, Kuyumcuoglu U, Celik Y. Vaginal douching practice
- and related symptoms in a rural area of Turkey. Arch
- Gynecol Obstet 2011;284:1153-1156.
- Shaaban OM, Youssef AE, Khodry MM, et al. Vaginal
- douching by women with vulvovaginitis and relation
- to reproductive health hazards. BMC Women’s Health
- ;13-23:1-6.
- Pepys MB, Hirschfield GM. C-reactive protein: a critical
- update. J Clin Invest 2003;111:1805–1812.
- Ni CY, Jia WX, Yi WM, et al. Practicability of using vaginal
- fluid markers in detecting premature rupture of membranes.
- Ann Clin Biochem. 2003;40:542-545.
- Torbé A, Czajka R. Are vaginal fluid procalcitonin levels
- useful for the prediction of subclinial infection in patients
- with preterm premature rupture of membranes? J Obstet
- Gynaecol Res 2005;31:464-470.
- Celik Y. Biostatistics, principles of research.2nd edition. Diyarbakir:
- Dicle University Press. 2007.
- Pavlova S.I, Tao L. In vitro inhibition of commercial douche
- products against vaginal microflora. Infect Dis Obstet
- Gynecol 2000;8:99-104.
- Brotman RM, Klebanoff MA, Nansel TR, et al. A longitudinal
- study of vaginal douching and bacterial vaginosis-a
- marginal structural modeling analysis. Am J Epidemiol
- ;168:188-196.
- Sutton M, Sternberg M, Koumans EH, et al. The prevalence
- of Trichomonas vaginalis infection among reproductive-age
- women in the United States, 2001-2004.
- Clin Infect Dis 2007;45:1319-1326.
- Heng L.S, Yatsuya H, Morita S, et al. Vaginal douching in
- Cambodian women: its prevalence and association with
- vaginal candidiasis. J Epidemiol 2009;20:70-76.
- Klebanoff MA, Nansel TR, Brotman RM, et al. Personal
- hygienic behaviours and bacterial vaginosis. Sex
- Transm Dis 2010;37:94–99.
- Eckert LO, Hawes SE, Stevens CE, et al. Vulvovaginal
- candidiasis: clinical manifestations, risk factors, management
- algorithm. Obstet Gynecol 1998;92:757–765.
- Corsello S, Spinillo A, Osnengo G, et al. An epidemiological
- survey of vulvovaginal candidiasis in Italy. Eur J
- Obstet Gynecol Reprod Biol 2003;110:66-72.
- Seña AC, Bachmann LH, Hobbs MM. Persistent and recurrent
- Trichomonas vaginalis infections: epidemiology,
- treatment and management considerations. Expert Rev
- Anti Infect Ther 2014;12:673-685.
- Schwebke JR, Muzny CA, Josey WE. Role of Gardnerella
- vaginalis in the Pathogenesis of Bacterial Vaginosis:
- A Conceptual Model. J Infect Dis 2014;[Epub ahead of
- print].
- Hillier S.L, Nugent R.P, Eschenbach D.A, et al. Association
- between bacterial vaginosis and preterm delivery
- of a low-birthweight infant. The Vaginal Infections and
- Prematurity Study Group. N Engl J Med 1995;333:1737–
- -
- Martin HL, Richardson BA, Nyange PM, et al. Vaginal
- lactobacilli, microbial flora, and risk of human immunodeficiency
- virus type 1 and sexually transmitted disease
- acquisition. J Infect Dis 1999;180:1863–1868.
- Wiesenfeld HC, Hillier SL, Krohn MA, et al. Bacterial
- vaginosis is a strong predictor of Neisseria gonorrhoeae
- and Chlamydia trachomatis infection. Clin Infect Dis
- ;36:663–668.
- Vodstrcil LA, Hocking JS, Law M, et al. Hormonal contraception
- is associated with a reduced risk of bacterial
- vaginosis: a systematic review and meta-analysis. PLoS
- One 2013;8:1-32.
- Thompson D, Pepys MB, Wood SP. The physiological
- structure of human C-reactive protein and its complex
- with phosphocholine. Structure 1999;7:169-177.
- Witkin S.S, Jeremias J, Ledger W.J. Recurrent vaginitis
- as a result of sexual transmission of IgE antibodies. Am
- J Obstet Gynecol 1988;159:32-36.
- Nawrot U, Grzybek H.K, Zielska U, et al. The study of
- cell-mediated immune response in recurrent vulvovaginal
- candidiasis. FEMS Immunol Microbiol 2000;29:89-94.
- Fidel PL. History and new insights into host defense
- against vaginal candidiasis. Trends Microbiol
- ;12:220-227.
- Weissenbacher TM, Witkin SS, Gingelmaier A, et al.
- Relationship between recurrent vulvovaginal candidosis
- and immune mediators in vaginal fluid. Eur J Obstet Gynecol
- Reprod Biol 2009;144:59-63.
- Lev SA, Nyirjesy P, Tarangelo N, et al. Hyaluronan in
- vaginal secretions: association with recurrent vulvovaginal
- candidiasis. Am J Obstet Gynecol 2009;201:206.e1-
- -
- Babula O, Lazdane G, Kroica J, et al. Relation between
- recurrent vulvovaginal candidiasis, vaginal concentrations
- of mannose-binding lectin and a mannose-binding
- lectin gene polymorphism in Latvian women. Clin Infect
- Dis 2003;37:733-737.
- Babula O, Lazdāne G, Kroica J, et al. Frequency of interleukin-4
- (IL-4) –589 gene polymorphism and vaginal
- concentrations of IL-4, nitric oxide and mannose-binding
- lectin in women with recurrent vulvovaginal candidiasis.
- Clin Infect Dis 2005;40:1258-1262.
Tekrarlayan veya tedaviye dirençli vajinit olgularında vajinal yıkama sıvısında C-reaktif protein düzeyleri
Öz
Amaç: Bu çalışmanın amacı tekrarlayan ve/veya tedaviye dirençli vajinit öyküsü olan olgularda vajinal yıkama sıvısı C-reaktif protein (CRP) düzeylerinin değerlendirilmesidir.Yöntemler: Bu prospektif vaka kontrollü çalışma hastanemizin jinekoloji kliniğinde yapılmıştır. Toplam 64 kadın (33 tekrarlayan ve/veya tedaviye dirençli vajinit öyküsü olan kadın çalışma grubu ve 31 sağlıklı kadın kontrol grubu) çalışmaya dâhil edilmiştir. Kaydedilen parametreler; yaş, başvuru şikâyeti, eğitim düzeyi, sosyoekonomik durum, vajinal duş (VD) sıklığı, periferik kan lökosit sayısı, vajinal sıvı CRP düzeyi, vajinal kültür, taze vajinal yayma ve idrar tetkikidir.Bulgular: Çalışma grubu istatistiksel olarak anlamlı düzeyde daha düşük eğitim düzeyi ve sosyoekonomik duruma sahipti (p<0,05). Periferik kanda ve taze vajinal sürüntüdeki ortalama lökosit sayısı, lökositüri ve vajinal yıkama sıvısı CRP düzeyleri çalışma grubunda istatistiksel anlamlı olarak daha yüksekti (p<0,05). Ayrıca haftada ≥ 3 kez VD yapanlarda vajinal yıkama sıvısı CRP düzeyleri istatistiksel olarak anlamlı yüksekti (p=0,012). Sonuç: Bu çalışmaya göre düşük sosyoekonomik durumu olan ve sık VD yapan kadınlarda tekrarlayan ve/veya tedaviye dirençli vajinit daha sık görülürken, bu hastalığın tanısında vajinal yıkama sıvısı CRP düzeyleri iyi bir belirteç olabilir
Anahtar Kelimeler
C-reaktif protein tekrarlayan vajinit tedaviye dirençli vajinit vajinal yıkama sıvısı
Kaynakça
- Ramírez SA, Pereiro MJ, Toribio J. Recurrent vulvovaginitis:
- diagnostic assessment and therapeutic management.
- Actas Dermo-Sifiliográficas 2008;99:190-198.
- Sivaranjini R, Jaisankar T, Thappa D.M, et al. Spectrum of
- vaginal discharge in a tertiary care setting. Trop Parasitol
- ;3:135-139.
- Guzel AI, Kuyumcuoglu U, Celik Y. Vaginal douching practice
- and related symptoms in a rural area of Turkey. Arch
- Gynecol Obstet 2011;284:1153-1156.
- Shaaban OM, Youssef AE, Khodry MM, et al. Vaginal
- douching by women with vulvovaginitis and relation
- to reproductive health hazards. BMC Women’s Health
- ;13-23:1-6.
- Pepys MB, Hirschfield GM. C-reactive protein: a critical
- update. J Clin Invest 2003;111:1805–1812.
- Ni CY, Jia WX, Yi WM, et al. Practicability of using vaginal
- fluid markers in detecting premature rupture of membranes.
- Ann Clin Biochem. 2003;40:542-545.
- Torbé A, Czajka R. Are vaginal fluid procalcitonin levels
- useful for the prediction of subclinial infection in patients
- with preterm premature rupture of membranes? J Obstet
- Gynaecol Res 2005;31:464-470.
- Celik Y. Biostatistics, principles of research.2nd edition. Diyarbakir:
- Dicle University Press. 2007.
- Pavlova S.I, Tao L. In vitro inhibition of commercial douche
- products against vaginal microflora. Infect Dis Obstet
- Gynecol 2000;8:99-104.
- Brotman RM, Klebanoff MA, Nansel TR, et al. A longitudinal
- study of vaginal douching and bacterial vaginosis-a
- marginal structural modeling analysis. Am J Epidemiol
- ;168:188-196.
- Sutton M, Sternberg M, Koumans EH, et al. The prevalence
- of Trichomonas vaginalis infection among reproductive-age
- women in the United States, 2001-2004.
- Clin Infect Dis 2007;45:1319-1326.
- Heng L.S, Yatsuya H, Morita S, et al. Vaginal douching in
- Cambodian women: its prevalence and association with
- vaginal candidiasis. J Epidemiol 2009;20:70-76.
- Klebanoff MA, Nansel TR, Brotman RM, et al. Personal
- hygienic behaviours and bacterial vaginosis. Sex
- Transm Dis 2010;37:94–99.
- Eckert LO, Hawes SE, Stevens CE, et al. Vulvovaginal
- candidiasis: clinical manifestations, risk factors, management
- algorithm. Obstet Gynecol 1998;92:757–765.
- Corsello S, Spinillo A, Osnengo G, et al. An epidemiological
- survey of vulvovaginal candidiasis in Italy. Eur J
- Obstet Gynecol Reprod Biol 2003;110:66-72.
- Seña AC, Bachmann LH, Hobbs MM. Persistent and recurrent
- Trichomonas vaginalis infections: epidemiology,
- treatment and management considerations. Expert Rev
- Anti Infect Ther 2014;12:673-685.
- Schwebke JR, Muzny CA, Josey WE. Role of Gardnerella
- vaginalis in the Pathogenesis of Bacterial Vaginosis:
- A Conceptual Model. J Infect Dis 2014;[Epub ahead of
- print].
- Hillier S.L, Nugent R.P, Eschenbach D.A, et al. Association
- between bacterial vaginosis and preterm delivery
- of a low-birthweight infant. The Vaginal Infections and
- Prematurity Study Group. N Engl J Med 1995;333:1737–
- -
- Martin HL, Richardson BA, Nyange PM, et al. Vaginal
- lactobacilli, microbial flora, and risk of human immunodeficiency
- virus type 1 and sexually transmitted disease
- acquisition. J Infect Dis 1999;180:1863–1868.
- Wiesenfeld HC, Hillier SL, Krohn MA, et al. Bacterial
- vaginosis is a strong predictor of Neisseria gonorrhoeae
- and Chlamydia trachomatis infection. Clin Infect Dis
- ;36:663–668.
- Vodstrcil LA, Hocking JS, Law M, et al. Hormonal contraception
- is associated with a reduced risk of bacterial
- vaginosis: a systematic review and meta-analysis. PLoS
- One 2013;8:1-32.
- Thompson D, Pepys MB, Wood SP. The physiological
- structure of human C-reactive protein and its complex
- with phosphocholine. Structure 1999;7:169-177.
- Witkin S.S, Jeremias J, Ledger W.J. Recurrent vaginitis
- as a result of sexual transmission of IgE antibodies. Am
- J Obstet Gynecol 1988;159:32-36.
- Nawrot U, Grzybek H.K, Zielska U, et al. The study of
- cell-mediated immune response in recurrent vulvovaginal
- candidiasis. FEMS Immunol Microbiol 2000;29:89-94.
- Fidel PL. History and new insights into host defense
- against vaginal candidiasis. Trends Microbiol
- ;12:220-227.
- Weissenbacher TM, Witkin SS, Gingelmaier A, et al.
- Relationship between recurrent vulvovaginal candidosis
- and immune mediators in vaginal fluid. Eur J Obstet Gynecol
- Reprod Biol 2009;144:59-63.
- Lev SA, Nyirjesy P, Tarangelo N, et al. Hyaluronan in
- vaginal secretions: association with recurrent vulvovaginal
- candidiasis. Am J Obstet Gynecol 2009;201:206.e1-
- -
- Babula O, Lazdane G, Kroica J, et al. Relation between
- recurrent vulvovaginal candidiasis, vaginal concentrations
- of mannose-binding lectin and a mannose-binding
- lectin gene polymorphism in Latvian women. Clin Infect
- Dis 2003;37:733-737.
- Babula O, Lazdāne G, Kroica J, et al. Frequency of interleukin-4
- (IL-4) –589 gene polymorphism and vaginal
- concentrations of IL-4, nitric oxide and mannose-binding
- lectin in women with recurrent vulvovaginal candidiasis.
- Clin Infect Dis 2005;40:1258-1262.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Araştırma Yazısı |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Mayıs 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 6 Sayı: 1 |