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Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis

Year 2015, , 5 - 9, 10.05.2015
https://doi.org/10.5799/ahinjs.01.2015.01.0477

Abstract

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

References

  • 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

Year 2015, , 5 - 9, 10.05.2015
https://doi.org/10.5799/ahinjs.01.2015.01.0477

Abstract

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

References

  • 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.
There are 102 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Aytekin Tokmak

İrfan Özer This is me

Selçuk Erkılınç This is me

Ali Güzel This is me

Mahmut Kokanalı This is me

Mustafa Uğur This is me

Publication Date May 10, 2015
Published in Issue Year 2015

Cite

APA Tokmak, A., Özer, İ., Erkılınç, S., Güzel, A., et al. (2015). Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis. Journal of Clinical and Experimental Investigations, 6(1), 5-9. https://doi.org/10.5799/ahinjs.01.2015.01.0477
AMA Tokmak A, Özer İ, Erkılınç S, Güzel A, Kokanalı M, Uğur M. Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis. J Clin Exp Invest. May 2015;6(1):5-9. doi:10.5799/ahinjs.01.2015.01.0477
Chicago Tokmak, Aytekin, İrfan Özer, Selçuk Erkılınç, Ali Güzel, Mahmut Kokanalı, and Mustafa Uğur. “Vaginal Washing Fluid C-Reactive Protein Levels in Women With Recurrent or Treatment Resistant Vaginitis”. Journal of Clinical and Experimental Investigations 6, no. 1 (May 2015): 5-9. https://doi.org/10.5799/ahinjs.01.2015.01.0477.
EndNote Tokmak A, Özer İ, Erkılınç S, Güzel A, Kokanalı M, Uğur M (May 1, 2015) Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis. Journal of Clinical and Experimental Investigations 6 1 5–9.
IEEE A. Tokmak, İ. Özer, S. Erkılınç, A. Güzel, M. Kokanalı, and M. Uğur, “Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis”, J Clin Exp Invest, vol. 6, no. 1, pp. 5–9, 2015, doi: 10.5799/ahinjs.01.2015.01.0477.
ISNAD Tokmak, Aytekin et al. “Vaginal Washing Fluid C-Reactive Protein Levels in Women With Recurrent or Treatment Resistant Vaginitis”. Journal of Clinical and Experimental Investigations 6/1 (May 2015), 5-9. https://doi.org/10.5799/ahinjs.01.2015.01.0477.
JAMA Tokmak A, Özer İ, Erkılınç S, Güzel A, Kokanalı M, Uğur M. Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis. J Clin Exp Invest. 2015;6:5–9.
MLA Tokmak, Aytekin et al. “Vaginal Washing Fluid C-Reactive Protein Levels in Women With Recurrent or Treatment Resistant Vaginitis”. Journal of Clinical and Experimental Investigations, vol. 6, no. 1, 2015, pp. 5-9, doi:10.5799/ahinjs.01.2015.01.0477.
Vancouver Tokmak A, Özer İ, Erkılınç S, Güzel A, Kokanalı M, Uğur M. Vaginal washing fluid C-reactive protein levels in women with recurrent or treatment resistant vaginitis. J Clin Exp Invest. 2015;6(1):5-9.