Research Article
BibTex RIS Cite

Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı

Year 2021, Volume: 8 Issue: 1, 18 - 22, 30.04.2021
https://doi.org/10.47572/muskutd.769354

Abstract

Vajinitler jinekoloji polikliniklerinde en sık karşılaşılan tanılardan biri olup, çoğunlukla enfeksiyöz kaynaklıdır. Çalışmamızda; jinekoloji polikliniklerine vajinal akıntı şikayeti ile başvuran hastalardan alınan vajinal sürüntü örneklerinin, mikrobiyolojik değerlendirme sonuçlarının ve etiyolojide rol alan mikroorganizmaların değerlendirilmesi amaçlanmıştır.
Ocak-Haziran 2019 tarihleri arasında hastanemiz jinekoloji polikliniklerinde vajinit ön tanısı konulan 290 hastadan alınan 305 vajinal sürüntü örneği çalışmaya dahil edildi. Örneklerin mikroskobik inceleme ve kültür sonuçları klinik mikrobiyoloji laboratuvar kayıtlarından retrospektif olarak değerlendirildi. Vaginal sürüntü kültürleri; %5 koyun kanlı agar, Çikolata agar, MacConcey agar, Sabouraud Dextroz agar besiyerlerine ekilerek, gram boyamaları ve direkt mikroskobik incelemeleri yapıldı. Plaklar 48-72 saat süre ile 37°C’de inkübe edildi. Üreyen mikroorganizmaların identifikasyonu ve antibiyogramı için VITEK 2 Compact® (bioMeriéux, Marcy l’Etoile, Fransa) otomatize sistemi kullanıldı. Hastaların ortalama yaşı 35.1±10.3 (18-84) olup, mikroorganizma üremesi saptanan örnek sayısı 131 (%42.9)’di ve bunların 84(%64.1)’ünde Candida albicans’ın etken olduğu belirlendi. Hastalar premenopozal ve postmenopozal (<45 yaş ve ≥45 yaş) olarak gruplandırıldı. Premenopozal grupta vajinal sürüntü örneği kültüründe üreme oranı (118/131), C. albicans üreme oranı (81/131) bakteriyel vajinoz ile ilişkili bulgular (25/262) daha fazla oranda belirlendi. Mikroskopik incelemede Trichomonas vaginalis saptanan hastaların tamamı premenopozal gruptaydı. Buna mukabil postmenopozal grupta ise, bakteriyel üreme oranı (10/13) daha fazlaydı. İzole edilen gram-pozitif bakterilerde ampisilin, penisilin ve gentamisin direnci saptanmadı. Gram-negatif bakterilerde ise karbapenemler ve gentamisine karşı direnç saptanmazken, diğer antibiyotiklere olan duyarlılık %47.2-97.2 arasında değişti. Çalışmamızda tüm hasta popülasyonu değerlendirildiğinde izole edilen en sık etken C. albicans’tır. Ancak postmenopozal grupta bakteriyel etkenlerin ön plana geçtiği, premenopozal grupta ise; literatürle uyumlu olarak Candida’ların daha sık vajinit etkeni olduğu belirlenmiştir. 

Supporting Institution

destekleyici yoktur.

References

  • 1. Mccormack WM. Vulvovaginitis and cervicitis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. pp 1495-1509.
  • 2. Sobel JD. Vaginitis, vulvitis, cervicitis and cutaneous vulvar lesions. In: Cohen J, Powderly WG, Opal SW editors. Infectious Diseases. 3rd edition. Edinburgh: Elsevier Limited; 2010. pp. 542-50.
  • 3. Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.
  • 4. Tempera G, Furneri PM. Management of aerobic vaginitis. Gynecol Obstet Invest. 2010;70(4):244-9.
  • 5. Mills BB. Vaginitis: Beyond the basics. Obstet Gynecol Clin North Am. 2017;44(2):159-77.
  • 6. Goje O, Munoz JL. Vulvovaginitis: Find the cause to treat it. Cleve Clin J Med. 2017;84(3):215-24.
  • 7. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review Am J Obstet Gynecol. 2013;209(6):505-23.
  • 8. Baruah FK, Sharma A, Das C, et al. Role of Gardnerella vaginalis as an etiological agent of bacterial vaginosis. Iran J Microbiol. 2014;6(6):409-14.
  • 9. Chandeying V, Skov S, Kemapunmanus M, et al. Evaluation of two clinical protocols for the management of women with vaginal discharge in Southern Thailand. Sex Transm Infect. 1998;74(3):194-201.
  • 10. Bansal R, Garg P, Garg A. Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2019;8:637-40.
  • 11. Chatzivasileiou P, Vyzantiadis TA. Vaginal yeast colonisation: From a potential harmless condition to clinical implications and management approaches—A literature review. Mycoses. 2019;62(8):638-50.
  • 12. Kalkancı A, Çiftçi B, Biri A, et al. Vajinit ön tanısı almış olgularda vajinal kültür sonuçlarının değerlendirilmesi. Türkiye Klinikleri J Gynecol Obst. 2005;15:137-9.
  • 13. Cengiz A, Cengiz L, Us E. Gebe kadınların vajinal akıntılarından üretilen mikroorganizmaların dağılımı ve antibakteriyellere duyarlılıkları. OMÜ Tıp Derg. 2004;21(2):84-9.
  • 14. Esim BE, Kars B, Karsidag AY, et al. Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis. Arch Gynecol Obstet. 2010;282(5):515-9.
  • 15. Kaambo E, Africa C, Chambuso R, et al. Vaginal microbiomes associated with aerobic vaginitis and bacterial vaginosis. Front Public Health. 2018;6:78.
  • 16. Sangeetha KT, Golia S, Vasudha CL. A study of aerobic bacterial pathogens associated with vaginitis in reproductive age group women (15-45 years) and their sensitivity pattern. Int J Res Med Sci. 2015;3:2268-73.
  • 17. Pal K, Sidhu SK, Devi P, et al. Etiology of vaginal infections and antimicrobial resistance pattern of aerobic bacterial isolates in women of reproductive age group attending a tertiary care hospital. Asian Pac J Health Sci. 2017;4(4):15-8.
  • 18. Hussain MS, Hussain A, Azam M, et al. Frequency and antimicrobial susceptibility of gram negative rods in high vaginal swabs. JSZMC. 2014;5(2):612-4.
  • 19. Raabe VN, Shane AL. Group B Streptococcus (Streptococcus agalactiae). Microbiol Spectr. 2019;7(2).
  • 20. Shaw C, Mason M, Scoular A. Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population. Sex Transm Infect. 2003;79:246–8.
  • 21. Van Gerwen OT, Muzny CA. Recent advances in the epidemiology, diagnosis, and management of Trichomonas vaginalis infection. F1000Res. 2019;8(F1000 Faculty Rev):1666.
  • 22. Madhivanan P, Bartman MT, Pasutti L, et al.. Prevalence of Trichomonas vaginalis infection among young reproductive age women in India: implications for treatment and prevention. Sex Health. 2009;6(4):339-44.
  • 23. Mulu W, Yimer M, Zenebe Y, et al. Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Flegehiwot Referral Hospital, Ethiopia: a cross sectional study. BMC Womens Health. 2015;15:42.
  • 24. Sönmez C, Usluca S. Ürogenital akıntısı olan olgularda: Trichomonas vaginalis sıklığı? FLORA. 2018;23(2):79-83.
  • 25. Akarsu GA. Investigation of Trichomonas vaginalis in patients with nonspecific vaginal discharge. Turkiye Parazitol Derg. 2006;30(1):19-21.

Does the Etiology Change in Vaginitis? Data Results of Samples from a Single Center

Year 2021, Volume: 8 Issue: 1, 18 - 22, 30.04.2021
https://doi.org/10.47572/muskutd.769354

Abstract

Vaginitis is one of the most common diagnoses in gynecology outpatient clinics and is mostly of infectious origin. The aim of this study was to evaluate microbiological results and microorganisms involved in etiology of the patients admitted to gynecology polyclinics with complaints of vaginal discharge. Between January-June 2019, a total of 305 vaginal swab samples taken from 290 patients who were admitted to gynecology outpatient clinics with vaginal discharge complaints were included in the study. Microscopic examination and culture results of the samples were retrospectively evaluated from clinical microbiology laboratory records. Vaginal swab cultures were cultivated on 5% sheep blood agar, Chocolate agar, MacConcey agar, Sabouraud Dextroz agar media, and gram staining and direct microscopic examinations were performed. Plates were incubated at 37°C for 48-72 hours. VITEK2Compact® (bioMeriéux, Marcy l'Etoile, France) automated system was used for identification and antibiogram of growing microorganisms. The mean age of the patients was 35.1±10.3 (18-84), the number of cultures with microorganism growth was 131 (42.9%), and 84 (64.1%) of them were Candida albicans. The patients included in the study were grouped as premenopausal and postmenopausal (<45and ≥45 years). In the premenopausal group, while microorganism growth rate was 118/131, C.albicans growth rate was 81/131, and findings related to bacterial vaginosis (25/262) were determined to be higher. In contrast, in the postmenopausal group, bacterial growth rate (10/13) was higher. In all gram-negative bacteria, no resistance to carbapenems and gentamycin were detected, while sensitivity to other antibiotics varied between 47.2-97.2%. In our study, C.albicans is the leading isolated organism among all patients. However, in the group defined as postmenopausal, bacterial agents were isolated at the highest proportion and in the premenopausal group; Candida was found to be the more common cause of vaginitis that is in consistent with the literature.

References

  • 1. Mccormack WM. Vulvovaginitis and cervicitis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. pp 1495-1509.
  • 2. Sobel JD. Vaginitis, vulvitis, cervicitis and cutaneous vulvar lesions. In: Cohen J, Powderly WG, Opal SW editors. Infectious Diseases. 3rd edition. Edinburgh: Elsevier Limited; 2010. pp. 542-50.
  • 3. Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.
  • 4. Tempera G, Furneri PM. Management of aerobic vaginitis. Gynecol Obstet Invest. 2010;70(4):244-9.
  • 5. Mills BB. Vaginitis: Beyond the basics. Obstet Gynecol Clin North Am. 2017;44(2):159-77.
  • 6. Goje O, Munoz JL. Vulvovaginitis: Find the cause to treat it. Cleve Clin J Med. 2017;84(3):215-24.
  • 7. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review Am J Obstet Gynecol. 2013;209(6):505-23.
  • 8. Baruah FK, Sharma A, Das C, et al. Role of Gardnerella vaginalis as an etiological agent of bacterial vaginosis. Iran J Microbiol. 2014;6(6):409-14.
  • 9. Chandeying V, Skov S, Kemapunmanus M, et al. Evaluation of two clinical protocols for the management of women with vaginal discharge in Southern Thailand. Sex Transm Infect. 1998;74(3):194-201.
  • 10. Bansal R, Garg P, Garg A. Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2019;8:637-40.
  • 11. Chatzivasileiou P, Vyzantiadis TA. Vaginal yeast colonisation: From a potential harmless condition to clinical implications and management approaches—A literature review. Mycoses. 2019;62(8):638-50.
  • 12. Kalkancı A, Çiftçi B, Biri A, et al. Vajinit ön tanısı almış olgularda vajinal kültür sonuçlarının değerlendirilmesi. Türkiye Klinikleri J Gynecol Obst. 2005;15:137-9.
  • 13. Cengiz A, Cengiz L, Us E. Gebe kadınların vajinal akıntılarından üretilen mikroorganizmaların dağılımı ve antibakteriyellere duyarlılıkları. OMÜ Tıp Derg. 2004;21(2):84-9.
  • 14. Esim BE, Kars B, Karsidag AY, et al. Diagnosis of vulvovaginitis: comparison of clinical and microbiological diagnosis. Arch Gynecol Obstet. 2010;282(5):515-9.
  • 15. Kaambo E, Africa C, Chambuso R, et al. Vaginal microbiomes associated with aerobic vaginitis and bacterial vaginosis. Front Public Health. 2018;6:78.
  • 16. Sangeetha KT, Golia S, Vasudha CL. A study of aerobic bacterial pathogens associated with vaginitis in reproductive age group women (15-45 years) and their sensitivity pattern. Int J Res Med Sci. 2015;3:2268-73.
  • 17. Pal K, Sidhu SK, Devi P, et al. Etiology of vaginal infections and antimicrobial resistance pattern of aerobic bacterial isolates in women of reproductive age group attending a tertiary care hospital. Asian Pac J Health Sci. 2017;4(4):15-8.
  • 18. Hussain MS, Hussain A, Azam M, et al. Frequency and antimicrobial susceptibility of gram negative rods in high vaginal swabs. JSZMC. 2014;5(2):612-4.
  • 19. Raabe VN, Shane AL. Group B Streptococcus (Streptococcus agalactiae). Microbiol Spectr. 2019;7(2).
  • 20. Shaw C, Mason M, Scoular A. Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population. Sex Transm Infect. 2003;79:246–8.
  • 21. Van Gerwen OT, Muzny CA. Recent advances in the epidemiology, diagnosis, and management of Trichomonas vaginalis infection. F1000Res. 2019;8(F1000 Faculty Rev):1666.
  • 22. Madhivanan P, Bartman MT, Pasutti L, et al.. Prevalence of Trichomonas vaginalis infection among young reproductive age women in India: implications for treatment and prevention. Sex Health. 2009;6(4):339-44.
  • 23. Mulu W, Yimer M, Zenebe Y, et al. Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Flegehiwot Referral Hospital, Ethiopia: a cross sectional study. BMC Womens Health. 2015;15:42.
  • 24. Sönmez C, Usluca S. Ürogenital akıntısı olan olgularda: Trichomonas vaginalis sıklığı? FLORA. 2018;23(2):79-83.
  • 25. Akarsu GA. Investigation of Trichomonas vaginalis in patients with nonspecific vaginal discharge. Turkiye Parazitol Derg. 2006;30(1):19-21.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Original Article
Authors

Zehra Çağla Karakoç 0000-0002-1618-740X

Publication Date April 30, 2021
Submission Date July 14, 2020
Published in Issue Year 2021 Volume: 8 Issue: 1

Cite

APA Karakoç, Z. Ç. (2021). Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 8(1), 18-22. https://doi.org/10.47572/muskutd.769354
AMA Karakoç ZÇ. Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı. MMJ. April 2021;8(1):18-22. doi:10.47572/muskutd.769354
Chicago Karakoç, Zehra Çağla. “Vajinitlerde Etiyoloji Değişiyor Mu? Tek Merkez Verilerinin Paylaşımı”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8, no. 1 (April 2021): 18-22. https://doi.org/10.47572/muskutd.769354.
EndNote Karakoç ZÇ (April 1, 2021) Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8 1 18–22.
IEEE Z. Ç. Karakoç, “Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı”, MMJ, vol. 8, no. 1, pp. 18–22, 2021, doi: 10.47572/muskutd.769354.
ISNAD Karakoç, Zehra Çağla. “Vajinitlerde Etiyoloji Değişiyor Mu? Tek Merkez Verilerinin Paylaşımı”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8/1 (April 2021), 18-22. https://doi.org/10.47572/muskutd.769354.
JAMA Karakoç ZÇ. Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı. MMJ. 2021;8:18–22.
MLA Karakoç, Zehra Çağla. “Vajinitlerde Etiyoloji Değişiyor Mu? Tek Merkez Verilerinin Paylaşımı”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 8, no. 1, 2021, pp. 18-22, doi:10.47572/muskutd.769354.
Vancouver Karakoç ZÇ. Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı. MMJ. 2021;8(1):18-22.