Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı

Year 2021, Volume: 8 Issue: 1, 18 - 22, 30.04.2021

Zehra Çağla Karakoç

https://doi.org/10.47572/muskutd.769354

Cited By: 1

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. 

Keywords

Candida, Postmenopoz, Premenopoz, Vajinit

Supporting Institution

destekleyici yoktur.

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

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.

Keywords

Candida, Postmenopause, Premenopause, Vaginitis

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