Vajinitli kadınlarda gardnerella vaginalisin sıklığı ve diğer mikroorganizmaların izolasyonu

Abstract

SUMMARY In this study, we examined 150 patients with vaginal discharge and 50 healthy women as a control group who were admitted to Izmir Obstetric and Gynecology Hospital and to Dokuz Eylül Uni versity Gynecology Policlinic between April and July in 1992. We examined the vaginal discharge samples for G. vaginalis, Candida sp., T. vaginalis and other facultative anaerob and aerob bacteries. A minimum diagnostic requirement for bacterial vaginosis is the presence of at least three of the following signs: excessive, ho- mogen white-gray discharge, vaginal pH of > 4.7, positivity of amine test and clue cells. According to these criteria we diagnosed bacterial vaginosis in 51 patients. In 46 of these patients we isolated G.vaginalis solely or with other bacteries. In 8 patients of control group G.vaginalis was isolated with other flora bacteries (P < 0.05). In our study C. albicans isolation rate was 19/150 while it was 2/50 in control group (P < 0.01). With direct examination we found T.vaginalis in 5 patients as a vaginitis factor but in control group we weren't able to show any T.vaginalis. According to this we accepted that T.vaginalis was 100 % vaginitis factor. We found Enterobacteriaceae species in 31 patients, Str.faecalis in 18 patients, whereas this rates were 6 and 1 in control group respectively. Enterobacteriaceae members were not accepted as vagi-nitis factor but our significant result obliged us to take into account these bacteries as we isolated them in pure cultures. We found that normal genital flora members as Lactobacillus and Corynebacterium decreased in patients but increased in control group. It is known that normal flora members disappear and leave the medium to the pathogens in vaginitis. -41-Abnormal discharge is a common clinical complaint in vagi nitis. Homogenous and malodorous discharge and disappearing of Lactobacillus and PMNS are significant. In vulvovaginal candidiasis the main complaint was pruritis of vulva and dysuri. This typical symptoms and physical signs were characteristic in women with candidiasis and enhanced the chance for diagnose. Generally there was a yellow discharge and increase in PMNS number in women with trichomonas infection. The rate of G.vaginalis with IUD and Candida albicans with oral contraseptives were significantly higher. As to G. vaginalis frequency we didin't find any differ ence between different age groups. As the rate of isolation is a little bit more in the patients over 30, comparing with the group under 29, we think that this bacteria is related with sexual activity. -42-

SUMMARY In this study, we examined 150 patients with vaginal discharge and 50 healthy women as a control group who were admitted to Izmir Obstetric and Gynecology Hospital and to Dokuz Eylül Uni versity Gynecology Policlinic between April and July in 1992. We examined the vaginal discharge samples for G. vaginalis, Candida sp., T. vaginalis and other facultative anaerob and aerob bacteries. A minimum diagnostic requirement for bacterial vaginosis is the presence of at least three of the following signs: excessive, ho- mogen white-gray discharge, vaginal pH of > 4.7, positivity of amine test and clue cells. According to these criteria we diagnosed bacterial vaginosis in 51 patients. In 46 of these patients we isolated G.vaginalis solely or with other bacteries. In 8 patients of control group G.vaginalis was isolated with other flora bacteries (P < 0.05). In our study C. albicans isolation rate was 19/150 while it was 2/50 in control group (P < 0.01). With direct examination we found T.vaginalis in 5 patients as a vaginitis factor but in control group we weren't able to show any T.vaginalis. According to this we accepted that T.vaginalis was 100 % vaginitis factor. We found Enterobacteriaceae species in 31 patients, Str.faecalis in 18 patients, whereas this rates were 6 and 1 in control group respectively. Enterobacteriaceae members were not accepted as vagi-nitis factor but our significant result obliged us to take into account these bacteries as we isolated them in pure cultures. We found that normal genital flora members as Lactobacillus and Corynebacterium decreased in patients but increased in control group. It is known that normal flora members disappear and leave the medium to the pathogens in vaginitis. -41-Abnormal discharge is a common clinical complaint in vagi nitis. Homogenous and malodorous discharge and disappearing of Lactobacillus and PMNS are significant. In vulvovaginal candidiasis the main complaint was pruritis of vulva and dysuri. This typical symptoms and physical signs were characteristic in women with candidiasis and enhanced the chance for diagnose. Generally there was a yellow discharge and increase in PMNS number in women with trichomonas infection. The rate of G.vaginalis with IUD and Candida albicans with oral contraseptives were significantly higher. As to G. vaginalis frequency we didin't find any differ ence between different age groups. As the rate of isolation is a little bit more in the patients over 30, comparing with the group under 29, we think that this bacteria is related with sexual activity. -42-