Flores-Paz Rocío, Rivera-Sánchez Roberto, García-Jíménez Elvia, Arriaga-Alba Myriam
Hospital Juárez de México, Dirección de Investigación y Enseñanza, Avenida Instituto Politécnico Nacional No 5160, colonia Magdalena de las Salinas, 07760 México, DF.
Salud Publica Mex. 2003;45 Supp 5:S694-7.
To identify the etiologic agents of cervicovaginal infection in order to establish an accurate diagnosis and proper treatment.
From January 1995 to December 1999, bacteriological studies were done in cervical discharge specimens from 6,811 patients aged 13 to 65 years, seen at Hospital Juarez in Mexico City. All patients had leucorrhea, pruritus, hyperemia, and abdominal pain. Statistical significance was assessed using the chi-squared test.
The frequencies of infectious agents were as follows: G. vaginalis, 22.65%, Candida spp, 19.13%, C, albicans, 7.8%, T. vaginalis, 1.5%, Streptococcus group D, 11.78%, Streptococcus beta hemolytic, 4.59%, E. coli, 13.46%, and Klebsiella spp, 2.0%. Less frequent enterobacteria were: Citrobacter spp, Enterobacter spp, Pseudomonas spp, M. morganii, and P. mirabilis. Almost 3% of patients presented anaerobic species, which were always associated with G. vaginalis. Neisseria spp and N. weaveri were isolated in 0.15% each; N. gonorrhoeae was not isolated in any of the patients. Comparative data showed that Streptococcus beta hemolytic and E. coli increased markedly in the past two years (p < 0.001 for the latter).
The diversity of etiologic agents requires performing bacteriological cultures of cervical and vaginal discharge to all symptomatic patients. The English version of this paper is available at:http://www.insp.mx/salud/index.html.
确定宫颈阴道感染的病原体,以便做出准确诊断并进行恰当治疗。
1995年1月至1999年12月,对墨西哥城华雷斯医院6811例年龄在13至65岁的患者的宫颈分泌物标本进行了细菌学研究。所有患者均有白带、瘙痒、充血和腹痛症状。采用卡方检验评估统计学意义。
病原体的检出频率如下:阴道加德纳菌,22.65%;念珠菌属,19.13%;白色念珠菌,7.8%;阴道毛滴虫,1.5%;D组链球菌,11.78%;β溶血性链球菌,4.59%;大肠杆菌,13.46%;克雷伯菌属,2.0%。较少见的肠杆菌有:柠檬酸杆菌属、肠杆菌属、假单胞菌属、摩根摩根菌和奇异变形杆菌。近3%的患者检出厌氧菌,且总是与阴道加德纳菌相关。淋病奈瑟菌和韦弗奈瑟菌的分离率均为0.15%;所有患者均未分离出淋病奈瑟菌。对比数据显示,β溶血性链球菌和大肠杆菌在过去两年中显著增加(后者p<0.001)。
病原体的多样性要求对所有有症状的患者进行宫颈和阴道分泌物的细菌学培养。本文的英文版本可在以下网址获取:http://www.insp.mx/salud/index.html。