Mulu Wondemagegn, Yimer Mulat, Zenebe Yohannes, Abera Bayeh
Department of Medical Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Womens Health. 2015 May 13;15:42. doi: 10.1186/s12905-015-0197-y.
Bacterial vaginosis, candidal, trichomonal and Gonococcal vaginal infections are a major health problems associated with gynecologic complications and increase in replication, shedding and transmission of HIV and other STIs in women of reproductive age. The study aimed at determining the prevalence of common vaginal infections and antimicrobial susceptibility profiles of aerobic bacterial isolates in women of reproductive age, attending Felegehiwot referral Hospital.
A hospital based cross sectional study was conducted from May to November, 2013. Simple random sampling technique was used. Demographic variables were collected using a structured questionnaire. Clinical data were collected by physicians. Two vaginal swab specimens were collected from each participant. Wet mount and Gram staining were carried out to identify motile T.vaginalis, budding yeast and clue cells. All vaginal specimens were cultured for aerobic bacterial isolates using standard microbiology methods. Antimicrobial susceptibility was performed using disc diffusion technique as per the standard by Kirby-Bauer method. The results were analyzed using descriptive, chi-square and fisher's exact test as appropriate.
A total of 409 women in reproductive age (15 - 49 years) participated in the study. The median age of the women was 28 years. Overall, 63 (15.4 %) of women had vaginal infections. The proportion of vaginal infection was higher in non-pregnant (17.3 %) than pregnant women (13.3 %) (P = 0.002). The most common identified vaginal infections were candidiasis (8.3 %) and bacterial vaginosis (2.8 %) followed by trichomoniasis (2.1 %). The isolation rate of N. gonorrhoeae and group B Streptococcus colonization was 4 (1 %) and 6 (1.2 %), respectively. Bacterial vaginosis was higher in non-pregnant (5.6 %) than pregnant women (0.5 %) (P = 0.002). Religion, age, living in rural area and having lower abdominal pain were significantly associated with bacterial vaginosis and candidiasis (P < 0.05). E.coli, Pseudomonas spp. and S.aureus were frequently isolated. Norfloxacin (75.6 %), ciprofloxacin (79.6 %) and gentamicin (77.6 %) revealed high level of sensitivity whereas high resistance rates were observed for amoxicillin (82.2 %), tetracycline (63.3 %) and cotrimoxazole (62.2 %).
Bacterial vaginosis, candidiasis and trichomoniasis are a common problem in women of reproductive age. Therefore, screening of vaginal infections in women of reproductive age should be implemented. Moreover, ciprofloxacin, norfloxacin and gentamicin are the recommended drugs for empiric therapy and prophylaxis as needed.
细菌性阴道病、念珠菌性、滴虫性和淋菌性阴道感染是与妇科并发症相关的主要健康问题，并且会增加育龄女性中艾滋病毒及其他性传播感染的复制、脱落和传播。本研究旨在确定费莱盖希沃特转诊医院就诊的育龄女性中常见阴道感染的患病率以及需氧菌分离株的抗菌药物敏感性谱。
2013年5月至11月进行了一项基于医院的横断面研究。采用简单随机抽样技术。使用结构化问卷收集人口统计学变量。临床数据由医生收集。从每位参与者采集两份阴道拭子标本。进行湿片检查和革兰氏染色以鉴定活动的阴道毛滴虫、芽生酵母菌和线索细胞。使用标准微生物学方法对所有阴道标本进行需氧菌分离株培养。按照 Kirby-Bauer 方法的标准，采用纸片扩散法进行抗菌药物敏感性检测。根据情况使用描述性、卡方检验和费舍尔精确检验对结果进行分析。
共有409名育龄（15 - 49岁）女性参与了该研究。这些女性的年龄中位数为28岁。总体而言，63名（15.4%）女性患有阴道感染。非孕妇（17.3%）的阴道感染比例高于孕妇（13.3%）（P = 0.002）。最常见的已确诊阴道感染为念珠菌病（8.3%）和细菌性阴道病（2.8%），其次是滴虫病（2.1%）。淋病奈瑟菌的分离率和B族链球菌定植率分别为4例（1%）和6例（1.2%）。非孕妇中的细菌性阴道病（5.6%）高于孕妇（0.5%）（P = 0.002）。宗教信仰、年龄、居住在农村地区以及下腹部疼痛与细菌性阴道病和念珠菌病显著相关（P < 0.05）。经常分离出大肠埃希菌、假单胞菌属和金黄色葡萄球菌。诺氟沙星（75.6%）、环丙沙星（79.6%）和庆大霉素（77.6%）显示出较高的敏感性，而阿莫西林（82.2%）、四环素（63.3%）和复方新诺明（62.2%）的耐药率较高。
细菌性阴道病、念珠菌病和滴虫病是育龄女性中的常见问题。因此，应开展育龄女性阴道感染的筛查。此外，环丙沙星、诺氟沙星和庆大霉素是经验性治疗和必要时预防的推荐药物。
