Composition of Vaginal microbiota and their antibiotic susceptibility in symptomatic women

Ushadevi Gopalan; Sathiyakala Rajendiran; Karthika Jayakumar; Ranganathan Karnaboopathy

doi:10.18203/2320-1770.ijrcog20170190

Authors

Ushadevi Gopalan Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India
Sathiyakala Rajendiran Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India
Karthika Jayakumar Department of Microbiology, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India
Ranganathan Karnaboopathy Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170190

Keywords:

Bacterial vaginosis, Culture and sensitivity, High vaginal swab, Vaginal discharge

Abstract

Background: Bacterial vaginosis is the most prevalent lower genital tract infection in women of reproductive age. The aim of this study was to identify the causative organism in patients with vaginal discharge and to study the sensitivity of the organism to antibiotics.

Methods: This was a hospital based prospective study in Department of Obstetrics and Gynecology in a tertiary care hospital over a period of two years. 2062 women with complaints of vaginal discharge were subjected to a high vaginal swab and the sample was cultured, the organisms were identified and antibiotic susceptibility was tested.

Results: There was no growth found in 40.7% of patients. E. coli was found to be the most common organism isolated followed by Klebsiella pneumonia and Klebsiella oxytoca. Candida species was isolated in 1.4 % of women. An increased frequency of vaginal infection was found in the age group 26-35 years, followed by age group 36-45 years. 73.2% of the organisms were sensitive to Imipenam, 70.4 % to Amikacin and 65.7% to Gentamycin. There were 10 MRSA strains isolated all of which were sensitive to Vancomycin, Amikacin and Gentamycin.

Conclusions: Our study provides information about the different microorganisms present in women with vaginal discharge. Since pathogenic bacteria were more common than Candida species it is recommended to offer treatment to patients after taking a high vaginal swab. Appropriate antibiotics based on culture and sensitivity has to be given along with antifungal agents.

Metrics

Metrics Loading ...

References

Larsen B, Monif GR. Understanding the bacterial flora of the human genital tract. Clin Infect Dis. 2001;32(4):69-77.

Puri R, Malhotra J. Recurrent urinary tract infection (UTI) in women .South Asian Federation of Obstetrics and Gynecology. 2009;1(1):10-3.

Allsworth JE, Peipert JF. Prevalence of bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey Data. Obstet Gynecol. 2007;109:114-20.

Wang J. Bacterial Vaginosis. Prim Care Update Ob Gyn. 2000;7:181-5.

Hillier SL, Nugent RP, Achenbach DA, Krohn MA, Gibbs RS, Martin DH et al. Association between bacterial vaginosis and preterm delivery of a low –birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995;333:1737-42.

Sweet RL. Role of bacterial vaginosis in pelvic inflammatory disease. Clin Infect Dis. 1995;20(2):S271-5.

Haggerty Cl, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis. 2004;39:990-5.

Morris M, Nicole A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG. 2001;108:439-50.

Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SS, McCulle SL, et al. Vaginal microbiome of reproductive age women. Proct Natl Acad Sci USA. 2011;108(1):4680-7.

Lakshmi K, Chitralekha S, Illimani V, Menezes GA. Prevalence of Bacterial vaginal Infections in pre and postmenopausal women Int J Pharm Bio Sci. 2012;3(4):949-56.

Klebanoff MA, Schwebke JR, Zhang J, Nansel Tr, Yu KF, Andrews WW. Vulvovaginal symptoms in women with bacterial vaginosis. Obstet Gynecol. 2004;104:267-72.

Zhou X, Brown CJ, Abdo Z, Davis CC, Hansmann MA, Joyce P et al. Differences in the composition of vaginal microbial communities found in healthy Caucasian and Black women. ISME J. 2007;1:121-33.

Bradshaw CS, Morton AN, Hodcking J, Garland SM, Morris MB, Moss Lm et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006;193:1478-86.

National Committee for Clinical Laboratory Standards. Abbreviated Identification of Bacteria and Yeast Approved Guidelines. NCCLS document M35-A.Wayne PA: NCCLS; 2002.

Khan SA, Amir F, Altaf S, Tanveer R. Evaluation of common organisms causing vaginal discharge. J Ayub Med College Abbottabad. 2009;21(2):90-3.

Srinivasan S, Fredricks DN. The Human Vaginal Bacterial Biota and Bacterial vaginosis. Interdisciplinary Perspectives on Infectious Diseases. 2008;750479:22.

Ling Z, Kong J, Liu F, Zhu H, Chen X, Wang Y, et al. Molecular analysis of the diversity of Vaginal Microbiota associated with bacterial vaginosis. BMC Genomics. 2010;11:488.

Narayana-Swami N, Ramalingappa P, Bhatara U. Antimicrobial Sensitivity pattern of Microorganisms isolated from vaginal infections at a Tertiary Hospital in Bangalore, India. IJMS. 2015;3:34-9.

Rahman T, Khan IH, Begum J. High vaginal swab (HVS), routine microscopy and culture sensitivity in Diabetic and non diabetic, a comparative retrospective study of five years. Indian J Med Sci. 1991;45:212-4.

Burton JP, Reid G. Evaluation of the bacterial vaginal flora of 20 post menopausal women by direct (Nugent score) and molecular (Polymerase chain reaction and denaturing gradient gel electrophoresis) techniques. J Infect Dis. 2002;186(12):1770-80.

Kumar G, Singh K. Microbial Profile of High vaginal Swab From Symptomatic Women of Reproductive Age Group.Data from Tertiary Care Hospital .Int J Of Science and Research. 2015;4(7):2672-73.

Balkus JE, Richardson BA, Mandaliya K, Kiarie J, Jaoko W, Ndinya-Achola JO et al. Establishing and sustaining a healthy vaginal environment: Analysis of data from a randomized trial of periodic presumptive treatment for vaginal infections. J Infect Dis. 2011;204(2):323-6.

Olinger GG, Hasemi FB, Sha BE, Spear GT. Association of indicator of bacterial vaginosis with a female genital tract factor that induces expression of HIV-1.AIDS. 1999;13:1905-12.

Patel J, Bhatt J, Javiya V, Patel K. Anti-microbial susceptibility patterns of Enterobateriaceae isolated from a tertiary care unit in Gujarat. Internet Journal of Microbiology. 2008:6(1).