ABSTRACT
BACKGROUND: Female vulvovaginitis was one of the most common gynecological diseases. It had a great negative impact on their work and quality of life. This retrospective study evaluated the clinical and laboratory data of patients with vulvovaginitis in Hangzhou, China. To analyze the clinical situation, species distribution and antibiotic resistance of pathogenic fungi and bacteria in 626 cases of vulvovaginitis in Hangzhou. Microorganism culture, identification, and antibiotic susceptibility testing were conducted. The study aimed to provide a theoretical value for an effective treatment of vulvovaginitis. METHODS: In total, 626 outpatients and inpatients diagnosed with vulvovaginitis were selected from January 2018 to January 2023. Data of all the patients were collected from the hospital's electronic medical records. Vaginal secretion was collected for testing and SPSS 25.0 software was used to perform statistical analysis. RESULTS: A total of 626 strains of fungi, Gram-positive, and -negative bacteria were detected. Clinical situations of patients infected with the top five pathogenic fungi and bacteria were analyzed. Pathogenic fungi and bacteria were slightly different in each age group and in each onset time group. The results of antibiotic susceptibility testing showed that the resistance rates of itraconazole and fluconazole were high and Gram- negative and -positive bacteria were multidrug resistant. Gram-negative bacteria were more sensitive to carbenicillins and compound antibiotics, while Gram-positive bacteria were sensitive to rifampicin and daptomycin. MRSA and non vancomycin-resistant strains were detected. CONCLUSIONS: Fungi and bacteria were usually detected as pathogenes in patients with vulvovaginitis in Hangzhou. Some factors, such as age and onset time, often affected the incidence. Pathogenic fungi and bacteria were resistant to some common antibiotics, and clinical treatments should be carried out in a timely and reasonable manner according to the results of antibiotic susceptibility testing.
Subject(s)
Fungi , Microbial Sensitivity Tests , Vulvovaginitis , Humans , Female , China/epidemiology , Adult , Vulvovaginitis/microbiology , Vulvovaginitis/drug therapy , Vulvovaginitis/epidemiology , Vulvovaginitis/diagnosis , Retrospective Studies , Fungi/drug effects , Fungi/isolation & purification , Fungi/classification , Middle Aged , Young Adult , Adolescent , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Bacteria/isolation & purification , Bacteria/classification , Drug Resistance, Fungal , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Drug Resistance, Bacterial , AgedABSTRACT
Objetivo: identificar a prevalência dos agentes microbiológicos das vulvovaginites. Método: estudo documental e retrospectivo da série histórica de 2007 a 2011, dos livros de registros dos exames citológicos das três Equipes de Saúde da Família do município de Jaçanã-RN. A coleta de dados foi realizada de abril a junho de 2013, após Parecer favorável do Comitê de Ética: nº 313.430. Os dados foram tabulados no Excel e analisados por meio de estatísticas descritivas. Resultados: houve prevalência de 4,45% para Cândida sp, 12,7% Gardnerella vaginallis, 2,48% Trichomas vaginalis e 0,33% Chlamídia. Conclusão: a Cândida sp e a Gardnerella vaginallis/mobilluncus que fazem parte da flora vaginal apresentaram-se, no geral, compatíveis com a sintomatologia clínica das mulheres, no entanto, fazem-se necessárias atividades de educação em saúde em relação ao uso do preservativo e os riscos de se ter múltiplos parceiros para minimizar as infecções sexualmente transmissíveis: tricomoníase e clamídia.(AU)
Objective: to identify the prevalence of microbiological agents of vulvovaginitis. Method: documentary and retrospective study of the time series from 2007 to 2011 of the record books of cytological examinations of the three Family Health Teams of Jacana-RN. Data collection was conducted from April to June 2013, after a favorable Opinion from the Ethics Committee: No. 313,430. Data were tabulated in Excel and analyzed using descriptive statistics. Results: there was prevalence of 4.45% for Candida sp, 12.7% for Gardnerella vaginallis, 2.48% for Trichomas vaginalis and 0.33% for Chlamydia. Conclusion: Candida sp and Gardnerella vaginallis/mobilluncus that compose the vaginal flora appeared, in general, compatibly with the clinical symptoms of women, however, health education activities are necessary regarding the use of condoms and risks of having multiple partners to minimize sexually transmitted infections: trichomoniasis and chlamydia.(AU)
Objetivo: identificar la prevalencia de los agentes microbiológicos de las vulvovaginitis. Método: estudio documental y retrospectivo de la serie histórica de 2007 a 2011, de los libros de registros de los exámenes citológicos de las tres Equipes de Salud de la Familia de la ciudad de Jaçanã-RN. La recolección de datos fue realizada de abril a junio de 2013, luego del Parecer favorable del Comité de Ética: nº 313.430. Los datos fueron tabulados en Excel y analizados por medio de estadísticas descriptivas. Resultados: hubo prevalancia de 4,45% para Candida sp, Gardnerella vaginallis 12,7%, 2,48% y 0,33% tricomas vaginalis Chlamydia. Conclusión: la Candida sp y la Gardnerella vaginallis/mobilluncus que son parte de la flora vaginal se presentaron, en general, compatibles con la sintomatología clínica de las mujeres, no obstante, son necesarias actividades de educación en salud en relación al uso del preservativo y a los riesgos de tener múltiples compañeros para minimizar las infecciones sexualmente transmisibles: tricomoniasis y clamidia.(AU)
Subject(s)
Humans , Female , Vaginal Smears , Vulvovaginitis , Vulvovaginitis/epidemiology , Women , Health Profile , Papanicolaou Test , Retrospective StudiesSubject(s)
Humans , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Vulvovaginitis/microbiology , Vulvovaginitis/diagnosis , Vulvovaginitis/etiology , Microbial Sensitivity Tests/trends , Microbial Sensitivity Tests , Leukocytes/microbiology , Vulvovaginitis/epidemiology , Vulvovaginitis/prevention & control , Retrospective Studies , Corynebacterium pyogenes/isolation & purification , Streptococcus pyogenes/isolation & purification , Streptococcus agalactiae/isolation & purificationABSTRACT
La vulvovaginitis candidiásica recurrente (VVCR) es una entidad presente en la práctica diaria en las consultas y en urgencias. Sus síntomas causan molestias crónicas que repercuten seriamente en la calidad de vida de la mujer, empujándola a buscar constantemente una solución que no siempre llega. El diagnóstico debe confirmarse siempre mediante cultivo y el tratamiento debe basarse en el uso de antifúngicos imidazoles, tópicos u orales, con un tratamiento inicial con triple terapia para eliminar los síntomas e intentar eliminar los reservorios; seguida de un tratamiento de mantenimiento durante 6 a 12 meses. Las opciones para la prevención de la VVCR son muy limitadas y, exceptuando la eliminación del agente causal, ninguna otra medida preventiva ha resultado eficaz. Presentamos esta actualización de la VVCR en un intento de ayudar al profesional y colaborar en mejorar la atención de la mujer afecta de VVCR(AU)
Recurrent vulvovaginal candidiasis (RVVC) is a common infection in daily clinical and emergency practice. The symptoms of this infection cause distressing chronic conditions that seriously affect women's quality of life, prompting them to seek solutions that are sometimes hard to find. Diagnosis should always be confirmed by culture and treatment should be based on the use of topical or oral antifungal imidazoles. Triple therapy focused on symptom and reservoir elimination should initially be used, followed by maintenance therapy for 6 to 12 months. The options to prevent RVVC are highly limited and, except for elimination of the causative agent, no other preventive measures have been effective. We provide an updated review of RVVC in an attempt to aid health professionals and improve the care of women with this infection(AU)
Subject(s)
Humans , Female , Vulvovaginitis/complications , Vulvovaginitis/diagnosis , Vulvovaginitis/drug therapy , Candidiasis, Vulvovaginal/complications , Candidiasis, Vulvovaginal/diagnosis , Candidiasis, Vulvovaginal/drug therapy , Antifungal Agents/therapeutic use , Imidazoles/therapeutic use , Vulvovaginitis/physiopathology , Recurrence , Vulvovaginitis/epidemiology , Vulvovaginitis/etiology , Vaginal Diseases/etiology , Vaginal Diseases/microbiology , Vaginal Discharge/microbiologyABSTRACT
La vulvovaginitis es el problema ginecológico más frecuente en las niñas prepúberes, favorecido por la menor protección del introito vaginal a los agentes externos y la presencia de factores anatómicos (proximidad del ano, labios mayores y menores menos desarrollados, etc.) y hormonales (hipoestrogenismo). A esto se suma el efecto de productos irritantes locales y la coexistencia en ocasiones de malos hábitos higiénicos. La mayoría de las vulvovaginitis en las niñas son inespecíficas, aunque en un porcentaje variable pueden aislarse bacterias patógenas específicas (entéricas, respiratorias, o de transmisión sexual), o ser secundarias a otros procesos como oxiurasis o cuerpos extraños intravaginales. En el presente artículo analizaremos la etiología, la patogénesis, la clínica y el manejo de esta entidad en la infancia, y realizaremos algunas consideraciones clínicas y microbiológicas sobre distintos cuadros con etiología específica(AU)
Vulvovaginitis is the most common gynecological problem in prepubertal girls, helped by lower introitus protection to external agents and the presence of anatomical (proximity of anus, minor and major labia less developed,...) and hormonal factors (low estrogen concentration) This is compounded by the effect of local irritants and sometimes co-existence of poor hygiene. Most vulvovaginitis in girls are nonspecific, although specific pathogenic bacteria (enteric, respiratory, or sexually transmitted) can be isolated and they can be also secondary to other causes as oxiurasis, or intravaginal foreign bodies. In this article we will analyze the etiology, pathogenesis, clinical features and management of this disorder in childhood, and we will have some clinical and microbiological considerations of different diseases with specific etiology(AU)
Subject(s)
Humans , Female , Child , Vulvovaginitis/epidemiology , Vulvitis/complications , Vulvitis/diagnosis , Enterobius/isolation & purification , Enterobius/pathogenicity , Candidiasis/complications , Sexually Transmitted Diseases, Bacterial/complications , Foreign Bodies/complications , Anti-Bacterial Agents/therapeutic use , Vulvovaginitis/complications , Vulvovaginitis/diagnosis , Vulvovaginitis/physiopathology , Vulvitis/physiopathology , Vulvitis , Menarche/physiologyABSTRACT
Se realizó un estudio pre-experimental de intervención comunitaria en los Consultorios 1 al 4 perteneciente al Grupo Básico de Trabajo del Policlínico Docente Ceballos, en el período de septiembre de 2009 a septiembre de 2010, para determinar el conocimiento que poseen las madres de niñas en edad escolar sobre los factores de riesgo de la vulvovaginitis y su modificación después de realizada una intervención educativa sobre el tema. El universo del estudio estuvo conformado por todas las madres de niñas de estos consultorio y se tomó como muestra a las madres de las niñas en edad escolar (149), se les aplicó una encuesta para identificar las necesidades de aprendizaje, basado en las cuales, se elaboró un programa de intervención educativa; una vez desarrollado, se aplicó nuevamente la encuesta inicial. La información obtenida fue procesada utilizando el sistema estadístico SPSS. Se representó la información en tablas utilizando el análisis porcentual como medida de resumen, se analizaron las diferencias estadísticas con un nivel de significación de p<0,05. Con este tipo de intervención se logra modificar el nivel de conocimientos de forma positiva en los temas tratados; la intervención educativa aplicada mostró ser eficaz para elevar el nivel de conocimiento de las madres en estudio(AU)
It was carried out a pre-experimental study of community intervention in the Offices 1 to 4 belonging to the Basic Group of Work of the Teaching General hospital Ceballos, in the period from September, 2009 until September, 2010, to determine the knowledge that the in school age girls' mothers possess on the risk factors of the vulvovaginitis and its modification after realized an educational intervention on the topic. The universe of the study was constituted by all the girls' mothers of these offices and it were took the mothers of the girls in school age as a sample (149). A survey was applied to them to identify the needs for learning, based on which, a program of educational intervention was prepared; once developed, the initial survey was applied again. The obtained information was processed using the statistical system SPSS. The information was represented in stage using the percentage analysis as a summary measurement, it were analyzed the statistical differences at a significance level of p < 0,05. With this type of intervention it is possible to modify the knowledge level in a positive way in the treated topics; the applied educational intervention showed to be effective to raise the level of knowledge of the mothers in study(AU)
Subject(s)
Humans , Female , Child , Vulvovaginitis/epidemiology , Risk Factors , Health Knowledge, Attitudes, Practice , Health Education , Mothers/educationABSTRACT
CONTEXT AND Objective: Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis. DESIGN AND SETTING: Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba). METHODS: Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios. RESULTS: The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age. CONCLUSIONS: There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.
CONTEXTO E OBJETIVO: Muitos fatores influenciam a ocorrência de vulvovaginites. Os objetivos foram avaliar diferenças relacionadas à cor da pele e idade na flora vaginal e vulvovaginites. TIPO DE ESTUDO E LOCAL: Estudo transversal; hospital de referência terciário (Universidade Federal do Triângulo Mineiro, Uberaba). MÉTODOS: Mulheres saudáveis em atendimento de rotina para exames ginecológicos foram divididas em brancas (n = 13.881) e não brancas (n = 5.295) e avaliadas quanto a vulvovaginites e flora vaginal. Para análise estatística, foram utilizados teste X², regressão logística e odds ratio. RESULTADOS: Microflora vaginal foi dependente da cor da pele, com maior ocorrência de "clue cells", Trichomonas vaginalis e bacilos cocoides em não brancas (p < 0,0001); bacilos de Döderlein e flora citolítica foram mais prevalentes em brancas (p < 0,0001 e p < 0,05, respectivamente). Flora vaginal foi dependente da idade nos grupos de cor da pele. Entre não brancas, "clue cells", Trichomonas e bacilos cocoides foram mais prevalentes nas idades: 21 a 50 anos, até 40 anos, e 21 a 40 anos respectivamente (p < 0,05). Durante as fases proliferativa e secretória, mulheres não brancas tiveram maior probabilidade de apresentar "clue cells", Trichomonas, Candida e cocoides (odds ratio, OR - fase proliferativa: 1,31; 1,79; 1,6 e 1,25 respectivamente; fase secretória: 1,31; 2,88; 1,74 e 1,21 respectivamente), e menor chance de apresentarem flora Döderlein (OR - fase proliferativa: 0,76; fase secretória: 0,66) comparadas com brancas, independentemente da idade. CONCLUSÕES: Há diferenças na ocorrência de vulvovaginites relacionadas com a cor da pele, podendo haver associação com variações na flora vaginal.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Candida/isolation & purification , Gram-Negative Bacteria/isolation & purification , Skin Pigmentation , Trichomonas vaginalis/isolation & purification , Vagina/microbiology , Vulvovaginitis/microbiology , Age Distribution , Epidemiologic Methods , Menstrual Cycle/physiology , Vulvovaginitis/epidemiologyABSTRACT
OBJETIVO: analizar el comportamiento de las vulvovaginitis en niñas y adolescentes. MÉTODOS: se realizó un estudio prospectivo, descriptivo y analítico de las vulvovaginitis en niñas y adolescentes con el objetivo de comparar ambos grupos según los factores desencadenantes, principales síntomas, gérmenes etiológicos más frecuentes, así como la correspondencia entre el diagnóstico clínico y el de laboratorio. Se tomó una muestra de pacientes con vulvovaginitis (VV), provenientes de la consulta de afecciones infanto-juveniles del Hospital Ginecoobstétrico "Ramón González Coro". Toda la información se registró y procesó utilizando los programas de computación Microsoft Word y Microsoft Excel. Se confeccionaron tablas y gráficos.RESULTADOS: el mal hábito higiénico es el principal factor desencadenante de esta afección en ambos grupos, constituyó el 76 % en las niñas y el 70 % en las adolescentes. De los gérmenes etiológicos en las niñas y en las adolescentes se reportó con mayor frecuencia la Candida albicans con un 34 % y un 36% respectivamente. En el caso de las niñas los gérmenes son secundados por la Escherichia coli con un 22 % del total. Los síntomas y signos más frecuentes para ambos grupos son el prurito vulvar (36 % y 44 %), el eritema vulvar (32 % y 24 %) y la fetidez (24 % y 30 %) respectivamente, mientras el diagnóstico definitivo de las vulvovaginitis para las niñas y las adolescentes prevaleció para ambos grupos, con un 36 % la VV inespecífica.CONCLUSIONES: el principal factor predisponente de las vulvovaginitis es el mal hábito higiénico, y el germen causal más frecuente es la Candida albicans
OBJECTIVE: to analyze the vulvovaginitis behavior present in girls and adolescents. METHODS: an analytical, descriptive and prospective study of vulvovaginitis present in girls and adolescents was conducted to compare both groups according the triggering factors, leading symptoms; the more frequent etiologic germs, as well as, the correspondence between clinical diagnosis and the laboratory one. Sample included the vulvovaginitis patients from the infantile-juvenile affections consultation of "Ram¾n Gonzßlez Coro" Gynecology-Obstetrics Hospital. All information was registered and processed using the Microsoft Word and Microsoft Excel computing programs. Tables and Charts were designed. RESULTS: the poor hygienic habit is the main triggering factor of this entity in both groups (76 percent of girls and ddd70 percent of adolescents). From the etiologic germs in girls and in adolescents the more frequent reported was Candida albicans for a 34 percent and 36 percent, respectively. In the case of girls germs are supported by Escherichia coli for a 22 percent of total. The more frequent symptoms and signs for both groups are the vulvar pruritus (36 percent and 44 percent), vulvar erythema (32 percent and 24 percent) and foul smell (24 percent and 30 percent), respectively, while the definite diagnosis of vulvovaginitis for girls and adolescents prevailed for both groups with a 36 percent of non-specific vulvovaginitis. CONCLUSIONS: the leading predisposing factor of vulvovaginitis is the poor hygienic habit and the more frequent causal germ is Candida albicans
Subject(s)
Humans , Female , Child , Adolescent , Vulvovaginitis/epidemiology , Vulvovaginitis/etiology , Epidemiology, Descriptive , Prospective StudiesABSTRACT
OBJETIVO: analizar el comportamiento de las vulvovaginitis en niñas y adolescentes. MÉTODOS: se realizó un estudio prospectivo, descriptivo y analítico de las vulvovaginitis en niñas y adolescentes con el objetivo de comparar ambos grupos según los factores desencadenantes, principales síntomas, gérmenes etiológicos más frecuentes, así como la correspondencia entre el diagnóstico clínico y el de laboratorio. Se tomó una muestra de pacientes con vulvovaginitis (VV), provenientes de la consulta de afecciones infanto-juveniles del Hospital Ginecoobstétrico "Ramón González Coro". Toda la información se registró y procesó utilizando los programas de computación Microsoft Word y Microsoft Excel. Se confeccionaron tablas y gráficos.RESULTADOS: el mal hábito higiénico es el principal factor desencadenante de esta afección en ambos grupos, constituyó el 76 % en las niñas y el 70 % en las adolescentes. De los gérmenes etiológicos en las niñas y en las adolescentes se reportó con mayor frecuencia la Candida albicans con un 34 % y un 36% respectivamente. En el caso de las niñas los gérmenes son secundados por la Escherichia coli con un 22 % del total. Los síntomas y signos más frecuentes para ambos grupos son el prurito vulvar (36 % y 44 %), el eritema vulvar (32 % y 24 %) y la fetidez (24 % y 30 %) respectivamente, mientras el diagnóstico definitivo de las vulvovaginitis para las niñas y las adolescentes prevaleció para ambos grupos, con un 36 % la VV inespecífica.CONCLUSIONES: el principal factor predisponente de las vulvovaginitis es el mal hábito higiénico, y el germen causal más frecuente es la Candida albicans (AU)
OBJECTIVE: to analyze the vulvovaginitis behavior present in girls and adolescents. METHODS: an analytical, descriptive and prospective study of vulvovaginitis present in girls and adolescents was conducted to compare both groups according the triggering factors, leading symptoms; the more frequent etiologic germs, as well as, the correspondence between clinical diagnosis and the laboratory one. Sample included the vulvovaginitis patients from the infantile-juvenile affections consultation of "Ram¾n Gonzßlez Coro" Gynecology-Obstetrics Hospital. All information was registered and processed using the Microsoft Word and Microsoft Excel computing programs. Tables and Charts were designed. RESULTS: the poor hygienic habit is the main triggering factor of this entity in both groups (76 percent of girls and ddd70 percent of adolescents). From the etiologic germs in girls and in adolescents the more frequent reported was Candida albicans for a 34 percent and 36 percent, respectively. In the case of girls germs are supported by Escherichia coli for a 22 percent of total. The more frequent symptoms and signs for both groups are the vulvar pruritus (36 percent and 44 percent), vulvar erythema (32 percent and 24 percent) and foul smell (24 percent and 30 percent), respectively, while the definite diagnosis of vulvovaginitis for girls and adolescents prevailed for both groups with a 36 percent of non-specific vulvovaginitis. CONCLUSIONS: the leading predisposing factor of vulvovaginitis is the poor hygienic habit and the more frequent causal germ is Candida albicans (AU)
Subject(s)
Humans , Female , Child , Adolescent , Vulvovaginitis/epidemiology , Vulvovaginitis/etiology , Epidemiology, Descriptive , Prospective StudiesABSTRACT
CONTEXT AND OBJECTIVE: Empirical discussion regarding an association between koilocytosis and vulvovaginitis often occurs. Thus, the objective of this study was to assess the prevalence of microorganisms associated with bacterial vaginosis and vulvovaginitis in women with and without koilocytosis. DESIGN AND SETTING: Analytical cross-sectional study including two cohorts of women (with and without koilocytosis) who attended a cancer hospital in the city of Goiânia, state of Goiás. METHODS: A total of 102 patients entered the study. The whiff test, Gram and Papanicolaou staining and bacterial and fungal culturing were performed. The results were observed using univariate analysis. The odds ratio and confidence interval (CI) of the variables were calculated; P-values < 0.05 were considered significant. RESULTS: The prevalence of bacterial colonization was similar in patients with and without koilocytosis. The odds ratio for candidiasis was 1.43 (CI 1.05-1.95) and the odds ratio for trichomoniasis was 1.78 (CI 1.49-2.12), in patients with koilocytosis. CONCLUSIONS: The prevalence of candidiasis and trichomoniasis seems to be higher in patients with koilocytosis.
CONTEXTO E OBJETIVO: Existe uma discussão empírica sobre a associação de coilocitose e vulvovaginite. Assim, o objetivo deste estudo foi saber a prevalência de microorganismos associados à vaginose bacteriana e à vulvovaginite em mulheres com e sem coilocitose. DESENHO E LOCAL: Estudo transversal analítico, que incluiu duas coortes de mulheres, com e sem coilocitose, atendidas em um hospital de referência de câncer, na cidade de Goiânia, estado de Goiás. MÉTODOS: Um total de 102 pacientes entrou no estudo. Foram feitos os testes whiff, Gram e Papanicolaou, além de cultura para bactérias e fungos. Utilizou-se análise univariada, com o cálculo do risco relativo e do intervalo de confiança (IC). Considerou-se significativo quando valor de P < 0,05. RESULTADOS: A prevalência de colonização bacteriana foi similar em pacientes com e sem coilocitose. O risco relativo para candidíase observado em mulheres com coilocitose foi de 1,43 (IC 1,05-1,95) e, para tricomoníase, 1,78 (IC 1,49-2,12). CONCLUSÃO: A prevalência de candidíase e de tricomoníase parece ser maior nas pacientes com coilocitose.
Subject(s)
Adult , Animals , Female , Humans , Middle Aged , Young Adult , Papillomavirus Infections , Vaginosis, Bacterial/epidemiology , Vulvovaginitis/epidemiology , Candida/isolation & purification , Candidiasis/epidemiology , Epidemiologic Methods , Papillomavirus Infections/diagnosis , Papillomavirus Infections/microbiology , Papillomavirus Infections/parasitology , Trichomonas Vaginitis/epidemiology , Trichomonas vaginalis/isolation & purification , Vaginosis, Bacterial/microbiology , Vaginosis, Bacterial/parasitology , Vulvovaginitis/microbiology , Vulvovaginitis/parasitology , Young AdultABSTRACT
Las vulvovaginitis de repetición son un problema común en la práctica clínica. El manejo de estas pacientes se complica a menudo con una larga anamnesis de tratamientos tan tentativos como inadecuados, ya que parten a menudo de un procedimiento diagnóstico incompleto. En este artículo revisamos las causas más frecuentes de estos cuadros, los pasos adecuados para establecer su diagnóstico, desde la anamnesis hasta las pruebas complementarias necesarias, y por último, las medidas terapéuticas oportunas. Nos centramos, por ser de mayor interés para el dermatólogo, en las de causa infecciosa, irritativa, alérgica y hormonal. Prestamos especial atención a los cuadros de etiología infecciosa y a su diagnóstico diferencial, por ser la causa más común de estos procesos y también frecuente motivo de tratamientos intempestivos (AU)
Recurrent vulvovaginitis is a common problem in clinical practice. Management is often complicated by a long history of inappropriate treatments based on tentative diagnoses after an incomplete diagnostic workup. We review the most common causes of recurrent vulvovaginitis; the appropriate steps with which to establish a diagnosis, from the medical history through to the additional tests needed; and, finally, the best therapeutic options. We will focus on infectious, irritant, allergic, and hormonal causes as the ones of most interest to the dermatologist. Given that infection is the most frequent cause of these processes and also a common reason for inopportune treatment, we will pay particular attention to infectious etiologies and their differential diagnosis (AU)
Subject(s)
Humans , Female , Adult , Vulvovaginitis/diagnosis , Vulvovaginitis/therapy , Diagnosis, Differential , Risk Factors , Trichomonas Infections/complications , Herpes Simplex/complications , Metronidazole/therapeutic use , Povidone-Iodine/therapeutic use , Clindamycin/therapeutic use , Medical History Taking/methods , Candida/isolation & purification , Candida/pathogenicity , Candida albicans/isolation & purification , Vulvovaginitis/epidemiology , Vulvovaginitis/etiology , Leukorrhea/complications , Tinidazole/therapeutic use , Azoles/therapeutic useABSTRACT
OBJETIVO: comparar a freqüência de vulvovaginites em mulheres infectadas pelo vírus da imunodeficiência humana (HIV) com mulheres não infectadas. MÉTODOS: estudo de corte transversal com 64 mulheres infectadas pelo HIV e 76 não infectadas. Foram calculadas as freqüências de vaginose bacteriana, candidíase e tricomoníase, que foram diagnosticadas por critérios de Amsel, cultura e exame a fresco, respectivamente. Para análise dos dados, utilizaram-se o teste do c2, teste exato de Fisher e regressão múltipla para verificar a independência das associações. RESULTADOS: a infecção vaginal foi mais prevalente em pacientes infectadas pelo HIV quando comparadas ao Grupo Controle (59,4 versus 28,9 por cento, p<0,001; Odds Ratio=2,7, IC95 por cento=1,33-5,83, p=0,007). Vaginose bacteriana ocorreu em 26,6 por cento das mulheres HIV positivas; candidíase vaginal, em 29,7 por cento e tricomoníase, em 12,5 por cento. Todas foram significativamente mais freqüentes no grupo de mulheres infectadas pelo HIV (p=0,04, 0,02 e 0,04, respectivamente). CONCLUSÕES: vulvovaginites são mais freqüentes em mulheres infectadas pelo HIV.
PURPOSE: to compare the frequency of vulvovaginitis in women infected with human imunnodeficiency virus (HIV) with the frequency in non-infected women. METHODS: a transversal study including 64 HIV infected women and 76 non-infected ones. The frequencies of bacterial vaginosis, candidiasis and trichomoniasis, diagnosed by Amsel's criteria, culture and fresh exam, respectively, were calculated. Chi-square test, Fisher's exact test and multiple regressions to verify the independence of associations were used to analyze the data. RESULTS: the vaginal infection was more prevalent in HIV infected patients, as compared to the control group (59.4 versus 28.9 percent, p<0,001; Odds Ratio=2.7, IC95 percent=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6 percent of the positive-HIV women; vaginal candidiasis, in 29.7 percent and trichomoniasis, in 12.5 percent of them. All the infections were significantly more frequent in the group of HIV infected women (p=0.04, 0.02 e 0.04, respectively). CONCLUSIONS: vulvovaginitis is more frequent in HIV infected women.
Subject(s)
Adult , Female , Humans , HIV Infections/complications , Vulvovaginitis/epidemiology , Vulvovaginitis/etiology , Cross-Sectional StudiesABSTRACT
OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica de candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45°C e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69 por cento dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (p<0,05). A positividade anal concomitante com a vaginal foi significativa, sugerindo uma possível contaminação vaginal a partir do ânus.
PURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology and results of anal culture, to identify the frequency of species of Candida albicans and non-C. albicans, and to correlate anal and vaginal colonization. METHODS: a total of 99 patients were included with suspected vulvovaginal candidiasis, from Natal, Brazil, between May 2003 and May 2005, totalling 294 collections. The clinical material, obtained by vaginal and anal swabs, was seeded on CHROMagar Candida®. The yeasts were identified using the classic method, in addition to the growth test at 42° and 45°C and the Hypertonic Saboraud broth test. Symptomatology, risk factors and anal colonization were assessed according to positive or negative culture for Candida spp. The cultures positive for C. albicans at the two sites were compared with other results encountered. YatesÆ chi2 test and FisherÆs exact test were used for statistical analysis. RESULTS: the most frequent was C. albicans in 69 percent of the cases. Wearing tight and/or synthetic underclothing, the presence of allergic diseases, the occurrence of itching, leukorrhea and hyperemia showed a significant association with positive culture for Candida spp in the vagina. The chance of a patient with positive anal colonization to present with concomitant positive vaginal colonization was 2.8 and 4.9 times greater for Candida spp and C. albicans, respectively. The risk of a patient with anal culture positive for C. albicans to present with positive vaginal colonization was 3.7 times greater when compared to non-C. albicans species. CONCLUSIONS: the most common species was C. albicans, and a relevant association between vaginal cultures positive for Candida spp and the use of tight and/or synthetic underclothing, allergic diseases, the occurrence of pruritus, leukorrhea and erythema was observed (p<0.05). Positive anal colonization concomitant with vaginal colonization was significant,suggesting...
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged, 80 and over , Anal Canal/microbiology , Candidiasis, Vulvovaginal/diagnosis , Vagina/microbiology , Vulvovaginitis/epidemiologyABSTRACT
Data in the Caribbean documenting the speciation of yeast associated with vulvovaginitis are lacking. The widespread use of antibiotics and increased availability of antimycotic agents, both prescribed and over-the-counter, predisposes both to a change in the epidemiologic patterns and the possible development of secondary resistance among previously susceptible yeast. This study was conducted to evaluate the aetiologic agents associated with mycotic vulvovaginitis and to review the appropriateness of prescribed antifungal therapy. Of 134 positive isolates, the most frequent yeast isolate was C. albicans accounting for 78%, C. tropicalis 10%, Prototheca wickerhamii (P. wickerhamii) 5%, C. glabrata 4%, Cryptococcus albidus (C. albidus) 2% and C. lusitaniae (1%) were also isolated. Of the positive cases, 75% were treated with antifungals, 17% with antibiotics and 8% were not treated. The azole group was the most frequently prescribed antifungal (71%). Of cases with negative yeast cultures, 83% were treated with antifungals. The presence of non-albicans Candida species and other opportunistic fungi is an important finding and combined with the pattern of therapy, represents a major challenge for future empirical therapeutic and prophylactic strategies in the treatment of mycotic vulvovaginitis
La región del Caribe carece de datos que documenten la especiación de la levadura asociada con la vulvovaginitis. El uso extendido de antibióticos y la mayor disponibilidad de agentes antimicóticos tanto los adquiridos mediante prescripción facultativa como los que pueden comprarse sin receta médica predisponen por un lado a un cambio en los patrones epidemiológicos, y por otro al posible desarrollo de resistencia secundaria en la levadura previamente susceptible. Este estudio se llevó a cabo con el fin de evaluar los agentes etiológicos asociados con la vulvovaginitis micótica y examinar cuán adecuada resulta la terapia antifúngica prescrita. De 134 aislados positivos, el aislado de levadura más frecuente fue el C albicans responsable del 78%. También fueron aislados C tropicalis 10%, Prototheca wickerhamii (P wickerhamii) 5%, C glabrata 4%, Cryptococcus albidus (C albidus) 2% y C lusitaniae (1%). El 75% de los casos positivos fueron tratados con antifúngicos, el 17% con antibióticos, en tanto que un 8% no recibió tratamiento alguno. Los medicamentos antifungosos de la familia azol (71%) fueron los más frecuentemente prescritos. El 83% de los casos con cultivos de levadura negativos, fue tratado con antifúngicos. La presencia de especies de Candida no albicans y otros hongos oportunistas, constituye un hallazgo importante, y en combinación con el modelo de terapia, representa un desafío de importancia considerable para las futuras estrategias empíricas tanto terapéuticas como profilácticas en el tratamiento de la vulvovaginitis micótica.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Antifungal Agents/therapeutic use , Vulvovaginitis/drug therapy , Vulvovaginitis/epidemiology , Vulvovaginitis/microbiology , Candidiasis, Vulvovaginal/drug therapy , Candidiasis, Vulvovaginal/epidemiology , Prospective Studies , Jamaica/epidemiology , Drug Resistance, FungalABSTRACT
Considerando la alta incidencia de vulvovaginitis en la consulta de ginecología pediátrica y de adolescentes, y los aspectos únicos de la microbiología y endocrinología de la paciente prepúber se presenta una revisión de la literatura con lo más relevante de los últimos 5 años, en lo que se refiere a epidemiología, etiología, diagnóstico y tratamiento de la vulvovaginitis bacteriana específica de la niña prepúber. No existe claridad acerca de la microflora vaginal normal, lo cual dificulta en gran medida la interpretación de muestras. De acuerdo con la evidencia actual podemos decir que ante la vulvovaginitis específica de la prepúber debemos tener en consideración como principales agentes causales: patógenos respiratorios, epidérmicos y entéricos; higiene defectuosa, cuerpos extraños, irritantes, enfermedades dermatológicas vulvares, defectos anatómicos y abuso sexual. Streptococcus hemolitico del grupo A y Haemophilus influenzae son patógenos prevalentes.
Subject(s)
Humans , Adolescent , Female , Child , Vaginal Diseases , Vulvovaginitis/diagnosis , Vulvovaginitis/epidemiology , Vulvovaginitis/drug therapy , Vulvovaginitis/therapy , Haemophilus influenzae/isolation & purification , Haemophilus influenzae/pathogenicity , Leukorrhea , Streptococcus/isolation & purification , Streptococcus/pathogenicity , Trichomonas Vaginitis/diagnosis , Trichomonas Vaginitis/epidemiology , Trichomonas Vaginitis/drug therapy , Trichomonas Vaginitis/therapyABSTRACT
La infección vulvovaginal (IVV) es una causa frecuente de consulta ginecológica en adolescentes siendo Vaginosis bacteriana, candidiasis y trichomoniasis sus etiologías más frecuentes. Estudios anteriores en adolescentes chilenas arrojan cifras disímiles respecto a la contribución de cada una de las etiologías anteriores. Nuestro objetivo fue identificar las etiologías más frecuentes de IVV en adolescentes sintomáticas que consultaron en un Centro de atención adolescente del área Norte de Santiago. Se tomaron muestras de flujo vaginal de 100 adolescentes las que fueron analizadas mediante Gram y cultivo. Noventa y una pacientes tenían vida sexual activa y 9 eran vírgenes. Se detectó 62% de vulvovaginitis, correspondiendo 31% a vaginosis bacteriana (VB), 24% a candidiasis, 2% a trichomoniasis y 5% etiología mixta (VB asociado candidiasis). Se encontró IVV en ambos grupos de adolescentes. Al analizar los resultados por edad, se observó un aumento en la incidencia de vulvovaginitis en adolescentes de mayor edad.
Subject(s)
Adolescent , Female , Vulvovaginitis/diagnosis , Vulvovaginitis/epidemiology , Vulvovaginitis/etiologyABSTRACT
Se realizó un estudio en 428 pacientes de la provincia de Guantánamo, con la finalidad de precisar los aspectos clínicos, epidemiológicos y microbiológicos de la vulvovaginitis durante el período comprendido desde septiembre de 1999 hasta agosto 2000. El grupo etáreo con más afectados resultó ser el de 25-34 años, con 193 pacientes, el área de salud que más casos aportó fue la rural, con 117 pacientes (27,3 por ciento), y el principal síntoma referido fue la secreción vaginal, presente en 308 pacientes. En más de la mitad de las pacientes estudiadas se aisló algún germen, y la Candida fue el más frecuente, en 235 pacientes (54,9 por ciento), seguido de la Trichomona vaginalis, en 88 pacientes (20,5 por ciento)(AU)
Subject(s)
Vulvovaginitis/epidemiology , Vulvovaginitis , Vulvovaginitis/microbiologyABSTRACT
A detecçäo de anticorpos anti-Herpesvírus Bovino tipo 1 (BHV-1) foi realizada, através da técnica de soroneutralizaçäo, em 1235 amostras de soro de bovinos adultos, näo vacinados contra Rinotraqueíte Infecciosa Bovina. As amostras de soro analisadas foram colhidas em 81 rebanhos, com histórico de problemas reprodutivos, incluindo animais com aptidäo para carne e leite, provenientes de 30 municípios do Estado do Paraná. Na amostragem proveniente de rebanhos leiteiros, 41,9 por cento (409/977) das amostras de soro e 90,5 por cento (57/63) dos rebanhos foram considerados positivos. Em bovinos de corte, o índice de soropositividade foi de 50,8 por cento (131/258) e 100 por cento (18/18) para amostras de soro e rebanhos, respectivamente. As frequências de 43,7 por cento (540/1235) de animais e 92,6 por cento (75/81) de rebanhos soropositivos demonstram que as infecçöes por BHV-1 apresentam-se amplamente disseminadas nas regiöes estudadas.
Subject(s)
Animals , Cattle , Cattle Diseases/epidemiology , Cattle Diseases/blood , Herpesvirus 1, Bovine , Herpesviridae Infections/epidemiology , Herpesviridae Infections/blood , Herpesviridae Infections/veterinary , Prevalence , Infectious Bovine Rhinotracheitis/epidemiology , Infectious Bovine Rhinotracheitis/blood , Vulvovaginitis/blood , Vulvovaginitis/epidemiology , Vulvovaginitis/veterinary , Serologic Tests/statistics & numerical data , Serologic Tests/veterinaryABSTRACT
As vulvovaginites e cervicites são achados de alta frequência na clínica ginecológica e obstétrica, embora não constituam na maioria das vezes patologias graves, são responsáveis por constantes queixas de desconforto na mulher. Neste trabalho realizamos um estudo epidemiológico das vulvovaginites, cervicites e neoplasias intraepiteliais cervicais (NIC) em 2096 mulheres que foram atendidas pelo Serviço de Ginecologia do Hospital Municipal de Aracati, no período de janeiro a dezembro de 1996. O estudo foi feito a partir da consulta de laudos citopatológicos avaliados por equipe especializada do Instituto de Prevenção de Câncer do Estado do Ceará (IPCC), através do qual constatamos que a incidência de vulvovaginites e cervicites foi bastante elevada (88,78%), enquanto que a de NIC foi na ordem de 0,72%. Esfregaços atróficos (3,82%), citolíticos (3,39%) e purulentos (3,29%) caracterizaram os demais tipos encontrados. Dos 2976 esfregaços cérvico-vaginais provenientes no município de Aracati avaliados com relação à frequência dos microagentes, observamos os seguintes casos: 1101 (37%) flora mista, 630 (21,17%) bacilos de Dõederlein, 512 (17,2%) Gardnerella vaginalis, 364 (12,23%) cocóides, 95 (3,19%) Trichomonas vaginalis, 71 (2,39%) fungos, 45 (1,51%) Trichomonas associada a cocóides, 31 (1,04%) Gardnerella associada a Trichomonas, 9 (0,3%) HPV, 6 (0,2%) Chlamydia trachomatis, 4 (0,13%) Gardnerella associada a fungos, 1 (0,04%) Mobiluncus e 107 (3,6%) corresponderam as vaginites atróficas. Conclui-se que, apesar da alta incidência de vulvovaginites na população estudada, o baixo índice de NIC deva-se ao trabalho preventivo que tem sido desenvolvido nesta região
Subject(s)
Humans , Female , Uterine Cervical Dysplasia , Uterine Cervicitis/epidemiology , Incidence , Vulvovaginitis/epidemiologyABSTRACT
Neste artigo säo abordados os aspéctos epidemiológicos das vulvovaginites sob uma perspectiva evolutiva eassistencial, enfocando praticamente todos os grupos etiológicos dessa afecçäo. Ressalta-se a influência negativa das discordâncias conceituais, terminológicas e etiológicas das vulvovaginites sobre suas avaliaçöes epidemiológicas e a necessidade de se estabelecer um consenso sobre estas questöes. Confirma-se que as vulvovaginites ligadas a vaginose bacteriana, candidíase e tricomoníase säo as mais prevalentes, abordando sua freqüência e seus fatores predisponentes e de recorrencia. Destaca-se também a importância das outras causas de vulvovaginite, alertando para suas dificuldades diagnósticas e sugerindo incorporá-las, metodica e definitivamente, no grupo dos diagnósticos diferenciais das causas de vulvovaginites