Identificación y susceptibilidad de Candida spp. en el área ginecológica

Resumen La candidiasis es una infección causada por la acción patógena de Candida spp., catalogada como la segunda causa a nivel mundial de infección vaginal en mujeres con edades comprendidas entre 15 y 45 años. Siendo Candida albicans la más prevalente con distribución global. Uno de los problemas de importancia clínica es la resistencia a los antifúngicos debido al uso irracional de los mismos como terapia empírica y profilaxis. Objetivo . Caracterizar la infección por Candida spp., según: perfiles de susceptibilidad y frecuencias de candidiasis vulvo - vaginal relacionada con el balance de contenido vaginal. Así como, la presencia de coinfecciones en mujeres de edad fértil en las ciudades Cuenca - Azogues, que asisten a consulta en el Hospital Monte Sinaí, periodo enero - noviembre de 2020. Materiales y métodos . Estudio de tipo descriptivo, documental de corte transversal, la muestra estuvo conformada por 136 aislados clínicos, se utilizó un muestreo por cobertura total. Resultados . El grupo etario que prevaleció fue de 19 - 39 años. Candida albicans fue la más prevalente en muestras de secreción vaginal con 92.6 %, seguido de Candida glabrata 6.6 % y Candida parapsilosis con 0.7 %. Las tasas de resistencia se diferenciaron en Miconazol con 19.9 %, Itraconazol 16.9 %, y Fluconazol 14%. Conclusiones . El agente etiológico causal de candidiasis vulvo - vaginal fue Candida albicans. La interpretación del balance de contenido vaginal y perfiles de susceptibilidad, son herramientas clave para el óptimo tratamiento de la paciente con infecciones vaginales, evitando la automedicación y la farmacorresistencia.

Abstract Candidiasis is an infection caused by the pathogenic action of Candida spp., Classified as the second worldwide cause of vaginal infection in women aged between 15 and 45 years. Being Candida albicans the most prevalent with global distribution. One of the clinically important problems is resistance to antifungals due to their irrational use as empirical therapy and prophylaxis. Objective : To characterize the infection by Candida spp., according to: susceptibility profiles and frequencies of vulvo-vaginal candidiasis related to the balance of vaginal content. As well as, the presence of co-infections in women of childbearing age in Cuenca - Azogues cities, who attend a consultation at the Monte Sinaí Hospital, January - November 2020 period. Materials and methods . A descriptive, observational cross-sectional study, the sample consisted of 136 clinical isolates, a full coverage sampling was used. Results. The age group that prevailed was 19 - 39 years. Candida albicans was the most prevalent in vaginal discharge samples with 92.6%, followed by Candida glabrata 6.6% and Candida parapsilosis with 0.7%. Resistance rates differed in Miconazole with 19.9%, Itraconazole 16.9%, and Fluconazole 14%. Conclusions . The causative etiological agent of vulvo-vaginal candidiasis was Candida albicans. The interpretation of the balance of vaginal content and susceptibility profiles are a key tool for the optimal treatment of the patient with vaginal infections, avoiding self-medication and drug resistance.

Resumo Candidíase é uma infecção causada pela ação patogênica de Candida spp., Classificada como a segunda causa mundial de infecção vaginal em mulheres com idade entre 15 e 45 anos. Sendo Candida albicans a mais prevalente com distribuição global. Um dos problemas clinicamente importantes é a resistência aos antifúngicos devido ao seu uso irracional como terapia empírica e profilaxia. Objetivo . Caracterizar a infecção por Candida spp., De acordo com: perfis de suscetibilidade e frequências de candidíase vulvovaginal relacionadas ao equilíbrio do conteúdo vaginal. Assim como, a presença de coinfecções em mulheres em idade fértil nos municípios de Cuenca - Azogues, atendidas em consulta no Hospital Monte Sinaí, período janeiro - novembro de 2020. Materiais e métodos . Estudo descritivo, observacional, transversal, a amostra foi composta por 136 isolados clínicos, foi utilizada uma amostra de cobertura total. Resultados . A faixa etária prevalente foi de 19 a 39 anos. Candida albicans foi a mais prevalente nas amostras de corrimento vaginal com 92,6%, seguida por Candida glabrata 6,6% e Candida parapsilosis com 0,7%. As taxas de resistência diferiram no Miconazol com 19,9%, Itraconazol 16,9% e Fluconazol 14%. Conclusões . O agente etiológico causador da candidíase vulvovaginal foi Candida albicans. A interpretação do equilíbrio do conteúdo vaginal e dos perfis de suscetibilidade é uma ferramenta fundamental para o tratamento ideal da paciente com infecções vaginais, evitando a automedicação e a resistência aos medicamentos

Relação entre vulvovaginite pré-natal e laceração perineal relacionada ao parto / Relación entre vulvovaginitis prenatal y desgarro perineal relacionado con el parto / Relationship between antenatal vulvovaginitis and birth-related perineal tear

Resumo Objetivo Determinar a relação entre vulvovaginite pré-natal e laceração perineal relacionada ao parto. Método Estudo transversal analítico com 100 puérperas ≥18 anos de idade que deram à luz por parto normal a um bebê único, vivo, a termo, em apresentação cefálica, em um centro de parto liderado por enfermeiras obstetras. Os dados foram coletados a partir da ficha de pré-natal e nascimento e por entrevista estruturada dos participantes. A distribuição das variáveis contínuas e categóricas de acordo com a ruptura perineal foi comparada com o teste t de Student, qui-quadrado e teste exato de Fisher. Para as variáveis significativamente associadas à ruptura perineal, foi estimado o Odds Ratio com modelos de regressão logística. Modelos de regressão múltipla foram ajustados para avaliar o efeito independente das variáveis. A significância estatística foi considerada com p<0,05. Resultado A média de idade das participantes foi de 23,1 anos, 16% dos trabalhos de parto foram induzidos com misoprostol, em 54% dos trabalhos de parto houve infusão de ocitocina sintética, 83% dos partos foram em posição de litotomia, 98% de manobra hands-on, 75% de laceração perineal, 54% de vulvovaginite pré-natal, média de peso ao nascer, circunferência cefálica e torácica dos recém-nascidos: 3,102g, 33,3cm e 32,2cm, respectivamente. Vulvovaginite pré-natal (p=0,005), peso ao nascer do recém-nascido (p=0,006) e perímetro cefálico (0,027) tiveram associação com a ruptura perineal. A análise múltipla mostrou que mulheres com vulvovaginite pré-natal tiveram uma chance de 4,6 (IC 95%: 1,712-14,125; p=0,004) de sustentar laceração perineal em comparação com aquelas sem vulvovaginite, independentemente do peso do recém-nascido (OR:1,182, IC 95%: 1,002-1,415; p=0,056) e do perímetro cefálico(OR: 1,160, IC 95%: 0,721-1892; p=0,544). Não houve associação entre o tratamento de vulvovaginite pré-natal e laceração perineal (p>0,999) ou vulvovaginite pré-natal e gravidade da laceração perineal (OR:1,061, IC 95%: 0,383-3,069; p=0,911). Conclusão Este estudo demonstrou associação entre laceração perineal no parto e vulvovaginite pré-natal. É necessário prevenir e tratar a vulvovaginite pré-natal e oferecer cuidados perineais adequados durante o parto às mulheres que tiveram vulvovaginite na gestação.

Resumen Objetivo Determinar la relación entre vulvovaginitis prenatal y desgarro perineal relacionado con el parto. Método Estudio transversal analítico con 100 puérperas de ≥18 años de edad que dieron a luz por parto vaginal a un bebé único, vivo, a término, en presentación cefálica, en un centro de parto liderado por enfermeras obstetras. Los datos se recopilaron a partir de la ficha de atención prenatal y nacimiento y mediante encuesta estructurada de las participantes. La distribución de las variables continuas y categóricas de acuerdo con la ruptura perineal fue comparada con el test-T de Student, la prueba χ2 de Pearson y la prueba exacta de Fisher. Para las variables significativamente asociadas a la ruptura perineal, se estimó el Odds Ratio con modelos de regresión logística. Se adaptaron los modelos de regresión múltiple para evaluar el efecto independiente de las variables. La significación estadística fue considerada con p<0,05. Resultado El promedio de edad de las participantes fue de 23,1 años, el 16 % de los trabajos de parto fueron inducidos con misoprostol, en el 54 % de los trabajos de parto hubo infusión de oxitocina sintética, el 83 % de los partos fueron en posición de litotomía, el 98 % de maniobra hands-on, el 75 % de desgarro perineal, el 54 % de vulvovaginitis prenatal, el promedio de peso al nacer de 3,102 g, de circunferencia cefálica de 33,3 cm y de circunferencia torácica de 32,2 cm de los recién nacidos. La vulvovaginitis prenatal (p=0,005), el peso al nacer del recién nacido (p=0,006) y el perímetro cefálico (0,027) tuvieron relación con la ruptura perineal. El análisis múltiple demostró que mujeres con vulvovaginitis prenatal tuvieron una probabilidad de 4,6 (IC 95 %: 1,712-14,125; p=0,004) de tener desgarro perineal en comparación con aquellas sin vulvovaginitis, independientemente del peso del recién nacido (OR:1,182, IC 95 %: 1,002-1,415; p=0,056) y del perímetro cefálico (OR:1,160, IC 95 %: 0,721-1892; p=0,544). No se observó relación entre el tratamiento de vulvovaginitis prenatal y desgarro perineal (p>0,999) o entre la vulvovaginitis prenatal y la gravedad del desgarro perineal (OR:1,061, IC 95 %: 0,383-3,069; p=0,911). Conclusión Este estudio demostró que existe relación entre desgarro perineal en el parto y vulvovaginitis prenatal. Es necesario prevenir y tratar la vulvovaginitis prenatal y ofrecer cuidados perineales adecuados durante el parto a las mujeres que tuvieron vulvovaginitis en el embarazo.

Abstract Objective To determine the relationship between antenatal vulvovaginitis and birth-related perineal tear. Methods An analytical cross-sectional study with 100 postpartum women, ≥18 years of age, who gave birth vaginally to a single, live, full-term baby in cephalic presentation at a midwife-led birth center. Data were collected from the antenatal and birth record and by structured interview of participants. Distribution of continuous and categorical variables according to perineal tear were compared by using the Student's T-test, Chi-square and Fisher Exact tests. For variables significantly associated with perineal tear, the Odds Ratio with logistic regression models was estimated. Multiple regression models were adjusted to evaluate the independent effect of variables. Statistical significance was considered at a level p<0.05. Results mean of participants' age 23.1 years, 16% labor induced with misoprostol, 54% synthetic oxytocin infusion in labor, 83% lithotomy birth position, 98% "hands on" maneuver, 75% perineal tear, 54% antenatal vulvovaginitis, mean of newborn birth weight, head and thoracic circumference: 3.102g, 33.3cm and 32.2cm, respectively. Antenatal vulvovaginitis (p=0.005) and newborn birth weight (p=0.006) and head circumference (0,027) were associated with perineal tear. The multiple analysis showed that women who had antenatal vulvovaginitis had a 4.6 (IC 95%:1.712-14.125; p=0.004) chance of sustaining perineal tear compared to those without vulvovaginitis, regardless of newborn birth weight (OR:1.182 IC 95%:1.002-1.415; p=0,056) and head circumference (OR:1.160 IC 95%: 0.721-1892; p=0.544). There was no association between treating antenatal vulvovaginitis and perineal tear (p>0,999) or antenatal vulvovaginitis and perineal tear severity (OR: 1.061 IC 95%: 0.383-3.069; p=0.911). Conclusion This study demonstrates an associated risk between antenatal vulvovaginitis perineal injury. It is necessary to prevent and treat antenatal vulvovaginitis, and offer proper perineal care to women who have had antenatal vulvovaginitis during childbirth.

Comportamiento del riesgo reproductivo preconcepcional en mujeres fértiles de San Juan y Martínez / Preconception reproductive risk behavior in fertile women from San Juan and Martinez municipality

RESUMEN Introducción: el control de la natalidad ha sido una constante preocupación desde los albores de la humanidad. El control y manejo del riesgo preconcepcional es de vital importancia, pues está condicionado por una serie de factores, enfermedades o circunstancias únicas o asociadas, que pueden repercutir de manera desfavorable en el binomio madre-hijo durante la gestación, parto o puerperio. Objetivo: caracterizar el riesgo reproductivo preconcepcional en mujeres en edad fértil, pertenecientes a los consultorios médicos 26 y 46 del municipio San Juan y Martínez, en el 2016. Métodos: se realizó un estudio observacional, descriptivo y longitudinal, el universo estuvo constituido por las 117 mujeres en edad fértil de los consultorios seleccionados y la muestra quedó conformada por 53 mujeres que cumplían los criterios de inclusión. Los datos se resumieron en frecuencias absolutas y relativas. Resultados: predominó el grupo de edad entre 30 y 39 años, en la mayoría se encontró la hipertensión arterial como enfermedad crónica asociada, como afecciones ginecológicas las más representativa fue la vulvovaginitis, y como factor de riesgo obstétrico predominó el periodo intergenésico corto. La preclampsia leve prevaleció como complicación de embarazo anterior y el tabaquismo fue el hábito tóxico más encontrado. Conclusiones: se caracterizó el riesgo reproductivo preconcepcional en las mujeres en edad fértil, se contribuyó así a una mayor atención y seguimiento en las consultas de planificación familiar.

ABSTRACT Introduction: birth control has been a constant concern since the dawn of humankind. Preconception risk control and management is of crucial importance, it is conditioned by a series of factors, diseases, unique or associated circumstances that may adversely affect the mother-child binomial during gestation, childbirth or puerperium. Objective: to characterize preconception reproductive risk factors women of childbearing ages, belonging to the medical offices No- 26 and No-46 of San Juan and Martinez municipality in 2016. Methods: an observational, descriptive and longitudinal study was carried out, the target group comprised 117 women of childbearing ages from the chosen clinics and the sample included 53 women who met the inclusion criteria. Data were summarized in absolute and relative frequencies. Results: there was predominance of the age group between 30 and 39 years old, in the majority of them hypertension was found as an associated chronic disease, as gynecological conditions the most representative were vulvovaginitis, and as obstetric risk factor, shorter intergenesis period predominated. Mild preeclampsia prevailed as a complication of previous pregnancy and smoking was the most common toxic habit. Conclusions: preconception reproductive risk was characterized in women of childbearing age; therefore it contributes to greater awareness and follow-up in family planning clinics.

Azole Resistance and Detection of the ERG11 Gene in Clinical Candida albicans Isolated from Pregnant Women with Vulvovaginitis Attending Federal Medical Centre, Yenagoa, Nigeria

Introduction:Candida albicansis one of the most important aetiological agents causing vaginal candidiasis in pregnant women.Most women will experience at least one episode during their reproductive years. Antifungal resistance is a particular problem with Candida infections. Some types of Candida are increasingly resistant to the first-line and second-line antifungal medications.Objective:To investigate the azole susceptibility of Candida albicans(C. albicans) from pregnant vulvovaginal candidiasis patients and to detect ERG11gene in these azole resistance isolates.Methods:Forty-one clinical isolates of C. albicanswere collected. Azole susceptibility was tested in vitrousing microdilution techniques.The ERG11genes of 27 isolates of C. albicans(All resistant to azoles) were amplified using PCR method

Evaluación de la eficacia de dos terapias estrogénicas locales más un lubricante vaginal, para el control de los síntomas del síndrome genitourinario de la menopausia

Objetivo: Evaluar la eficacia de dos terapias estrogénicas locales más un lubricante vaginal (K-Y gel), para el control de los síntomas del síndrome genitourinario de la menopausia. Materiales y métodos: Ensayo clínico, aleatorizado, prospectivo y controlado, no enmascarado. Se incluyeron 57 mujeres posmenopáusicas atendidas en la consulta de climaterio, entre julio de 2014 y julio de 2016. Se asignaron dos grupos aleatorizados: grupo A (30 mujeres recibieron 0.625 mg intravaginales de estrógenos equinos conjugados dos veces a la semana), y grupo B (27 mujeres recibieron 0,5 mg intravaginales de estriol dos veces a la semana) durante seis meses. Ambos grupos recibieron, adicional a la terapia hormonal, 5 gramos intravaginales del lubricante cada 6 horas. A todas las mujeres, para evaluar el estatus hormonal, antes del inicio y a los seis meses, se les determinó el índice de maduración vaginal, y mensualmente se les evaluaba la mejoría de la sintomatología del síndrome genitourinario de la menopausia, además de calcularles el índice de salud vaginal. Resultados: La edad promedio del grupo fue de 58,03±4,85 años. Se observó una significativa disminución en los síntomas en el grupo B, comparado con el grupo A (p<0,001), al mes (p<0,001) y a los 6 meses de seguimiento (p=0,018). El tiempo para lograr una mejor puntuación en el índice de salud vaginal, fue significativamente menor en el grupo B. Al final de la investigación, la evaluación de los cambios en el índice de maduración vaginal, mostró un aumento en las células superficiales e intermedias, en el grupo B, superior al grupo A, mientras se reportó mayor disminución en el porcentaje de células parabasales del grupo B. Las mujeres del grupo A mostraron una reducción en la sintomatología, al final del estudio, del 72% frente al 87% del grupo B. Conclusiones: El uso de la terapia estrogénica local, en el síndrome genitourinario de la menopausia, a los seis meses de seguimiento, pone de manifiesto una mejoría significativa de los síntomas. El uso de estriol más lubricante, se asoció con mejores resultados y menores efectos adversos, en comparación con los estrógenos equinos conjugados más lubricante.

Objective. To evaluate the efficacy of the combination of two local estrogenic therapies with a vaginal lubricant (K-Y gel), to control the symptoms of the severe atrophic vulvovaginitis. Materials and methods. Prospective, controlled and randomized study. Fifty-seven postmenopausal women treated by the author in the climacteric consultation, between July 2014 and July 2016 were included. Two groups were established, 30 women received twice a week 0.625 mg intrava-ginal conjugated equine estrogens (group A), and 27 Women received twice a week during six months Estriol at doses of 0.5 mg intravaginal (group B). Both groups received, in addition to the hormonal therapy, 5 grams of intravaginal lubricant every 6 hours. In order to evaluate the hormonal status of all women, before starting and six months later, their vaginal maturity index was determined, simultaneously, the vaginal health index was calculated monthly in each control. Results. The women of group A showed a symptoms reduction, at the end of the study, of 72% compared to 87% of group B. None of the women presented complications related to therapy. Conclusions. The use of local estrogen therapy, in severe atrophic vulvovaginitis, is a well-tolerated measure; after six months of monitoring, a significant improvement of the symptoms and the vaginal health index is evidenced. The use of estriol with lubricant was associated with better results and less adverse effects, compared to conjugated equine estrogens and lubricant; however, the rates of sexual satisfaction were similar.

Objetivo. Avaliar a eficácia da combinação de duas terapias com estrogênio local com um lubrificante vaginal (K-Y gel), para o controle dos sintomas da vulvovaginite atrófica grave. Materiais e métodos. Estudo prospectivo, controlado e randomizado. Foram incluídas 57 mulheres na pós-menopausa que frequentam consulta de clima-tério do autor, entre julho de 2014 e julho de 2016. Dois grupos foram estabelecidos, 30 mulheres receberam 0,625 mg de estrogénios equinos conjugados, duas vezes por semana por via intravaginal (grupo A), e 27 mulheres receberam estriol em doses de 0,5 mg intravaginalmente duas vezes por semana durante seis meses (grupo B). Ambos os grupos receberam, além da terapia hormonal, 5 gramas de lubrificante intravaginal a cada 6 horas. A fim de avaliar o estado hormonal, antes do início e aos seis meses, determinou-se o índice de maturidade vaginal, para todas as mulheres, calculando-se simultaneamente o índice de saúde vaginal, que foi continuado mensalmente em cada controle. Resultados. As mulheres do grupo A apresentaram redução da sintomatologia, ao final do estudo, de 72% contra 87% do grupo B. Nenhuma das mulheres apresentou complicações relacionadas à terapia. Conclusões. O uso de terapia de estrogênio local, na vulvovaginite atrófica grave, é uma medida bem tolerada; aos seis meses de acompanhamento, é evidente uma melhora significativa dos sintomas e do índice de saúde vaginal. O uso de estriol com lubrificante, foi associado com melhores resultados e menos efeitos adversos, comparado aos estrogênios e lubrificantes equinos conjugados; no entanto, as taxas de satisfação sexual foram semelhantes.

A clinicoetiological study of vulvovaginitis in a tertiary care hospital

Background: Vulvovaginitis is a common unavoidable health problem encountered in a woman’s life. Because of its recurrent and persistent symptoms, it leaves a negative impact on the quality of woman’s life and its management poses a challenge. This study is aimed to analyse the clinical profile, clinical symptoms - presentations and various etiological agents in vulvovaginitis.Methods: A study of 125 cases of vulvovaginitis in the age group of 18-50 years was done. This study was based on the data collected like - age, parity, symptoms, clinical presentations and cytological findings. Speculum examination was done with the given consent and high vaginal swabs were taken for cytological study. Based on Amsel’s criteria bacterial vaginosis was confirmed, trichomoniasis by wet mount examination and candidiasis by culture study were confirmed.Results: The present study showed maximum incidence of vaginitis 63.2% among 21-30 years age group, more common in multiparous women 44.8% and vaginal discharge was the commonest symptom 88%. Cytological study showed 53.6% bacterial vaginosis {BV), 27.2% vulvovaginal candidiasis (VVC), 2.4% trichomoniasis and remaining 17% mixed infections like BV + VVC 15.2% and 1.6% BV + VVC + Trichomoniasis.Conclusions: All women of reproductive age should have mandatory regular evaluation for early detection and proper management of vulvovaginitis. Creating awareness among women improves their quality of life.

Recurrent vaginal discharge: a myth or a fact? / Corrimento vaginal recorrente: mito ou fato?

Introduction: Vaginal discharge is a frequent gynecological complaint, and may represent a disease or not. A vaginal discharge is considered recurrent when it occurs four or more episodes per year. Among the aetiologies, physiological and infectious conditions are mentioned, being the infectious ones, particularly those caused by Candida spp. fungus, the most related to the symptom. Despite the diagnostic and therapeutic resources available, empirical clinical treatments and self-treatments are very frequent and related to ineffective therapeutic results, leading this population to question what the differences regarding women with no symptoms are. Objective: To identify sociodemographic, behavioral and microbiological differences between women with recurrent vaginal discharge and asymptomatic women. Methods: Cross-sectional study involving 126 women with recurrent discharge complaints (study group) and 155 (control group), totaling 281 evaluated women. The group included women in the menacme, sexually active, and those who fit in the criteria of recurrent vaginal discharge, without definite previous diagnosis, compared with asymptomatic women, who attended an annual routine examination. Pregnant, diabetic and immunosuppressed women were excluded. The study was based on the principle of the null hypothesis, when there are no differences between the two studied groups. Results: The average age was 29.95 years, predominantly single and without children. There was no significant difference in the analysis of relationship time with the current partner, numbers of partners throughout life, gender and contraceptive method. There was predominance of normal vaginal flora (type 1) in both groups, with average prevalence of 44.9%. The alkaline vaginal pH was predominant in the study group. Conclusion: The null hypothesis was confirmed. Biological, behavioral and sociodemographic differences in the studied populations were not identified. In women with recurrent discharge group, there were no infectious etiologic factors, suggesting that clinical diagnoses are not sufficient for the most efficient management of these situations, indicating laboratory evaluation for these cases in order to improve diagnostic accuracy

Introdução: O corrimento vaginal é queixa ginecológica frequente, podendo ou não representar doença. Conceitua-se como corrimento vaginal recorrente aquele que ocorre em quatro ou mais episódios ao ano. Entre as etiologias, citam-se condições fisiológicas e infecciosas, sendo as infecciosas, particularmente as causadas por fungo Candida spp., as mais relacionadas ao sintoma. Apesar dos recursos diagnósticos e terapêuticos disponíveis, tratamentos clínicos empíricos e autotratamentos são muito frequentes e associados a resultados terapêuticos pouco efetivos, levando essa população a questionamentos sobre quais diferenças elas teriam em relação a mulheres sem sintomas. Objetivo: Identificar diferenças sociodemográficas, comportamentais e microbiológicas entre mulheres com corrimento vaginal recorrente e mulheres assintomáticas. Métodos: Estudo transversal envolvendo 126 mulheres com queixa de corrimento recorrente (grupo de estudo) mais 155 controles, totalizando 281 mulheres avaliadas. Foram incluídas no grupo de estudo mulheres no menacme, sexualmente ativas e enquadradas nos critérios de corrimento vaginal recorrente, sem diagnóstico prévio definido, comparadas a mulheres assintomáticas, que compareciam a exame de rotina anual. Foram excluídas as gestantes, diabéticas e imunossuprimidas. Partiu-se de princípio da hipótese nula, em que não há diferenças entre os dois grupos estudados. Resultados: A média de idade foi de 29,95 anos, predominando solteiras e sem filhos. Não houve diferença significativa quando analisados: tempo de relacionamento com o atual parceiro, número de parceiros ao longo da vida, sexarca e método anticoncepcional. Houve predomínio da flora vaginal normal (tipo 1) em ambos os grupos, com prevalência média de 44,9%. O pH vaginal alcalino foi predominante no grupo de estudo. Conclusão: Confirmou-se a hipótese nula, não se identificando diferenças biológicas, comportamentais e sociodemográficas nas populações estudadas. Não se observaram, no grupo de mulheres com corrimento recorrente, fatores etiológicos infecciosos, sugerindo que diagnósticos clínicos não são suficientes para o manejo mais eficiente dessas situações, indicando-se avaliação laboratorial para esses casos com o objetivo de melhorar a acurácia diagnóstica.

Prevalência de vulvovaginites na gestação e sua associação com complicações perinatais / Prevalence of vulvovaginitis in pregnancy and their relationshio to perinatal complications

Introdução: Vulvovaginite é o processo infeccioso do trato geniturinário inferior feminino, podendo gerar complicações perinatais como trabalho de parto prematuro, rotura prematura de membranas e corioamnionite. Objetivo: Avaliar a prevalência de vulvovaginites na gestação e definir sua associação com fatores sociodemográficos e complicações perinatais. Métodos: Estudo transversal, com análise de 216 prontuários das pacientes que realizaram o pré-natal em ambulatório-escola de julho/2010 até fevereiro/2012. Os dados foram analisados pelo programa SPSS 16.0. O teste qui-quadrado testou a homogeneidade de proporções. Foram calculadas as razõoes de prevalência e seus respectivos intervalos de confiança, com nível de significância de p < 0,05. Resultados: A prevalência de vulvovaginites na gestação foi de 38,9%. A idade maior ou igual a 30 anos esteve menos associada (p = 0,003) ao desenvolvimento de vulvovaginites [RP 0,24 (IC95% 0,07-0,68)]. O aparecimento de vulvovaginites na gestação aumentou em quase quatro vezes [RP 3,80 (1,29-12,63)] a probabilidade de ocorrência de rotura prematura de membranas (p = 0,007). As vulvovaginites não se mostraram associadas ao trabalho de parto prematuro e/ou corioamnionite. Conclusões: A prevalência de vulvovaginites na gestação foi de 38,9%. Pacientes com 30 anos ou mais apresentaram menos probabilidade de desenvolverem vulvovaginites, porém a patologia aumentou em quase quatros vezes a probabilidade de ocorrência de rotura prematura de membranas.

Background: Vulvovaginitis is the infectious process of the female lower genitourinary tract, which can lead to perinatal complications such as preterm labor, premature rupture of membranes and chorioamnionitis. Objective: To evaluate the prevalence of vulvovaginitis in gestation and to define its association with sociodemographic factors and perinatal complications. Methods: Cross-sectional study with analysis of 216 medical records of patients who performed prenatal care in an outpatient clinic from July / 2010 to February / 2012. The data were analyzed by the SPSS 16.0 program. The chi-square test tested the homogeneity of proportions. The prevalence ratios and their respective confidence intervals were calculated, with a significance level of p < 0.05. Results: The prevalence of vulvovaginitis in pregnancy was 38.9%. Age greater than or equal to 30 years was less associated (p = 0.003) with the development of vulvovaginitis [RP 0.24 (CI95% 0.07-0.68)]. The occurrence of vulvovaginitis during pregnancy increased the probability of premature rupture of membranes (p = 0.007) by almost four times [RP 3.80 (CI95%1.29-12.63)]. Vulvovaginitis was not associated with preterm labor and/or chorioamnionitis. Conclusions: The prevalence of vulvovaginitis in pregnancy was 38.9%. Patients 30 years of age or older were less likely to develop vulvovaginitis, but the condition increased by almost four-fold the likelihood of premature rupture of membranes.

A study of pediatric gynecological problems in a tertiary hospital

Introduction: Gynecological disorders of children are rare. The investigations and treatment are also difficult and need expertise. Gynecologists should undergo training and also be able to diagnose and treat pediatric gynecological problems. Aim: This study was mainly aimed at the problems presenting at pediatric age group that will interest the practicing Gynecologist in planning and management of problems. Some of them require further follow up to their adolescence and child bearing period also. Materials and methods: 50 cases with gynecological problems up to the age of 12 years attending the government general hospital, Guntur were studied. Results: 96% of cases belonged to low socio-economic group. 42% were from urban areas 58% were from rural areas. Their educational status was very poor .Only 20% are attending the primary school. 30% never attended the school. Rest was drop outs before primary school. In this series, the incidence of labial –vulvar agglutination was 10%. Conclusion: The Gynecologist should be able to diagnose and treat pediatric gynecological problems. As the examination and investigations are difficult in children and needs expertise, the gynecologists should undergo training.

Candidosis vaginal: Revisión de la literatura y situación de México y otros países latinoamericanos / Vaginal Candidiasis: current situation of Mexico and other Latin American countries

Las levaduras del género Candida causan enfermedades en los humanos que abarcan desde infecciones superficiales no graves, hasta sistémicas y potencialmente mortales. La candidiasis o candidosis, es el origen común de enfermedad vaginal y aunque es una infección no considerada como incapacitante, suele causar síntomas molestos que alteran la conducta del paciente. En México se considera la única micosis de reporte obligatorio ante las autoridades sanitarias. Por lo anterior, en este trabajo se efectuó una revisión bibliográfica para conocer el estado del arte de la vulvovaginitis causada por Candida spp. (VVC), y ofrecer una breve descripción acerca de la frecuencia presentada por esta infección en diversos países de Latinoamérica, con especial énfasis en México. Se muestra que las frecuencias de VVC en Latinoamérica, son muy parecidas a las reportadas en países como Estados Unidos de América; asimismo, Candida albicans sigue prevaleciendo como el principal agente etiológico. Las diferencias encontradas entre países desarrollados con respecto a los latinoamericanos, consisten básicamente en los métodos diagnósticos y el tipo de tratamiento. Desafortunadamente, en México, a pesar de que la VVC ocupa el noveno lugar entre las 20 principales causas de enfermedad del país, en muy pocos casos se efectúa la identificación de la especie causante, lo que constituye un dato de importancia epidemiológica, considerado como la base para investigar los factores que aumentan el riesgo de contagio, en especial por especies Candida no-albicans y para determinar si la enfermedad es prevenible o controlable

Yeasts of the genus Candida cause diseases in humans ranging from superficial, non-serious, to systemic and potentially life-threatening infections. Candidiasis or thrush, is the common origin of vaginal disease and although it is not considered disabling, infection usually cause troublesome symptoms that alter the behavior of the patient. In Mexico it is considered the unique mycosis of mandatory reporting to health authorities. Therefore, in this work a literature review was conducted to know the state of the art of the vulvovaginitis caused by Candida spp. (VVC), as well as provide a brief description about the frequency presented by this infection in different countries of Latin America, with special emphasis on Mexico. It shows that the frequencies of VVC in Latin America, are very similar to those reported in countries such as the United States of America; in addition, Candida albicans still prevails as the main etiologic agent. The differences found between developed countries with respect to Latin American countries basically consist of the diagnostic methods and the type of treatment. Unfortunately, in Mexico, while the VVC ranks ninth among the 20 principal causes of disease in the country, in very few cases is carried out the identification of the causative species, which constitutes a fact of epidemiological importance, considered as the basis for investigating the factors that increase the risk of infection, especially by Candida nonalbicans species and to determine if the disease is preventable or controllable

Vaginosis citolítica en pacientes con diagnóstico clínico de vulvovaginitis candidiásica / Cytolytic vaginosis in patients with clinical diagnosis of vulvovaginal candidiasis

La microbiota vaginal en la edad fértil está dominada por Lactobacillus spp. Su sobrecrecimiento provoca el aumento en la producción de ácido láctico, disminución del pH vaginal y lisis de células del epitelio vaginal, causando vaginosis citolítica, la cual se confunde con vulvovaginitis candidiásica (VVC) por la aparición de signos y síntomas similares. Se determinó la prevalencia de vaginosis citolítica, así como sus características clínicas y epidemiológicas en pacientes que consultaron con clínica sugestiva de VVC durante el período agosto-septiembre del año 2015. Se encontraron 12 pacientes con clínica compatible de VVC. En 11 (91,7%) se realizó el diagnóstico de vaginosis citolítica y en 1 (8,3%) de vulvovaginitis candidiásica. El 63,7% de las pacientes (7) tenían diagnóstico previo de VVC recurrente. Los síntomas más frecuentes fueron prurito vaginal o vulvar y secreción vaginal blanquecina de aspecto grumoso como leche cortada. La clínica iniciaba entre los 4-6 días posteriores a la menstruación, y desaparecía días antes o justo con el inicio de una nueva fase menstrual. En conclusión, se encontró que en las pacientes examinadas la sintomatología de ambas patologías resultó indistinguible, por tanto el diagnóstico clínico no es suficiente y debe recurrirse al diagnóstico de laboratorio para distinguir entre vaginosis citolítica y vulvovaginitis candidiásica.

The vaginal microbiota in fertile age is dominated by Lactobacillus spp. Its overgrowth causes increased production of lactic acid, decreased vaginal pH and lysis of cells of the vaginal epithelium, causing cytolytic vaginosis, which can be confused with vulvovaginal candidiasis (VVC) due to the similar signs and symptoms. The prevalence of cytolytic vaginosis, as well as its clinical and epidemiological characteristics was determined in patients who consulted with suggestive signs and symptoms of VVC during the period August to September of the year 2015. Twelve patients with signs and symptoms compatible with VVC were considered. Of those, 11 (91.7%) were diagnosed as cytolytic vaginosis and 1 (8.3%) corresponded to vulvovaginal candidiasis. From the 12 patients included, 7 (63.7%) had previous diagnosis of recurrent VVC. The most frequent symptoms recorded were vaginal or vulvar pruritus and whitish, cheesy or curd-like vaginal discharge. Signs and symptoms started between 4 to 6 days after menstruation, and disappeared days before or just with the onset of a new menstrual cycle. In conclusion, it was found that in the patients examined, signs and symptoms of both pathologies were indistinguishable. Therefore, the clinical diagnosis is not enough and laboratory studies should be used to distinguish between cytolytic vaginosis and vulvovaginal candidiasis.

Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009-2014: a single center experience

OBJECTIVE: To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. METHODS: A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded. RESULTS: Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05). CONCLUSION: Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens.

Identification of Candida spp. isolated from vaginal swab by phenotypic methods and multiplex PCR in Duhok, Iraq.

Background: Candida species are the second most common cause of vulvovaginitis worldwide. The purpose of this study was to identify the species of vaginal Candida isolates by using phenotypic and Multiplex PCR techniques. Methods: 91 isolates from patients admitted to Azadi hospital and Maternity hospital in Duhok city were collected. The vaginal swab specimens were inoculated on Sabouraud dextrose agar. Colonies were then sub cultured on Chromogenic Candida agar. Genomic DNA extraction was performed using a Genomic DNA Extraction kit. For rapid identification of Candida spp., specific primers based on the genomic sequence of DNA topoisomerase 11 of C. albicans, C. parapsilosis I, C. parapsilosis II, C. guilliermondi, C. dubliniensis, C. krusei, C. kefyr and C. glabrata, C. tropicalis I, C. tropicalis II, C. lusitaniae were used. The multiplex PCR products were separated by electrophoresis in 1.5% agarose gel, visualized by staining with ethidium bromide, and photographed. Results: 4 Candida species, namely C. albicans, C. glabrata, C. krusei and C. tropicalis were distinguished by Chromogenic Candida agar on the basis of colony colour and morphology. PCR with the primer mixes yielded 7 different sized of PCR products corresponding to C. albicans, C. guilliermondii, C. dubliniensis, C. glabrata, C. kefyr, C. krusei and C. tropicalis II. The analysis revealed C. glabrata and C. albicans were the most common species isolated with the percentage 40% and 30% respectively. Conclusions: This study concluded that phenotypic characteristics on selective agar medium such as chromogenic candida agar are useful for presumptive identification of Candiada spp. with the support of molecular method such as multiplex PCR.

O papel dos parceiros sexuais sintomáticos e assintomáticos nas vulvovaginites recorrentes / The role of the symptomatic and asymptomatic sexual partners in the recurrent vulvovaginitis

OBJETIVO: Identificar as espécies predominantes e o papel dos parceiros sexuais na manutenção das vulvovaginites recorrentes por Candida spp. MÉTODOS: Entre agosto de 2007 e março de 2012, foi efetuado estudo prospectivo de 830 pacientes com idades variáveis entre 18 e 65 anos e vaginites fúngicas. Foram excluídos pacientes com diabetes mellitus, síndrome da imunodeficiência adquirida (AIDS), em uso de corticoterapia, antibioticoterapia, hormonoterapia, imunossupressão, duchas vaginais, dispositivos intrauterinos (DIUs) ou espermicidas. A identificação das espécies de Candida foi feita por métodos fenotípicos e genotípicos. O teste do χ2 foi usado para correlacionar a Candida spp. nos parceiros masculinos e a recorrência nas vaginites. RESULTADOS: O agente fúngico foi isolado em um total de 40 mulheres, sendo 24 com vaginites recorrentes, e em 15 dos seus parceiros sexuais, dos quais 10 eram assintomáticos, e 5, sintomáticos. Houve concordância das espécies encontradas no casal em 100% das recorrências. C. albicans (62,4 e 60%), C. glabrata (29,1 e 33,3%) e C. guilliermondii foram as espécies identificadas. Candida tropicalis (4,1%) foi isolada de apenas uma paciente. Nas 16 mulheres restantes que tinham vaginites não complicadas, C. albicans foi isolada em todas. C. glabrata foi isolada em apenas dois de seus parceiros assintomáticos. CONCLUSÃO: Houve predominância de C. albicans; parceiros sintomáticos ou assintomáticos podem ter papel importante como reservatório e fonte de transmissão de leveduras, principalmente nos quadros de vulvovaginites recorrentes. .

PURPOSE: To identify the predominant species and the role of sexual partners in the maintenance of recurrent vulvovaginitis by Candida spp. METHODS: A prospective study of 830 patients aged 18 to 65 years with yeast vaginitis was performed between August 2007 and March 2012. Patients with diabetes mellitus, AIDS or taking corticosteroids, antibiotics or hormone therapy and immunosuppressed patients, patients using vaginal douches, spermicides or intrauterine devices were excluded from the study. Candida species were identified by phenotypic and genotypic methods. The chi-square test was used to correlate the presence of Candida spp. in male partners with the recurrence of vaginitis. RESULTS: The fungal agent was isolated from a total of 40 women, 24 with recurrent vaginitis and from 15 of their sexual partners, 10 of whom were asymptomatic while 5 were symptomatic. There was agreement of the species found in the couple in 100% of recurrences. C. albicans (62.4 and 60%), C. glabrata (29.1 and 33.3%) and C. guilliermondii species were identified. Candida tropicalis (4.1%) was isolated from only one patient. Candida albicans was isolated from the remaining 16 women who had uncomplicated vaginitis. C. glabrata was isolated from only two of the asymptomatic partners. CONCLUSION: There was a predominance of C. albicans and symptomatic or asymptomatic partners can play an important role as a reservoir and source of transmission of yeast, especially in cases of recurrent vulvovaginitis. .

Candidosis vaginal. primera parte: revisión de la clínica, epidemiología y situación de México / Vaginal candidiasis. first part: epidemiology and current state of Mexico

En esta sección se presentan los datos de diversos autores en cuanto a etiología, epidemiología, fisiopatogenia y el perfil clínico de la candidosis o candidiasis vulvo vaginal, con especial atención al escenario actual en México, país en donde es la única micosis de reporte obligatorio ante las autoridades sanitarias, situación que nos motivó a efectuar la presente revisión bibliográfica. La literatura evaluada contempló el período 2007-2013. La vulvovaginitis por Candida spp (VVC), es una infección que habitualmente no se considera incapacitante, aunque sus manifestaciones clínicas pueden dar lugar a gran estrés en las pacientes. En México, los estudios epidemiológicos, han estado enfocados, principalmente, a describir la frecuencia con la que Candida se asocia a casos de vulvo vaginitis y la respuesta clínica a diferentes terapias; sin embargo, es evidente la falta de estudios que relacionen la presencia de Candida con diversos factores de riesgo, la frecuencia de mujeres que recurren a la automedicación y estudios enfocados a la fisiopatología de la vulvo vaginitis causada por este patógeno. Según la literatura consultada, todas estas circunstancias son conocidas y siguen siendo motivo de estudio en países desarrollados.

This section presents data from different authors in terms of etiology, epidemiology, physiopathogeny and the clinical profile of vulvovaginal candidiasis or vulvovaginal candidosis, with special attention to the current scenario in Mexico, a country where it is the only mycosis of mandatory reporting to health authorities, situation that motivated us to carry out the present literature review. The assessed literature took into account the 2007- 2013 period. The vulvovaginitis by Candida spp. (VVC), is an infection that usually is not considered disabling, but its clinical manifestations can give rise to great stress in patients. In Mexico, the epidemiological studies have been focused, primarily, in describing the frequency with which Candida is associated with cases of vulvovaginitis and the clinical response to different therapies; However, it is evident the lack of studies that relate the presence of Candida with different risk factors, the frequency of women who resort to selfmedication and studies focused on the pathophysiology of the vulvovaginitis caused by this pathogen. According to the literature consulted, these circumstances are known and are still cause for study in developed countries.

Genitorragia en una paciente prepuberal: reporte de un caso y su diagnóstico diferencial / Vaginal bleeding in the prepubescent child: clinical case and differential diagnosis

la genitorragia en pacientes prepuberales es siempre anormal, por lo que requiere estudio. Objetivo: presentar el caso clínico de una paciente prepuberal con genitorragia y revisar en la literatura los diagnósticos diferenciales. Caso clínico: paciente de 10 años con historia de 3 meses de genitorragia sin otros síntomas. Al examen físico mamas Tanner I, vello púbico Tanner II. Genitales externos sin lesiones, himen anular, rojo y delgado. Se descartó pubertad precoz. Se insertó una tórula húmeda en la vagina que dio salida a un trozo de papel higiénico y vello púbico. Después del procedimiento no ha presentado nuevos episodios de sangrado. Conclusión: la genitorragia es un signo alarmante, pero la mayoría de las veces las causas son benignas. En este caso la causa del sangrado fue un cuerpo extraño. Se recomienda derivar a ginecólogo infanto juvenil para evaluación exhaustiva...

Vaginal bleeding in prepubescent girls is always abnormal and needs evaluation. Objective: to present a clinical case and discuss differential diagnosis. Case report: A 10 years old girl with 3 months of vaginal bleeding and no other symptoms. Her breast exam is Tanner stage 1. Her pubic hair is Tanner stage 2, external genitalia were normal; her hymen was red, thin and annular. Precocious puberty was ruled out. By inserting a small sterile catheter into the vagina a piece of pubic hair and toilet paper were easily removed, after that all symptoms resolved. Conclusion: Vaginal bleeding in prepubertal children is an alarming symptom. Our patient vaginal bleeding was due to a vaginal foreign body one of the most common causes. It is recommended that all patients must be referred to a pediatric gynecologist in order to be exhaustively evaluated...

Analysis of Pathogens and Drug Resistance in 380 Children with Vulvovaginitis / 中国药房

OBJECTIVE:To explore the characteristics of pathogens distribution of pediatric vulvovaginitis and drug resis-tance,and to provide reference for clinical drug use. METHODS:409 strains of positive routine bacteria and fungus culture were collected from 380 children with vulvovaginitis in 2014. The pathogens culture and drug sensitivity were recorded. RESULTS:The top 5 bacteria were Escherichia coli [36.67%(150/409)],Haemophilus influenzae [20.29%(83/409)],Streptococcus hemolyticus group A [13.20%(54/409)],Klebsiella pneumonia [8.80%(36/409)] and Staphylococcus aureus [5.37%(22/409)]. CONCLU-SIONS:The main pathogenic bacteria of pediatric vulvovaginitis is Gram negative bacilli,so that drug resistance should be paid at-tention to improve therapeutic efficacy when antibiotics are used in the clinic. The result of sensitivity test should be taken as basis for rational application of antibiotics in the treatment.

Clinical and Immunological Evaluation of Application of Ronkoleukin in Nonspecific Vulvovaginitis at Adolescent Girls.

Package Insert: According to immunological parameters there was found that during the sub-acute there is the secondary immune deficiency and the immunodeficiency is absent during the acute. During the acute phagocytic function of the local secret is satisfactory, and during the sub-acute against satisfactory absorption function there is a decrease of bacterial growth-inhibitory activity of vaginal secretions, indicating the necessity of correction of phagocytic component of these patients. The Purpose of the Research: Clinical and immunological evaluation of ronkoleukin using depending on the routes of entry in the treatment of non-specific vulvovaginitis among adolescent girls in different variants of the disease state. Design of their Search: Prospective study. Methodology: From 2006 to 2010 years by the assignment of adolescent therapist and upon periodic screening the adolescent girls with a variety of complains for genitalia were examined in the child and adolescent consulting room in Municipal Polyclinic № 11 and «The City Center of Human Reproduction» in Almaty. 124 menstruate adolescent girls from 11 to 18 years, not sexually active, were selected to accomplish the target objective. I group -20 healthy (control). II group - 62 with per-acute nonspecific vulvovaginitis. III group - 42 with sub-acute nonspecific vulvovaginitis. In cooperation with the scientific consultant and immunologist, M.D. Prof. A. Kurmanova there was developed a dosage schedule of roncoleukine in the complex therapy, based on the results of the analyses of the immune and cytokine status and phagocytic vaginal system. II group - 62 patients with per-acute nonspecific vulvovaginitis. II А– 20 patients with sub-acute nonspecific vulvovaginitis. (Standard therapy + roncoleukine 250 000 U/ml vaginal irrigation once a day). II B– 25 adolescent girls with sub-acute. (Standard therapy + roncoleukine 250 000 U/ml twice subcutaneously, every other day). II C – 17 adolescent girls with sub-acute (standard therapy). III group - 42 patients with acute nonspecific vulvovaginitis. (standard therapy + roncoleukine 250 000 U/ml twice subcutaneously, every other day). Standard therapy of 7-10 days included [1,2]: Efficacy of the drug was assessed by patient complaints, inspection, and data of microbiological studies of vaginal discharge, immune state, cytokine status, and local phagocytic system on the 7th and 14th days of treatment.

Vulvovaginites na infância: visão do dermatologista / Vulvovaginites in children: a dermatologic approach

Vulvovaginites, adesões labiais e outros distúrbios vulvares ocorrem comumente em crianças e levam à ansiedade, tanto em pais como nas pacientes. As condições vistas mais frequentemente incluem vulvovaginite bacteriana recorrente, irritação vulvar, dermatite alérgica de contato, líquen escleroso e outras doenças dermatológicas. Neste artigo apresentamos uma revisão sobre as doenças vulvares comuns na infância, do ponto de vista dermatológico.

Vulvovaginitis en una población pediátrica: relación entre el agente etiológico, la edad y el estadio de Tanner mamario / Vulvovaginitis in a pediatric population: relationship among etiologic agents, age and Tanner staging of breast development

Introducción. La vulvovaginitis representa el 25% de las consultas en ginecología pediátrica. Objetivo. Evaluar las etiologías de las vulvovaginitis en función de la edad y el estadio de Tanner mamario. Material y métodos. Estudio descriptivo y transversal realizado entre el 1 de enero y el 31 de diciembre de 2011. Se analizaron pacientes con vulvovaginitis en función de dos variables: la edad (GI: 0 a 8,9 años; GII: 9 a 15,9 años y GIII: 16 a 18 años) y el estadio de Tanner mamario (I; II-III; IV-V). Resultados. Se incluyeron 229 pacientes; 78 niñas en GI, 134 en GII y 17 en GIII; en relación con el estadio de Tanner mamario, se agruparon 81 niñas en TI, 36 en TII-III y 112 TIV-V. Shigella y Oxiurus se presentaron con mayor frecuencia a temprana edad. Candida albicans, otras especies de Candida, Gardnerella y Ureaplasma urealyticum se observaron en niñas mayores. Oxiurus predominó en la etapa prepuberal y Candida albicans, en la pospuberal. Conclusiones. En relación con la etiología de las vulvovaginitis, la influencia hormonal es más relevante que la edad cronológica de la paciente.

Introduction. Vulvovaginitis accounts for 25% of all pediatric gynecology consultations. Objective. To assess the etiology of vulvovaginitis based on age and Tanner staging of breast development. Material and Methods. Descriptive, cross-sectional study conducted between January 1st and December 31st, 2011. Patients with vulvovaginitis were assessed based on two outcome measures: age group (GI: 0 to 8.9 years old, GII: 9 to 15.9 years old, and GIII: 16 to 18 years old), and the Tanner staging of breast development (I, II-III, IV-V). Results. Two hundred and twenty-nine patients were included, 78 girls in the GI group, 134 in the GII group, and 17 in the GIII group; 81 girls were classified as TI, 36 as TII-III, and 112 as TIV-V based on Tanner staging. Shigella and Oxyuris were the most commonly found etiologic agents in younger girls. Candida albicans, other Candida species, Gardnerella and Ureaplasma urealyticum were the germs most commonly observed in older patients. Oxyuris was predominant in prepubertal girls, while Candida albicans, in postpubertal girls. Conclusions. Hormonal influence was more relevant than the patient's age in terms of vulvovaginitis etiology.