Vulvovaginites: estudo das variaçoes de pH vaginal e microflora associada / Vulvovaginitis: vaginal pH changes and associated microflora

PURPOSE: To establish a correlation between pH vaginal and the microflora associated in carriers of vulvovaginites. METHODS: In the present study, the cytopathological examination and the vaginal flow in a group of 65 sexually active women had been carried through, 20 and 72 years, taken care of in the Laboratório de Citologia Clínica do Departamento de Análises Clínicas e Toxicológicas da Universidade Federal do Rio Grande do Norte, for determination of microorganisms in cervicovaginal sample and of pH in the vaginal flow. RESULTS: Associating pH vaginal with the presence of vulvovaginitis, it was evidenced that the Candida sp. occurred more frequently in pH 4.0, Trichomonas vaginalis in pH 6.0, Gardnerella vaginalis in pH 5.0, coconuts in pH 5.0, bacilli in pH 4.0 and cocos/bacilos in pH 6.0. It was observed that all the patients had presented at least one type of ethiological agent of vulvovaginiti and an associated microflora. CONCLUSION: The joint accomplishment of the cytological examinations and the determination of pH revealed important for directing the microflora associated with the vulvovaginiti, suggesting, of this form, that pH vaginal plays preponderant role how much to the presence of the infectious agents in the vaginal ecosystem.

Aspectos clínicos, patogênese e diagnóstico de Trichomonas vaginalis / Clinical aspects, pathogenesis and diagnostic of Trichomonas vaginalis

Trichomonas vaginalis é o agente etiológico da tricomoníase, a doença sexualmente transmissível (DST) não-viral mais comum no mundo. Esse protozoário flagelado atinge o parasitismo com sucesso em um ambiente hostil através dos vários mecanismos pelos quais estabelece sua patogenicidade e também por sua capacidade de evadir a resposta imune do hospedeiro. A infecção apresenta uma ampla variedade de manifestações clínicas, desde quadro assintomático até severa vaginite. A tricomoníase tem sido associada à transmissão do vírus da imunodeficiência humana (HIV), à doença inflamatória pélvica, ao câncer cervical, à infertilidade, ao parto prematuro e ao baixo peso de bebês nascidos de mães infectadas. A investigação laboratorial é essencial na diagnose dessa patogenia, uma vez que leva ao tratamento apropriado e facilita o controle da propagação da infecção. A prevalência mundial anual da tricomoníase é de 180 milhões de casos, e na Europa é responsável por 41 por cento dos casos de vaginite. A terapia da tricomoníase inclui as mesmas medidas profiláticas destinadas às outras DSTs, como prática de sexo seguro e uso de preservativos. O metronidazol é o medicamento de escolha no tratamento da tricomoníase, entretanto, devido à ineficácia dos tratamentos de dose única e ao iminente surgimento de cepas resistentes, outras alternativas terapêuticas estão sendo investigadas.

study on trichomoniasis vaginalis and female infertility

In this study, a total of 280 patients [240 infertile and 40 pregnant] was subjected to thorough history taking, general and local examination for the exclusion of organic lesion, laboratory investigations to exclude parasitic, bacterial and fungal infections. Sterile vaginal swab was taken from the posterior fornix and examined by wet smear preparation, Giemsa staining and cultivation on CPLM medium for Trichomoniasis infection. Out of 240 infertile women; 18.75% complained of discharge, 17.5% itching, 15.42% dysuria, 14.58% dyspareunia and 10% had cervical lesion. Of the 40 controls; 5% complained of discharge, 2.5% complained of itching, dysuria and dyspareunia and none had cervical lesion. Of the total cases, 36 had T. vaginalis. The clinical data observed were significantly higher among the infertile group than the control group. Cultures were positive in 14.58% of the infertile group and 2.5% in the control group

Incidence of Gardnerella vaginalis, Candida sp and human papilloma virus in cytological smears

CONTEXT: In spite of the wide-ranging literature on the microbiology of normal and abnormal flora of the vagina, there are few studies on the relationship between human papilloma virus (HPV) and other vaginal microorganisms. OBJECTIVE: To analyze the frequency of infection by human papilloma virus (HPV) and other agents like Candida sp., Gardnerella vaginalis and Trichomonas vaginalis in cytological smears. DESIGN STUDY: Retrospective study SETTING: A public tertiary referral center. SAMPLE: An analysis of 17,391 cytologies from outpatients seen between January 1997 and August 1998. The control group was made up of patients in the same age group and same period with no cytological evidence of HPV infection. Patients with a diagnosis of cervical intraepithelial neoplasia (CIN) II or III were excluded from this analysis. MAIN MEASUREMENTS: The diagnosis of HPV infection was made in accordance with the criteria of Schneider et al. and the diagnosis of Gardnerella vaginalis was made with a finding of clue cells. RESULTS: 390 (2.24 per cent) had alterations consistent with infection by HPV, sometimes associated with CIN I. The results showed that Gardnerella vaginalis was the most frequent agent in women with HPV infection (23.6 per cent versus 17.4 per cent; P <0.05), while in the control group the most frequent agent was Candida sp. (23.9 per cent versus 13.8 per cent; p <0.001). CONCLUSION: In spite of this study being based solely on cytological criteria, in which specific HPV and Gardnerella diagnostic tests were not used, the cytological smear is widely used in clinical practice and the data presented in this investigation show that there is an association between Gardnerella vaginalis and HPV infection. It remains to be established whether the microorganisms favor each other

The prevalence of Chlamydia trachomatis infection in rural Thai women.

A cross sectional study was designed to investigate the prevalence of Chlamydia trachomatis among different groups of rural women in the northeast Thailand. The presence of chlamydial antigens in endocervical swabs was detected by ELISA. The prevalences of Chlamydia trachomatis were 6.8% (31/485), 5.2% (24/466) and 6.7% (12/179) in women attending antenatal, postpartum and family planning clinics respectively. The average prevalences of C. trachomatis among hospital-based and community-based women were 6.1% (67/1,103) and 3.6% (15/411) respectively. In addition, the prevalences of some pathogens including Candida albicans, Trichomonas vaginalis, Treponema pallidum and Neisseria gonorrhoea among hospital-based and community-based women were 14.2, 2.8, 0.7, 0.2 and 10.9, 5.1, 2.7, 0.0% respectively. It was concluded that C. trachomatis was a problem of woman's reproductive health.

Cytodiagnosis of discharge per vaginum.

Simple, rapid, inexpensive methods such as pH determination, wet mount, KOH mount, amine test, Gram staining of vaginal discharge were undertaken prior to Pap stained smears of 158 patients of leucorrhoea. We were able to detect non-specific vaginitis (44.30%), Trichomoniasis (16.45%), Candida vaginitis (9.49%), gonococcal vaginitis (0.63%) and senile vaginitis (12 cases). No specific pathology was shown in 26 cases. 1.69% of the cases were of cervical erosion and 3.79% cases suggestive of squamous malignancy.

Laboratory diagnosis of Trichomonas vaginalis among women attending a venereal diseases control division. First report

El estudio presente fue efectuado con el objeto de determinar la incidencia de infecciones por Trichomonas vaginales asociadas a otras enfermedades venéreas. Fuerron investigadas 200 mujeres con este objeto tomando en cuenta su historia clínica, examen físico y examen en fresco, asi como cultivo. El parásito fue fue demonstrado 75 (37,5%) de 200 mujeres. También fueran relizadas pruebas para el diagnóstico de Candida albicans, Corynebacterium vaginales y Treponema pallidum