RESUMO
Background: Aerobic vaginitis (AV) is caused by a displacement of the healthy vaginal Lactobacillus species with aerobic pathogens such as Enterococcus faecalis, Escherichia coli and Staphylococcus aureus that triggers a localized vaginal inflammatory immune response. AV if it is not diagnosed and treated early, especially during pregnancy can place the health of both the mother and the foetus at risk as it is associated with preterm birth, premature rupture of membranes (PROM) and chorioamnionitis. Hence the present study aims at analysing the prevalence of aerobic vaginitis in females in the reproductive age group (15-45 years) with special reference to pregnancy, pathogens involved and their antibiogram. Methods: Over one year period, high vaginal swabs were collected from 125 women with clinical suspicion of vaginitis. They were then subjected to Gram’ staining and culture was made onto blood agar, chocolate agar and MacConkey agar and incubated aerobically at 37 0c for 24 hours. The AV score was determined and the organisms were then identified and antibiotic sensitivity test of isolates were performed. Results: The prevalence of Aerobic vaginitis in this study was 20.8% (26/125) and the most common age group affected was between 26-30 years. Out of the 26 positive cases, 21 samples yielded monobacterial growth and 5 cases polybacterial growth. The most common organism isolated was Enterococcus faecalis (32.26%), followed by Escherichia coli (25.8%), Staphylococcus aureus (19.35%) and β-hemolytic streptococci (9.68%). Antibiotics like β–lactams/ β–lactamase inhibitor combinations, vancomycin and linezolid were found to be more effective against all Gram positive isolates whereas the Gram negative isolates were more sensitive towards β–lactams/ β–lactamase inhibitor combination, aminoglycosides and meropenem. Conclusions: This study emphasized on the need to identify the aerobic vaginal pathogens associated with vaginitis especially in reproductive age group women which can go a long way in preventing the adverse outcomes associated with pregnancy and also ensures the necessity to determine the antibiotic sensitivity pattern of the pathogens which can aid in making a suitable therapeutic choice for 'aerobic vaginitis' by considering an antibiotic that is characterized by an intrinsic activity against the majority of bacteria of faecal origin, bactericidal effect and without any interference with the vaginal microbiota.
RESUMO
Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009). Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4%) had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2nd trimester (42.86%) and in primigravidas (52.38%). E. coli (57.14%) was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications.