RESUMO
Ureaplasma diversum infection in bovine females may result in various reproductive problems, including granular vulvovaginitis, abortion, weak calves, salpingitis, and spontaneous abortion. The presence of U. diversum in a dairy bovine population from midwestern Brazil has not been established. The aim of this study was to determine whether U. diversum was present in dairy cattle from midwestern Brazil using polymerase chain reaction (PCR). Vulvovaginal mucus was analyzed from 203 cows located in six municipalities in the north region of Mato Grosso State, Brazil. A total of 25% of dairy cows with vulvovaginitis were positive for U. diversum. The factors evaluated were included in a multivariable logistic regression model with the presence of at least one positive cow in the herd serving as the dependent variable. Three variables were significantly associated with a U. diversum-positive PCR and were included in the final multivariable model: number of parities, vulvar lesions, and reproductive problems. For each new parity, the chance of U. diversum infection decreased 0.03-fold, indicating that cows with the highest number of parities were more protected. The presence of vulvar lesions was increased 17.6-fold in females positive for U. diversum, suggesting that this bacterium could be related to the red granular lesions in the vulvar mucosa, whereas reproductive problems were increased 7.6-fold. However, further investigations should be conducted to ascertain the effects of U. diversum in association with other mycoplasma species in the herds studied.
Assuntos
Doenças dos Bovinos/epidemiologia , Infecções por Ureaplasma/veterinária , Ureaplasma/isolamento & purificação , Vulvovaginite/veterinária , Aborto Animal/epidemiologia , Animais , Brasil/epidemiologia , Bovinos , Doenças dos Bovinos/microbiologia , Indústria de Laticínios , Feminino , Reação em Cadeia da Polimerase/veterinária , Gravidez , Ureaplasma/genética , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/microbiologia , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologiaRESUMO
To evaluate the frequency of yeast, bacteria or protozoa in pregnant women and to correlate the possible associations of these microorganisms and their relationships with vulvovaginitis (VV) and cervicitis. Vaginal specimens were collected and prepared for smears in microscope slides for the evaluation of yeast, Trichomonas vaginalis and bacteria. Samples were cultured in specific culture medium. Cervical specimens were used to investigate the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis. We enrolled 210 pregnant women, aged 10-42 years old. Of them, 38.1% were symptomatic. Symptoms were most prevalent in the second and third trimesters of pregnancy coincident with a major prevalence of microorganisms. In this study, 39.5% of pregnant women had normal microbial biota and symptoms of VV due to non-infectious causes were observed (6.2%). The occurrence of vulvovaginal candidiasis was 25% and Candida albicans with a prevalence of 80.7% was the dominant species (P = 0.005) while non-albicans Candida species and other yeast were more common in asymptomatic ones (P = 0.0038). The frequency of bacterial vaginosis, T. vaginalis, C. trachomatis and N. gonorrhoeae were 18.1%, 1.4, 1.4% and 0.5% respectively.
Assuntos
Candida albicans/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Candidíase Vulvovaginal/microbiologia , Complicações Infecciosas na Gravidez/epidemiologia , Vulvovaginite/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Infecções Assintomáticas/epidemiologia , Candidíase Vulvovaginal/diagnóstico , Colo do Útero/microbiologia , Criança , Feminino , Humanos , Mycoplasma/isolamento & purificação , Neisseria gonorrhoeae/isolamento & purificação , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Estudos Prospectivos , Trichomonas vaginalis/isolamento & purificação , Ureaplasma/isolamento & purificação , Cervicite Uterina/epidemiologia , Cervicite Uterina/microbiologia , Vagina/microbiologia , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/microbiologia , Vulvovaginite/diagnóstico , Vulvovaginite/microbiologia , Adulto JovemRESUMO
INTRODUCTION: The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics. OBJECTIVES: To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse. MATERIAL AND METHODS: Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed. RESULTS: One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03). CONCLUSIONS: Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.
Assuntos
Abuso Sexual na Infância/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologia , Adolescente , Canal Anal , Criança , Pré-Escolar , Feminino , Genitália Feminina , Humanos , Lactente , Prevalência , Estudos RetrospectivosRESUMO
OBJECTIVES: To evaluate the epidemiology of perineal streptococcal infection and recurrence rates following amoxicillin treatment. STUDY DESIGN: We used laboratory logs in a single pediatric practice to identify patients 0-18 years of age with perineal cultures positive for group A Streptococcus (GAS) and reviewed their medical charts. We described epidemiologic features, determined recurrence rates following antibiotic treatment, and performed a case-control study to identify possible risk factors for recurrence in patients treated with amoxicillin. RESULTS: We found a perineal streptococcal infection rate of 4.6 per 10,000 patient encounters and a recurrence rate in 157 patients with perineal streptococcal infection of 12.4% after amoxicillin. In male patients, the predominant site of involvement was the perianal region (86%), and for female patients, the perivaginal area (62%). Nearly 80% of patients were 2-7 years of age (range 18 days-12.5 years). Perineal streptococcal infection and GAS pharyngitis followed a similar seasonal pattern of occurrence with 65% of perineal streptococcal infection occurring October through March. In patients with perineal streptococcal infection, 95% had a concomitant pharyngeal culture positive for GAS. Best predictive factors for recurrence after amoxicillin were longer duration of symptoms prior to diagnosis and having a sibling with perineal streptococcal infection at some time before or after the initial episode. CONCLUSIONS: Following treatment with amoxicillin, we found a low recurrence rate of 12.4%. Amoxicillin can be expected to be reliable first-line therapy for perineal streptococcal infection.
Assuntos
Períneo/microbiologia , Dermatopatias Bacterianas/microbiologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Amoxicilina/uso terapêutico , Canal Anal/microbiologia , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Masculino , North Carolina/epidemiologia , Faringite/epidemiologia , Faringite/microbiologia , Recidiva , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Irmãos , Dermatopatias Bacterianas/epidemiologia , Streptococcus pyogenes , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologiaRESUMO
Ureaplasma diversum has been associated with various reproductive problems in cattle that include granular vulvovaginitis, weak calves, and abortion. This study was conducted in a beef herd situated in the Middle-West region of Brazil, and the objectives were to verify the presence of U. diversum and to elucidate its possible relationships with independent variables in this bovine herd population. A total of 134 vaginal mucous swabs were taken for polymerase chain reaction (PCR). Of these, 51 (38 %) were PCR positive for U. diversum. Of the 58 heifers with vulvovaginal lesions characterized by hyperemia, granulated lesions, and edema distributed throughout the vulvar mucosa, 37 (64 %) were U. diversum positive; of the 76 heifers without reproductive lesions, 14 (18 %) were U. diversum positive. All tested samples were negative for bovine herpesvirus 1 (BoHV-1). Multivariate logistic regression revealed that the following two variables were significantly associated with the presence of U. diversum: the presence of vulvar lesions (p = 0.001) and the presence of a progesterone (P4) device (p = 0.001). These findings indicate that U. diversum should be considered a pathogen that is associated with pustular vulvovaginitis in heifers from the Mato Grosso state and that additional studies of the risk factors associated with intravaginal P4 device transmission should be performed.
Assuntos
Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Infecções por Ureaplasma/veterinária , Ureaplasma/isolamento & purificação , Vulvovaginite/veterinária , Animais , Brasil/epidemiologia , Bovinos , Feminino , Modelos Lineares , Reação em Cadeia da Polimerase/veterinária , Gravidez , Ureaplasma/genética , Infecções por Ureaplasma/epidemiologia , Vulvovaginite/epidemiologiaRESUMO
OBJECTIVE: To evaluate whether the use of "breathable" panty liners (BPLs) alters the normal vaginal flora, increases the incidence of bacterial vaginosis and/or vaginal candidiasis, or causes vulvar irritation. METHODS: A randomized controlled trial assessed the vaginal ecosystem of women without complaints of vaginal discharge. The study group (n=53) wore BPLs for 10-12 hours each day for 75 consecutive days, whereas the control group (n=54) wore only their usual underwear. At each of 6 visits during 3 menstrual cycles, participants underwent gynecologic examination with colposcopic evaluation and pH measurement, in addition to assessment of vaginal microbial flora, intensity of inflammatory processes, and presence of vaginal candidiasis/bacterial vaginosis in Gram-stained smears. RESULTS: After 75 consecutive days of BPL use, 40/44 (90.9%) and 42/44 (95.5%) women reported no complaints of vaginal discharge or vulvar itching/burning, respectively. There was no significant difference between the study group and the control group with regard to positive vaginal fungus cultures (5/44 [11.4%] vs 8/50 [16.0%]; P=0.7848) or bacterial vaginosis (3/44 [6.8%] vs 2/50 [4.0%]; P=0.7974) at the end of the study period. CONCLUSION: After 75 days of BPL use, there was no significant increase in vulvovaginal candidiasis, bacterial vaginosis, vulvovaginal irritation, or vulvovaginal inflammation.
Assuntos
Candidíase Vulvovaginal/epidemiologia , Produtos de Higiene Feminina , Vaginose Bacteriana/epidemiologia , Vulvovaginite/epidemiologia , Adulto , Candidíase Vulvovaginal/diagnóstico , Colposcopia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Ciclo Menstrual , Esfregaço Vaginal , Vaginose Bacteriana/diagnóstico , Vulvovaginite/diagnóstico , Vulvovaginite/microbiologia , Adulto JovemRESUMO
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.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Candida/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Pigmentação da Pele , Trichomonas vaginalis/isolamento & purificação , Vagina/microbiologia , Vulvovaginite/microbiologia , Distribuição por Idade , Métodos Epidemiológicos , Ciclo Menstrual/fisiologia , Vulvovaginite/epidemiologiaRESUMO
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
Assuntos
Humanos , Feminino , Criança , Adolescente , Vulvovaginite/epidemiologia , Vulvovaginite/etiologia , Epidemiologia Descritiva , Estudos ProspectivosRESUMO
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.
Assuntos
Candida/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Pigmentação da Pele , Trichomonas vaginalis/isolamento & purificação , Vagina/microbiologia , Vulvovaginite/microbiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Métodos Epidemiológicos , Feminino , Humanos , Ciclo Menstrual/fisiologia , Pessoa de Meia-Idade , Vulvovaginite/epidemiologia , Adulto JovemRESUMO
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.
Assuntos
Adulto , Animais , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Infecções por Papillomavirus , Vaginose Bacteriana/epidemiologia , Vulvovaginite/epidemiologia , Candida/isolamento & purificação , Candidíase/epidemiologia , Métodos Epidemiológicos , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/microbiologia , Infecções por Papillomavirus/parasitologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/parasitologia , Vulvovaginite/microbiologia , Vulvovaginite/parasitologia , Adulto JovemRESUMO
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.
Assuntos
Adulto , Feminino , Humanos , Infecções por HIV/complicações , Vulvovaginite/epidemiologia , Vulvovaginite/etiologia , Estudos TransversaisRESUMO
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.
Assuntos
Infecções por Papillomavirus , Vaginose Bacteriana/epidemiologia , Vulvovaginite/epidemiologia , Adulto , Animais , Candida/isolamento & purificação , Candidíase/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/microbiologia , Infecções por Papillomavirus/parasitologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/parasitologia , Vulvovaginite/microbiologia , Vulvovaginite/parasitologia , Adulto JovemRESUMO
PURPOSE: to compare the frequency of vulvovaginitis in women infected with human immunodeficiency 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%, p<0,001; Odds Ratio=2.7, IC95%=1.33-5.83, p=0.007). Bacterial vaginosis occurred in 26.6% of the positive-HIV women; vaginal candidiasis, in 29.7% and trichomoniasis, in 12.5% 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.
Assuntos
Infecções por HIV/complicações , Vulvovaginite/epidemiologia , Vulvovaginite/etiologia , Adulto , Estudos Transversais , Feminino , HumanosRESUMO
BACKGROUND: Vulvovaginitis caused by Candida sp is one of the most frequent infections. OBJECTIVES: To culture and to identify the fungi related to clinical manifestations of patients based on a suspected diagnosis of vulvovaginal candidiasis. PATIENTS AND METHODS: A prospective, transversal and comparative study was performed on 181 women older than 18 years with vulvovaginitis by Candida sp. A correlation was made between the clinical characteristics of this entity and mycological tests such as direct examination and cultures. RESULTS: The direct exam or fresh vaginal exam and cervical sample was positive for the different microscopic forms of Candida (blastoconidia, pseudohyphye or pseudomycelia) in 60.8% (110 women); at the same time that cultures were positive for Candida sp in 51.9% (94 patients). CONCLUSIONS: The direct examination and the cultures of vaginal and cervical exudate are mandatory tests for diagnosis of Candida sp in women with vulvovaginitis.
Assuntos
Candida/isolamento & purificação , Candidíase/diagnóstico , Candidíase/microbiologia , Técnicas de Tipagem Micológica/métodos , Vulvovaginite/diagnóstico , Vulvovaginite/microbiologia , Adulto , Idoso , Candidíase/epidemiologia , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Vulvovaginite/epidemiologiaRESUMO
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...
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Canal Anal/microbiologia , Candidíase Vulvovaginal/diagnóstico , Vagina/microbiologia , Vulvovaginite/epidemiologiaRESUMO
Vaginitis (V) and bacterial vaginosis (BV) are one of the most common reasons the middle class patient has to consult a gynaecologist. The purpose of this work is to analyse samples of vaginal fluid targeting the infection etiology and its relationship to related factors: (intrauterine devices, contraceptive pills, condoms, use of antibiotics), symptoms and signs. From November 1, 2001 to October 30, 2003, a cross-section study was carried out of 400 nonpregnant, sexually active women in an age range of 15 to 55. Vaginal secretions were analysed by Gram and Giemsa stains and culturing was used. Interpreting: (1) normal--no observable changes, absence of the infecting agents studied here; (2) infected--changes observed: bacterial vaginosis, vaginal candidiasis (CV) and trichomoniasis (TC) and (3) imbalance in vagina ecology, with medium alterations (D). Results obtained: (1) normal: 209 (52.2%); infected: 115 (28.8%) including 13.5% VB, 12.5% CV, 2.8% TC, and (3) 76 (19%) with imbalance of vagina ecology. Bacterial vaginosis and flora imbalance were related to the use of intrauterine devices, and candidiasis to contraceptive pills and previous antibiotic use. The number of symptoms increased in patients with vaginal candidiasis and trichomoniasis.
Assuntos
Vaginose Bacteriana/epidemiologia , Vulvovaginite/epidemiologia , Adolescente , Adulto , Antibacterianos/efeitos adversos , Argentina/epidemiologia , Líquidos Corporais/microbiologia , Candidíase Vulvovaginal/epidemiologia , Candidíase Vulvovaginal/microbiologia , Preservativos/efeitos adversos , Anticoncepcionais Orais Hormonais/efeitos adversos , Estudos Transversais , Feminino , Humanos , Dispositivos Intrauterinos/efeitos adversos , Pessoa de Meia-Idade , Fatores de Risco , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/microbiologia , Vagina/microbiologia , Vaginose Bacteriana/microbiologia , Vulvovaginite/microbiologiaRESUMO
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.
Assuntos
Antifúngicos/uso terapêutico , Vulvovaginite/tratamento farmacológico , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologia , Adolescente , Adulto , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/epidemiologia , Farmacorresistência Fúngica , Feminino , Humanos , Jamaica/epidemiologia , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
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.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antifúngicos/uso terapêutico , Vulvovaginite/tratamento farmacológico , Vulvovaginite/epidemiologia , Vulvovaginite/microbiologia , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/epidemiologia , Estudos Prospectivos , Jamaica/epidemiologia , Farmacorresistência FúngicaRESUMO
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.
Assuntos
Humanos , Adolescente , Feminino , Criança , Doenças Vaginais , Vulvovaginite/diagnóstico , Vulvovaginite/epidemiologia , Vulvovaginite/tratamento farmacológico , Vulvovaginite/terapia , Haemophilus influenzae/isolamento & purificação , Haemophilus influenzae/patogenicidade , Leucorreia , Streptococcus/isolamento & purificação , Streptococcus/patogenicidade , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/tratamento farmacológico , Vaginite por Trichomonas/terapiaRESUMO
The results of microbiological vaginal secretions samples obtained from 749 women (from July 2001 to July 2002) were studied in the Bacteriology Unit of the Francisco Javier Muñiz Hospital from Buenos Aires. All patients suffered acute vulvovaginitis were child bearing and sexually active women, 334 of them were HIV-positive. The following are the results of the microbiological studies: Lactobacillus spp 50.6%, Gardnerella vaginalis 25.6%, Candida spp 17.4%, Trichomonas vaginalis 5.3%, Neisseria gonorrhoeae 0.3% and B group Streptococcus 0.8%. Candida vaginitis was significantly more frequent in HIV-positive patients, (21.6% vs 14%; p = 0.0086); meanwhile, trichomoniasis was less common although the difference was not statistically significant (3.6 vs 6.7%, p = 0.0810). The following Candida species were isolated in this study: Candida albicans 76.8%, Candida glabrata 15.6%, Candida parapsilosis 2.9%, Candida tropicalis 1.5% and Candida krusei 0.7%. Eight cases (6.2%) of vaginitis were produced by two Candida species (C. albicans and C. glabrata), and in three cases (2.17%) Saccharomyces cerevisiae were isolated. Five women suffering acute vaginitis with Candida spp presented another etiologic agent of vaginal infection, three cases T. vaginalis and two cases G. vaginalis. The following are some of the most important findings of this study: 1) Half of the patients presented a normal microbial biota; 2) Candida spp vaginitis was significantly more frequent among HIV-positive women; 3) we observed a high incidence of Candida glabrata infections (15.9%), 4) 6.2% of vaginal candidiasis were caused by more than one Candida species and, 5) the susceptibility pattern of C. albicans and C. glabrata isolates against fluconazole was similar to the one observed in other studies. The majority of C. albicans isolates were susceptible to fluconazole (MIC90 = 0.5 microg/ml) meanwhile C. glabrata strains were much less susceptible to this drug (MIC50 and MIC90 = 32 microg/ml).