Antimicrobial Sensitivity Pattern of Microorganisms Isolated from Vaginal Infections at a Tertiary Hospital in Bangalore, India
Keywords:Vaginitis, Microbiota, Anti-Bacterial Agents, Microbial Sensitivity Tests
Background: The vagina contains dozens of microbiological species in variable quantities and is, therefore, considered a complex environment. Among the microorganisms, bacteria have important repercussions on women’s health. The present study was conducted to elucidate this type of vaginal isolates and their sensitivity towards currently used antibiotics.
Methods: This was a retrospective study conducted at the Department of Obstetrics and Gynaecology, Sapthagiri Hospital, Bangalore, India from January 2012 to December 2013. All symptomatic women who had a high vaginal swab taken for culture and sensitivity testing were included in this study. Antibiotic susceptibility was tested using disc diffusion method (modified Kirby-Bauer’s method). The antibiotic sensitivity patterns of isolated microorganisms were studied.
Results: Out of 200 patients, 95% had positive vaginal cultures. Fifteen types of microorganisms were isolated. The highest frequency of infection was seen at the age of 20-30 years, followed by 41-50 years and 31-40 years, and a low frequency of infection was observed above 50 years of age. The most prevalent pathogen was Escherichia coli, followed by Streptococcus agalactiae and diphtheroids with equal incidence. Among the antibiotics tested, isolated pathogens were completely resistant to nalidixic acid and highly sensitive to meropenem and imepenem.
Conclusion: The high prevalence of gynaecological infections demands that patients with symptoms undergo thorough investigation with cultures and sensitivity essays. Changes in treatment protocols are required to treat
vaginal infections effectively.
1. Larsen B, Monif GR. Understanding the bacterial flora of the female genital tract. Clin Infect Dis. 2001 Feb 15;32(4):e69-77.
2. Romero R, Hassan SS, Gajer P, Tarca AL, Fadrosh DW, Nikita L, et al. The composition and stability of the vaginal microbiota of normal pregnant wo¬men is different from that of non-pregnant women. Microbiome. 2014 Feb 3;2(1):4.
3. Puri R, Malhotra J. Recurrent urinary tract infection (UTI) in women. South Asian Federation of Obstetrics and Gynecology. 2009 Jan-Apr;1(1):10-3.
4. Lehman R. Clinical approach to recognizing and managing a patient with vaginal atrophy: a guide for physician assistants. Internet Journal of Acade¬mic Physician Assistants. 2009;8(1).
5. Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SS, McCulle SL, et al. Vagi¬nal microbiome of reproductive-age women. Proc Natl Acad Sci U S A. 2011 Mar;108(Suppl 1):4680-7.
6. Ahmed HM, Rasool VH, Al-Tawil NG. Prevalence of abnormal vaginal signs and symptoms among attendees of Obstetrics and Gynecology Department of Shaqlawa Hospital. Medical Journal of Babylon. 2014;11(1):120-9.
7. Jejeebhoy S, Koenig M, Elias C, editors. Investigating reproductive tract infections and other gynaecological disorders: a multidisciplinary research approach. Cambridge (UK): Cambridge University Press; 2003. p. 30-81.
8. Karou SD, Djigma F, Sagna T, Nadembega C, Zeba M, Kabre A, et al. Antimi¬crobial resistance of abnormal vaginal discharges microorganisms in Ouaga¬dougou, Burkina Faso. Asian Pac J Trop Biomed. 2012 Apr;2(4):294-7.
9. Bergström S. Infection-related morbidities in the mother, fetus and neona¬te. J Nutr. 2003 May;133(5 Suppl 2):1656S-1660S.
10. Aubyn GB, Tagoe DN. Prevalence of vaginal infections and associated lifestyles of students in the University of Cape Coast, Ghana. Asian Pac J Trop Dis. 2013 Aug;3(4):267-70.
11. Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician. 2004 Dec 1;70(11):2125-32.
12. Khan SA, Amir F, Altaf S, Tanveer R. Evaluation of common organisms cau¬sing vaginal discharge. J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):90-3.
13. Shipitsyna E, Roos A, Datcu R, Hallén A, Fredlund H, Jensen JS, et al. Com¬position of the vaginal microbiota in women of reproductive age—sensitive and specific molecular diagnosis of bacterial vaginosis is possible? PLoS ONE. 2013 Apr 9;8(4):e60670.
14. Lakshmi K, Chitralekha S, Illamani V, Menezes G A. Prevalence of bacterial vaginal infections in pre and postmenopausal women. Int J Pharm Bio Sci. 2012 Oct;3(4):(B)949-56.
15. Cauci S, Driussi S, De Santo D, Penacchioni P, Iannicelli T, Lanzafame P, et al. Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women. J Clin Microbiol. 2002 Jun;40(6):2147-52.
16. Kohli R, Konya WP, Obura T, Stones W, Revathi G. Prevalence of genital Chlamydia infection in urban women of reproductive age, Nairobi, Kenya. BMC Res Notes. 2013 Feb 4;6:44.
17. Dutta S, Hassan MR, Rahman F, Jilani MS, Noor R. Study of antimicrobial susceptibility of clinically significant microorganisms isolated from selected areas of Dhaka, Bangladesh. Bangladesh Journal of Medical Science. 2013 Jan 1;12(1):34-42.
18. Witkin SS, Linhares IM, Giraldo P. Bacterial flora of the female genital tract: function and immune regulation. Best Pract Res Clin Obstet Gynaecol. 2007 Jun;21(3):347-54.
19. Shrestha S, Tuladhar NR, Basnyat S, Acharya GP, Shrestha P, Kumar P. Pre¬valence of vaginitis among pregnant women attending Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal. Nepal Med Coll J. 2011 Dec;13(4):293-6.
20. David MZ, Daum RS. Community-associated methicillin-resistant Sta¬phylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010 Jul;23(3):616-87.
21. Buchan BW, Faron ML, Fuller D, Davis TE, Mayne D, Ledeboer NA. Multi¬center clinical evaluation of the Xpert GBS LB assay for detection of group B Streptococcus in prenatal screening specimens. J Clin Microbiol. 2015 Feb;53(2):443-8.
22. Balkus JE, Richardson BA, Mandaliya K, Kiarie J, Jaoko W, Ndinya-Achola JO, et al. Establishing and sustaining a healthy vaginal environment: analysis of data from a randomized trial of periodic presumptive treatment for vaginal infections. J Infect Dis. 2011 Jul 15;204(2):323-6.
23. Patel J, Bhatt J, Javiya V, Patel K. Anti-microbial susceptibility patterns of Enterobacteriaceae isolated from a tertiary care unit in Gujarat. Internet Journal of Microbiology. 2008;6(1).
24. Fuchs BB, Tegos GP, Hamblin MR, Mylonakis E. Susceptibility of Crypto¬coccus neoformans to photodynamic inactivation is associated with cell wall integrity. Antimicrob Agents Chemother. 2007 Aug; 51(8):2929-36.
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