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.
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to email@example.com
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to firstname.lastname@example.org