medigraphic.com
Órgano Oficial del Instituto Nacional de Pediatría

2005, Number 3

<< Back Next >>

Acta Pediatr Mex 2005; 26 (3)

Vaginal culture for the diagnosis of vulvovaginitis in children and adolescents

Gayón-Vera E, Hernández-Orozco H, Sam-Soto S, Lombardo- Aburto E, Rodríguez-Hernández R

Language: Spanish
References: 15
Page: 141-148
PDF size: 72.05 Kb.


ABSTRACT

Vulvovaginitis in children and adolescents is a frequent problem. For this reason we conducted a retrospective, transverse, comparative and non-experimental study to identify the most frequent microorganisms present in vaginal cultures of 308 children and adolescents who were studied in the Reproductive Health Service of the Instituto Nacional de Pediatría, in Mexico City. The results of the vaginal cultures of patients with vaginal and vulvar inflammatory symptoms between February 1st 2002 and September 30th 2003 were studied to analyze the differences between the pre-menarcheal and post-menarcheal girls, as well as those between patients with and without inflammatory signs on physical examination. A total of 406 bacterial colonies were isolated; 91.1% were non-specific microorganisms (Escherichia coli -28.70%-, Staphylococcus epidermidis -16.74%-, Enterococcus faecalis -11.09%- and others, who individually accounted for less than 5%); 8.9% were specific (Candida sp. -5.22%-, Staphylococcus aureus and Shigella flexneri -1.52% each- and others, which accounted for less than 0.22%). No statistical difference was found (p=0.08) regarding the incidence of unspecific microorganisms in pre-menarcheal girls with and without signs of vulvovaginitis, or either between post-menarcheal girls (p=0.54). We conclude that the presence of unspecific microorganisms in vaginal cultures of children and adolescents in the group studied represent the normal vaginal flora, while the specific microorganisms are the consequence of a self inoculus from respiratory or enteric microorganisms or sexually transmitted pathogens.


REFERENCES

  1. Datos proporcionados por el Archivo Clínico del Instituto Nacional de Pediatría, basados en el Informe Diario del Médico. Octubre 2003.

  2. Vandeven AM, Emans SJ. Vulvovaginitis in the child and adolescent. Pediatrics in Review. 1993;4:141-7.

  3. Paradise JE, Campos JM, Friedman HM, Frishmuth G. Vulvovaginitis in premenarcheal girls: clinical features and diagnostic evaluation. Pediatrics 1982;70:193-8.

  4. Adler MW. Vaginal Discharge: Diagnosis. En: Adler MW, Weller I, Gilson R, Williams I, Goldmeier D, editores. ABC of Sexually Transmited Diseases. 4ª ed. London BMJ Books 1998;pp9-12.

  5. Reyna Figueroa J, Morales Rangel V, Ortiz Ibarra FJ, Casanova Román G, Beltrán Zúñiga M. Eficacia de un instrumento clinimétrico en el diagnóstico de candidiasis vulvovaginal. Ginecol Obstet Mex 2004;72:219-26.

  6. Emans JS. Vulvovaginitis in the child and adolescent. Pediatrics in Review 1986;8:12-9.

  7. Hammerschlang MR, Alpert S, Rosner I, et al. Microbiology of the vagina in children: normal and potentially pathogenic organisms. Pediatrics 1978;62:57-62.

  8. Hammerschlag MR, Alpert S, Onderdonk AB, et al. Anaerobic microflora of the vagina in children. Am J Obstet Gynecol 1978;131:853-6.

  9. Pierce AM, Hart CA. Vulvovaginitis: causes and management. Arch Dis Child 1992;67:509-12.

  10. 11 Stricker T, Navratil F, Sennhauser FH. Vulvovaginitis in prepuberal girls. Arch Dis Child 2003;88:324-6.

  11. Pokorny S. Genital examination of prepuberal and peripuberal females. En: Sanfilippo JS, Muram D, Lee PA, Dewhurst J, editores. Pediatric and Adolescent Gynecology. 1ª ed. W.B. Saunders Co. Philadelpia. 1994;pp170-86.

  12. Emmans SJ, Laufer MR, Goldstein DP. Office evaluation of the child and adolescent. En: Emmans SJ, Laufer MR, Goldstein DP, ed. Pediatric and Adolescent Gynecology. 4ª ed. Lippincott-Raven Publishers. Philadelphia. 1998;pp1-48

  13. Miller JM, Holmes HT. Specimen collection, transport and storage. En: Murray PR, Baron EJ, Pfaller MA, et al, editores. Manual of Clinical Microbiology. 7ª ed. American Society of Microbiology Press. Washington D.C. 1999;pp33-63

  14. Reisner BS, Woods GL, Thomson RB, et al. Specimen Processing. En: Murray PR, Baron EJ, Pfaller MA, et al, editores. Manual of Clinical Microbiology. 7ª edición. American Society of Microbiology Press. Washington D.C. 1999;pp64-104

  15. González Pedraza A, Sánchez Hernández G, Ponce Rosas RF. Frecuencia, factores de riesgo y colonización por Escherichia coli. Ginecol Obstet Mex 2004;72:68-75.




2020     |     www.medigraphic.com