Prevalence of vaginal pathogens in childhood and adolescence

Abstract number: 1134_03_20

Kourkouli R., Baka S., Kouskouni E.

Objective:  

The microbiology of the female genital tract is a complex entity always found in a dynamic situation. In children and adolescents normal flora cannot be easily defined. The purpose of this study was to assess the prevalence of pathogens in vaginal cultures obtained from children presenting to our hospital.

Methods:  

Between January 2003 and October 2004 we examined 227 vaginal cultures from an equal number of symptomatic non-sexually active young girls (mean age 8.5 years, range 5–14 years). Vaginal secretions were inoculated onto culture plates and were incubated in aerobic and anaerobic conditions for 24 and 48 h, respectively. Isolation, identification and susceptibility to antibiotics were carried out under standard conditions using the VITEK System ATB Expression (BioMerieux, France). For the detection of Mycoplasma hominis each specimen was inoculated on DNA agar and then incubated in anaerobic conditions for 48 h whereas Ureaplasma urealyticum was identified by urease production using urea broth.

Results:  

Our results show that out of 227 young girls 146 (64.3%) had positive cultures, 69 (30.4%) had negative cultures for pathogens and in 12 cases (5.2%) there was no growth on the plates whatsoever. Of the 146 positive cultures we isolated 179 pathogens: 29.6% anaerobic bacteria, 22.9% Streptococci, 16.8%Ureaplasma urealyticum, 13.4% Gram-negative rods, 13.4%Gardnerella vaginalis, 3.3% Staphylococci and 0.6%Mycoplasma hominis.

Conclusions:  

Distinguishing pathogenic isolates from nonpathogenic ones is not a simple task in children and adolescents. The most commonly isolated pathogens were anaerobic bacteria and streptococci. The prevalence of Ureaplasma urealyticum in our study group was high. Since our results indicate the involvement of Ureaplasma urealyticum in young girls’ vulvovaginitis a routine examination for this pathogen is suggested.