Reproductive Tract Infection in Women Attending Obstetrics and Gynaecology Department of a Tertiary Care Hospital in Bihar

Abstract

BACKGROUND Reproductive tract infection (RTI) is a common problem among women and represents a threat to their health. RTI including sexually transmitted disease (STD) and HIV/ AIDS are increasingly being recognised as a serious public health problem. The most common long-term sequelae are pelvic inflammatory disease (PID), cervical cancer, infertility, spontaneous abortion and ectopic pregnancy, which may lead to maternal death. The common infective agents are Gardnerella vaginalis, Trichomonas vaginalis, Candida species and Neisseria gonorrhoeae. Agents such as toxoplasma, rubella, CMV and HSV are important causes of infections during pregnancy. Most of the TORCH infections cause mild maternal morbidity, but have serious foetal consequences. MATERIALS AND METHODS Study Design-This prospective observational study was conducted in the Department of Microbiology, in a tertiary care medical college hospital in eastern Bihar. A total of 200 high vaginal swabs were collected in duplicate from an equal number of patients attending Obstetrics and Gynaecology Department with symptoms suggestive of RTI. In the laboratory one swab was used for culture and identification of the organism, the other was used for direct microscopic examination (Gram stain and wet mount) and other tests like amine test and measurement of pH. RESULTS Maximum patients were seen in the age group of 21-30 years, 43.5% (87/200). Least number of cases were seen in the age group of < 20 years 2.5% (5/200). Out of the 200 samples processed in the laboratory, 88 were found to show no growth. The most common isolate was Candida species, 25.5% (51/200). Neisseria gonorrhoeae 0.5% (1/200) was the least common organism isolated. Moreover, the overall rate of isolation of organisms was higher in patients with bad obstetric history. CONCLUSION Vulvovaginal candidiasis was the most common RTI followed by trichomoniasis and bacterial vaginosis. A single case of gonorrhoea was detected. Interestingly, the incidence of RTI was higher in patients with bad obstetric history.