Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurrence

Abstract

Physiological or non-physiological factors may affect the vaginal flora. The occurrence of genital microorganisms in non-pregnant females of all ages was studied, as were the risk factors associated with each microorganism. A retrospective analysis of vaginal and endocervical cultures and wet smears from 27,172 non-pregnant women, between 1996 to 2005, was performed taking into consideration clinical and socio-demographic characteristics. No microorganisms were observed in 55.7% of the individuals studied and 44.3% had positive cultures. There was no microbiological aetiology in 49% of women with genital symptoms. Poor hygiene, chemical irritants, sexual behaviour, vaginal blood, birth control type, and/or the lack of an oestrogen effect may have caused the symptoms. The highest occurrence of Gram-negative bacteria (p<0.01), mainly Escherichia coli, was observed in prepubescent girls. The highest occurrence of Candida species (p<0.01) was in women of childbearing age, and of Gram-positive bacteria (p<0.01) in menopausal women. Adolescents, particularly asymptomatic girls, carried more frequently Ureaplasma urealyticum and Chlamydia trachomatis (p<0.01). Hormonal contraception and consistent condom use was protective against bacterial vaginosis and U. urealyticum colonization. Users of intrauterine devices had an increased risk of bacterial vaginosis or of contracting U. urealyticum, Mycoplasma hominis and Candida species. Genital complaints were an independent indicator of Candida species, Gram-negative and Gram-positive bacteria, Trichomonas vaginalis and bacterial vaginosis.Chlamydia trachomatis infections were often asymptomatic. It is concluded that the hormonal milieu and non-physiological factors are major determinants of the vaginal flora. If diagnosis of genital infections is based on symptoms alone and not on culture results, it may be erroneous. Sexual abuse should be investigated when a child presents with a sexually transmitted disease.

Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss?

“…Table 2 LGTI with respect to CD4 cell counts in HIV-seropositive women The present study also reported increase in prevalence of candidiasis in HIV-seropositive women, which was 43.2 % as compared to 18 % in the HIV-uninfected women of reproductive age group, and like other LGTI, risk of candidial vaginal colonization increases with lower CD4 cell counts [3,7]. Likewise in the study conducted by McClelland et al, the risk of vaginal candidiasis in HIV-positive women with decreasing CD4 cell counts showed stepwise increase as compared with the risk in seronegative women [7].…”

“…The prevalence of bacterial vaginosis, trichomoniasis, and candidiasis is estimated 8-23, 3.2, and 18 % respectively [1][2][3]. There is a complex interaction between HIV infection and LGTI.…”

Infecciones de Transmisión Sexual en Semen: El Hombre como Vector de Transmisión

“…Otros de los microorganismos que se encuentran frecuentemente en el tracto genitourinario de pacientes sintomáticos y asintomáticos son los Mollicutes (Tibaldi et al, 2009 Ureaplasma urealyticum posee la singular capacidad de hidrolizar la urea. Es potencialmente patógeno y tiene un rol etiológico infecciones del tracto urinario y genital (Gdoura et al, 2007).…”

Evaluation of In Vitro Antimicrobial Susceptibility in Ureaplasma urealyticum and Mycoplasma hominis Strains Isolated from Genitourinary Tract Samples

“…Ureaplasma urealyticum ve Mycoplasma hominis insan genitoüriner sisteminde (GÜS) asemptomatik olarak bulunmasının yanı sıra infertilite, orşit, prostatit ve nongonokoksik üretrit gibi klinik tablolar ile ilişkilen-dirilmektedir (15,25,31) . Bu mikroorganizmaların gebelerde koryoamniyonit, erken doğum ve düşük gibi patolojilerle ilişkili oldukları ve doğum sonrasında yenidoğanda akciğer patolojileri, bakteriyemi ve menenjit gibi komplikasyonlara neden olabilecekleri ileri sürülmüştür (4) .…”