Vaginal organisms in prepubertal children with and without vulvovaginitis

Abstract

In a prospective clinical and microbiological study covering 67 prepubertal children the vaginal flora of 31 asymptomatic children was compared to 36 children suffering from abnormal vaginal discharge and/or vulvovaginitis. Vaginoscopy was employed to obtain bacteriological specimens without contamination. Swabs were inoculated into prereduced transportmedia (PORT A CUL, BBL) and cultured aerobically and anaerobically. The most prevalent aerobic organisms were Staphylococcus epidermidis. Enterococci and Escherichia coli; the predominant anaerobic bacteria were Peptococcus and Peptostreptococcus, Veillonella parvula, Eubacteria, Propionibacterium and Bacteroides species. A similar microbiological pattern was found in both groups, although anaerobes, like Peptococci and Peptostreptococci and Bacteroides species, as well as yeasts, like Candida albicans were significantly more frequent in the group with signs and symptoms. Lactobacilli were less common in this group.

Urogenital Symptoms in Premenarchal Girls: Parents' and Girls' Perceptions and Associations with Irritants

“…19 Others have hypothesized that symptoms develop in response to inadequate genital hygiene, based on physical examination findings demonstrating fecal contamination and/or predominance of fecal flora in vaginal cultures of symptomatic girls. 3,7,8 These hypotheses are further supported by girls' clinical responses to empiric treatments aimed at improving genital hygiene and avoiding irritant exposures. 2,3,6,7,9,15e17,20 However, more research is needed to better understand nonspecific causes of urogenital symptoms in premenarchal girls; current diagnosis and treatment is based more on clinical experience than on evidence-based studies.…”

“…Other studies mention that parents reported specific products incited urogenital symptoms in their daughters. 7,8 Obtaining histories about irritant exposures or asking parents and girls to take more notice of symptoms following exposure to different products may help make the diagnosis. As noted by other authors, this type of vulvovaginitis can be treated by avoiding exposure to specific irritants and by applying emollient creams when exposures occur.…”

“…These and other studies focus primarily on describing vaginal microflora in girls with and without vulvovaginitis. 1,2,4,8 In these reports, 33%e80% of girls were diagnosed with nonspecific vulvovaginitis, after no pathogens or other causes were identified. Some authors have hypothesized that symptoms develop in premenarchal girls following exposure to personal hygiene products known to cause skin reactions in adults because of their different anatomy and physiology.…”

Vaginal microbiocoenosis and cytology of prepubertal and adolescent girls: their role in health and disease

“…Thus, Gardnerella vaginalis are considered as co-inhabitants of the vagina, though some experts feel that Gardnerella species can be pathogenic in some cases. [7,[15][16][17] Leptothrix are gram-variable bacilli that can have the form of coccobacilli; they are facultative anaerobes growing in the vagina and do not grow on ordinary culture media. These bacteria are found in nature in streams of slowing running water polluted by various industries such as paper or milk factories.…”

“…[1,4] Other vaginal fl ora A variety of fl ora can be found in the vagina at different ages and in different stages of health, growth, or disease. [7,15,16] An important group is the cocci bacteria. The biological feature of cocci lies in the fact that young cocci are intensively colored by Gram staining, and when the cocci become older they turn to be gram-negative.…”