IJCRR - Vol 07 Issue 01, January, 2015
PROSPECTIVE STUDY OF VAGINAL DISCHARGE AND PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN A TERTIARY CARE HOSPITAL
Author: Twinkle N. Gandhi, Manish G. Patel, Mannu R. Jain
Objective: To study the etiology of vaginal discharge and to detect prevalence of Candida in patients with vaginal discharge from
patients attending at SMIMER medical college, Surat, Gujarat.
Material & Methods: The present study was carried out in the Department of Microbiology, SMIMER medical college, Surat during the period of July 2010 to October 2011. A total 410 suspected cases of vaginal discharge, attending Obstetrics & Gynaecology OPD were included in the study. Detailed history of all patients was taken. All women were subjected to gynecological examination, pH test and Whiff test. Two swabs were collected one for direct microscopy and one for culture and sent immediately
to the laboratory for microbiological examination.
Results: The percentage of Bacterial vaginosis was the highest (47.31%) followed by Candida species (29.75%), E.coli (11.98%), Gram positive cocci (3.41%) and least was Trichomonas vaginalis (1.21%). The age group which was most prone to the infection was 26-35years (41.68%), followed by 15-25 years (40.98%), 36-45 years (13.11%) and least in >46 years (4.23%). Among VVC various associated risk factors observed, like pregnancy (33.6%), OCPS (14.75%), Diabetes mellitus (13.93%) and HIV (5.73%).
Conclusions: In our study the most common pathogen in vaginal infections was Bacterial vaginosis (47.31%) followed by Candida species (29.75%). Distribution of Candida species among different age groups showed the highest incidence in reproductive age group of 26 – 35 years, followed by 16 – 25 years. VVC is more common with risk factors like pregnancy and Diabetes mellitus.
Keywords: RTIs, Bacterial vaginosis, VVC, Candida Spp., Vaginal discharge
Twinkle N. Gandhi, Manish G. Patel, Mannu R. Jain. PROSPECTIVE STUDY OF VAGINAL DISCHARGE AND PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN A TERTIARY CARE HOSPITAL International Journal of Current Research and Review. Vol 07 Issue 01, January, 34-38
1. E. E. Akortha, V. O. Nwaugo and N. O. Chikwe. Antifungal reistance among Candida species from patients with genitourinary tract infection isolated in benincity,Nigeria. African Journal of Microbiology Research Vol.3 (11) pp.694- 699; November 2009.
2. Sangeetha S Balamurugan, ND Bendigeri.CommunityBased Study of Reproductive Tract Infections Among Women of the Reproductive Age Group in the Urban Health Training Centre Area in Hubli, Karnataka. Indian Journal of Community MedicineVol 37;Issue 1,January 2012.
3. MahnazMahmoudi Rad, AmenehSh Zafarghandi, Maryam Amel Zabihi,MahkamTavallaee, and Yasaman Mirdamadi. Identification of Candida Species Associated with Vulvovaginal Candidiasis byMultiplex PCR.Infectious Diseases in Obstetrics and GynecologyVolume 2012, Article ID 872169.
4. R. Scott McClelland, Barbra A. Richardson, Wisal M. Hassan,Susan M. Graham, James Kiarie, Jared M. Baeten et al. Prospective Study of Vaginal Bacterial Flora andOther Risk Factors for Vulvovaginal Candidiasis;Vaginal Bacterial Flora and VVC.The Journal of Infectious Diseases 2009; 199:1883–90.
5. P. Madhivanan ,K Krupp,VChandrasekaran, C Karat, A Arun, CR Cohen et al. Prevalence and corelates of bacterial vaginosis among young women of reproductive age in mysore. Indian journal of medical microbiology (2008)26(2):132- 7.
6. Indulata ,Yashodhara Pradeep, Sujata, Amita Jain. Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in north india.Indian Journal of Community Medicine,Vol 35;Issue 2,April 2010.
7. Centers for Disease Control and Prevention; Sexually Transmitted Diseases guidelines; 2006.
8. Francisca I. Okungbowa, Omoanghe S.Isikhuemhen & Alice P. O. Dede.The distribution frequency of Candida species in the genitourinary tract among symptomatic individuals in Nigerian cities. Rev Iberoam Micol 2003; 20: 60-63.
9. JyotiThulkar, AlkaKriplani&Nutan Agarwal.Utility of pH test & Whiff test in syndromic approach of abnormal vaginal discharge. Indian J Med Res 131;March 2010, pp 445- 448.
10. Fouzia Khan, RakhshandaBaqai. In vitro antifungal sensitivity of fluconazole, clotrimazole and nystatin against vaginal candidiasis in females of childbearing age. J Ayub Med Coll Abbottabad 2010;22(4).
11. Seema Sood, Arti Kapil. An update on Trichomonas vaginalis.Indian J Sex Transm Dis 2008; Vol. 29, No. 1.
12. Arul Sheeba, Malar S., Viswanathan T., Malarvizhi A., Lavanya V. and Moorthy K. Isolation, characterisation and antifungal susceptibility pattern of Candida albicans and non albicans Candida from Integrated counselling and testing centre (ICTC) patients.African Journal of Microbiology Research ;Vol. 6(31), pp. 6039-6048, 16 August, 2012.
13. J.E. Hoppe, P. Frey.Evaluation of Six Commercial Tests and the Germ-Tube Test for Presumptive Identification of Candida albicans. Eur J ClinMicrobiol Infect Dis (1999) 18:188–191.
14. Arthur E. Crist, Theresa J. Dietz, And Kristin Kampschroer. Comparison of the MUREX C. albicans, Albicans-Sure, and BactiCard Candida Test Kits with the Germ Tube Test for Presumptive Identification of Candida albicans. Journal Of Clinical Microbiology, Oct. 1996, p. 2616–2618, Vol. 34, No.10.
15. William J. Watson, Gregory DeMarchi : Vaginal Discharge: An approach to diagnosis and management Can. Fam. Physician Vol. 33: August 1987.
16. Puri KJ, Madan A, Bajaj K.Incidence of various causes of vaginal discharge among sexually active females in age group 20-40 years. Indian Journal Of Dermatology,Venereology And Leprology;Year: 2003, Volume : 69 , Issue : 2 ,Page : 122-125.
17. SrujanaMohanty, SeemaSood, ArtiKapil&Suneeta Mittal. Interobserver variation in the interpretation of Nugent scoring method for diagnosis of bacterial vaginosis. Indian J Med Res. 131, Januray 2010, pp 88-91.
18. Ella M de Leon, Scott J Jacober, Jack D Sobel and Betsy Foxman. Prevalence and risk factors for vaginal Candida colonization in women with type 1 and type 2 diabetes 1. BMC Infectious Diseases 2002.
19. Oviasogie F.E, and Okungbowa F.I. Candida species amongst pregnant women in benin City, nigeria: effect of predisposing factors. African journal of clinical and experimental microbiology;May2009 ISBN 1595-689x;vol 10(2).
20. Md. Abdullah Yusuf, Md. AbulQuashem Chowdhury,AbuNaser IbneSattar, Md. Mostaqimur Rahman. Evaluation of the Effect of Contraceptives on Prevalence of Candida Species on Vaginal Candidiasis in Dhaka, Bangladesh. Bangladesh J Med Microbiology 2007; 01 (02): 61-64.
21. Jack D Sobel.Vulvovaginal candidosis. Lancet 2007; 369: 1961–71Vol 369 June 9, 2007.
22. Flavia De Bernardis, Haiqun Liu, Rachel OMahony, Roberto La Valle, Silvia Bartollino, Silvia Sandini, et al.Human Domain Antibodies against VirulenceTraits of Candida albicans Inhibit Fungus Adherence to Vaginal Epithelium and Protect against Experimental Vaginal Candidiasis. The Journal of Infectious Diseases 2007; 195:149–57.
23. Jagdish Chander.Textbook of Medical Mycology.3 rded. New Delhi: Mehta publishers;May 2011.
24. Ismaeel Khan, Umar Ali Khan. A hospital based study of frequency of aerobic pathogens in vaginal infections Shifa College of Medicine, Islamabad, January 6, 2004.
25. Luciana Basili Dias, Marcia de Souza CarvalhoMelhem, Maria WalderezSzeszs,JoseMeirellesFilho, Rosane Christine Hahn. Vulvovaginal candidiasis in matograsso, Brazil: Pregnancy status,causative species and drug tests. Brazilian journal of Microbiology (2011) 42:1300-1307.
26. S. I. Nwadioha, D. Z. Egah, O. O. Alao. Risk factors for vaginal candidiasis among women attending primary health care centers of Jos, Nigeria. Journal of Clinical Medicine and Research Vol. 2(7), pp. 110-113, July 2010.
27. Deepa Babin,Subbannayya Kotigadde,P.Sunil Rao. Clinicomycological profile of vaginal candidiasis in a tertiary care hospital in Kerala.Inter. Journal of Research in Biological Sciences 2013; 3(1): 55-59.
28. Marcia Edilaine Lopes Consolaro, Thamara AlineAlbertoni, Celina Shizue Yoshida, JosmarMazucheli&Terezinha Inez EstivaletSvidzinski. Correlation of Candida species and symptoms among patients with vulvovaginal candidiasis in Maringa,Parana, Brazil. Rev IberoamMicol 2004; 21: 202- 205.