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Abstract：
Abnormal vaginal discharge is a common complaint among women of reproductive age, affecting about one- third of all women. In resource-limited settings where access to laboratory services is limited, treatment is usually syndromic. This approach may result in ineffective treatment, with high recurrence rates and a potential of developing antibiotic resistance. This study aimed to determine the bacterial isolates and antibiotic susceptibility among women with an abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in Southwestern Uganda.
We conducted a hospital based cross-sectional study among 361 women aged 15-49 years, presenting with abnormal vaginal discharge at the gynecology clinic of Mbarara Regional Referral Hospital from December 2020 to June 2021. Demographic characteristics were collected using a structured questionnaire. We collected cervical and vaginal sterile swabs and subjected them to wet preparation and gram stain. The specimens were cultured for bacterial isolates. Susceptibility testing was performed on samples with bacterial isolates using the Kirby-Bauer disc diffusion method, on the commonly prescribed antibiotics in this setting. We summarized and described the bacterial isolates and antibiotic susceptibility patterns as frequencies and percentages.
We enrolled 361 women with abnormal vaginal discharge. Bacteria were isolated in 29.6% (107/361) of the women, and the commonest isolates included; Staphylococcus aureus 48.6% (52/107), Klebsiella pneumoniae 29.9% (32/107) and Enterococcus faecalis 15% (16/107). Yeast cells were found in 17.7% (64/361) of the women with abnormal vaginal discharge. Cefuroxime (90.7%) and Ciprofloxacin (81.3%) had a high level of sensitivity while high levels of resistance were observed for Doxycycline (86.0%) and Azithromycin (67.0%).
The common bacterial isolates were Staphylococcus aureus, Klebsiella pneumoniae and Enterococcus faecalis. The isolated bacteria were most sensitive to Cefuroxime and Ciprofloxacin but resistant to Doxycycline and Azithromycin. There is need for routine culture and susceptibility testing of women with abnormal vaginal discharge so as to guide treatment, minimize inappropriate antibiotic use and consequently reduce antibiotic resistance.
We conducted a hospital based cross-sectional study among 361 women aged 15-49 years, presenting with abnormal vaginal discharge at the gynecology clinic of Mbarara Regional Referral Hospital from December 2020 to June 2021. Demographic characteristics were collected using a structured questionnaire. We collected cervical and vaginal sterile swabs and subjected them to wet preparation and gram stain. The specimens were cultured for bacterial isolates. Susceptibility testing was performed on samples with bacterial isolates using the Kirby-Bauer disc diffusion method, on the commonly prescribed antibiotics in this setting. We summarized and described the bacterial isolates and antibiotic susceptibility patterns as frequencies and percentages.
We enrolled 361 women with abnormal vaginal discharge. Bacteria were isolated in 29.6% (107/361) of the women, and the commonest isolates included; Staphylococcus aureus 48.6% (52/107), Klebsiella pneumoniae 29.9% (32/107) and Enterococcus faecalis 15% (16/107). Yeast cells were found in 17.7% (64/361) of the women with abnormal vaginal discharge. Cefuroxime (90.7%) and Ciprofloxacin (81.3%) had a high level of sensitivity while high levels of resistance were observed for Doxycycline (86.0%) and Azithromycin (67.0%).
The common bacterial isolates were Staphylococcus aureus, Klebsiella pneumoniae and Enterococcus faecalis. The isolated bacteria were most sensitive to Cefuroxime and Ciprofloxacin but resistant to Doxycycline and Azithromycin. There is need for routine culture and susceptibility testing of women with abnormal vaginal discharge so as to guide treatment, minimize inappropriate antibiotic use and consequently reduce antibiotic resistance.
摘要：
背景：阴道分泌物异常是育龄妇女的常见病，影响了大约三分之一的女性。在资源有限的环境中，获得实验室服务的机会有限，治疗通常是综合征。这种方法可能导致治疗无效，具有高复发率和发展抗生素耐药性的潜力。这项研究旨在确定在乌干达西南部一家三级医院妇科诊所就诊的阴道分泌物异常的女性中的细菌分离株和抗生素敏感性。
方法：我们在361名15-49岁的女性中进行了一项基于医院的横断面研究。从2020年12月至2021年6月，Mbarara地区转诊医院妇科诊所出现异常阴道分泌物。使用结构化问卷收集人口统计学特征。我们收集宫颈和阴道无菌拭子，并对其进行湿制备和革兰氏染色。对标本进行细菌分离培养。使用Kirby-Bauer圆盘扩散法对具有细菌分离物的样品进行了敏感性测试，在这种情况下常用的抗生素。我们总结并描述了细菌分离株和抗生素敏感性模式的频率和百分比。
结果：我们招募了361名阴道分泌物异常的女性。29.6%(107/361)的女性分离出细菌，最常见的分离株包括；金黄色葡萄球菌48.6%(52/107)，肺炎克雷伯菌29.9%(32/107),粪肠球菌15%(16/107)。17.7％（64/361）的阴道分泌物异常妇女中发现了酵母细胞。头孢呋辛（90.7％）和环丙沙星（81.3％）具有较高的敏感性，而强力霉素（86.0％）和阿奇霉素（67.0％）具有较高的耐药性。
结论：常见细菌为金黄色葡萄球菌，肺炎克雷伯菌和粪肠球菌。分离的细菌对头孢呋辛和环丙沙星最敏感，但对强力霉素和阿奇霉素耐药。有必要对阴道分泌物异常的妇女进行常规培养和药敏试验，以指导治疗。尽量减少不适当的抗生素使用，从而减少抗生素耐药性。
方法：我们在361名15-49岁的女性中进行了一项基于医院的横断面研究。从2020年12月至2021年6月，Mbarara地区转诊医院妇科诊所出现异常阴道分泌物。使用结构化问卷收集人口统计学特征。我们收集宫颈和阴道无菌拭子，并对其进行湿制备和革兰氏染色。对标本进行细菌分离培养。使用Kirby-Bauer圆盘扩散法对具有细菌分离物的样品进行了敏感性测试，在这种情况下常用的抗生素。我们总结并描述了细菌分离株和抗生素敏感性模式的频率和百分比。
结果：我们招募了361名阴道分泌物异常的女性。29.6%(107/361)的女性分离出细菌，最常见的分离株包括；金黄色葡萄球菌48.6%(52/107)，肺炎克雷伯菌29.9%(32/107),粪肠球菌15%(16/107)。17.7％（64/361）的阴道分泌物异常妇女中发现了酵母细胞。头孢呋辛（90.7％）和环丙沙星（81.3％）具有较高的敏感性，而强力霉素（86.0％）和阿奇霉素（67.0％）具有较高的耐药性。
结论：常见细菌为金黄色葡萄球菌，肺炎克雷伯菌和粪肠球菌。分离的细菌对头孢呋辛和环丙沙星最敏感，但对强力霉素和阿奇霉素耐药。有必要对阴道分泌物异常的妇女进行常规培养和药敏试验，以指导治疗。尽量减少不适当的抗生素使用，从而减少抗生素耐药性。
