High Vaginal Swabs Research Articles

Evaluation of Genitourinary Infection in Preterm Labour: A Descriptive Cross-Sectional Study

Introduction: Preterm labour is defined as the occurrence of regular uterine contractions (≥ 4 in 20 minutes or ≥ 8 in 1 hour) and cervical changes (effacement ≥ 80% and dilatation ≥ 1cm) in women with intact fetal membrane and gestational age less than 37 weeks. Genitourinary infection is the most important cause of preterm labour. The aim of this study was to determine the role of Genitourinary infection in causation of preterm labour. Methods: This is a descriptive cross sectional study done at National Medical College Teaching Hospital from 10 November 2021 to 9 November 2022 after obtaining IRC (F-NMC/549/078-79). Total of 90 patients in preterm labour fulfilling the inclusion criteria were enrolled in this study after taking informed consent. Clinical examination was done, vaginal swab, endocervical swab and urine samples were sent to microbiological department for examination. Preformed proforma were used to record the demographic, clinical finding and result of investigation. The data was analyzed statistically using SPSS 22 and mean age, frequency and prevalence of genitourinary infection were calculated. Results: In this study, 90 patients of preterm labour were enrolled. The mean age group of patients was 23.61 ± 4.25 years. Genital infection compromised of 41%, high vaginal swab showed 30% prevalence and endocervical swab showed 20% prevalence. The most common organism identified in genital infection was Gardenella vaginalis 55.55%. The prevalence of Urinary tract infection was 40% where E.coli was the most common organism 66.66%. Conclusions: Genitourinary tract infection plays an important role in causation of preterm labour and can easily be diagnosed with routine urine examination, urine culture and vagino-cervical swab. The prevalence of genital infections and urinary tract infection was 41% and 40% respectively. Gardnerella vaginalis was the most common pathogen identified in genital tract whereas E.coli was leading cause of UTI in Preterm labour patients.

Antimicrobial Resistance Profile of Different Clinical Isolates against Augmentin, Imipenem and Ceftriaxone

Background: Antibiotic resistance is a growing global public health concern because it jeopardizes the effective control and treatment of bacterial infections. The purpose of this study was to determine the bacterial profiles and susceptibility patterns to Imipenem, Augmentin, and Ceftriaxone in various clinical specimens from Al Saleem laboratory in Benghazi, Libya.
 Methods: Two separate studies were carried out. Each experiment lasted three months. The patients' clinical samples included wound swabs, urine, sperm, blood, high vaginal swabs, and cerebrospinal fluid. Bacterial species were isolated and identified using standard microbiological methods in each study. Kirby-Bauer disc diffusion was used to conduct antimicrobial susceptibility tests from September 2020 to November 2020.
 Results: There were 711 isolates obtained from 535 female and 503 male patients. The most common organisms isolated from specimens were E. coli spp, Klebsiella spp, and Staph aureus.
 Conclusion: Bacterial resistance levels to various antibiotics varied greatly. We found that Augmentin has less activity against gram negative bacteria isolated from clinical specimens, whereas Imipenem has a much stronger effect on isolates than Augmentin. Appropriate monitoring of prevalent pathogenic organisms and their sensitivities will assist clinicians in making appropriate antibiotic treatment choices to avoid the spread of antimicrobial resistance.

Pap smear changes and cervical inflammation in women with infertility in correlation to clinical and microbiological findings

Abstract Introduction: One of the prime causes of infertility is reproductive tract infections as they can produce marked cervical inflammation. These can be seen in Pap smears at various stages as cervical health plays an imperative role in blocking ascending infections. This study assesses infections and related changes in Pap smears from women with infertility and its association with clinical and microbiological findings. Materials and Methods: A prospective observational study was done for 3.5 years. Pap smears of women with infertility were taken, and those showing significant inflammation (>50%) were studied. Relevant history and “per-speculum” findings were noted. Pap smear changes, infections or intraepithelial changes, and lactobacilli were studied. High vaginal swab culture was done, and follow-up conception data were correlated. Results: Almost 50% of women with inflammatory smears showed the presence of an infection; of which the most common was candidiasis followed by bacterial vaginosis. Out of the 12 women whose culture reports were available, 11 showed growth (90%). Most women showed depleted lactobacilli. On follow-up, the conception rate despite assisted reproductive technology was significantly lower in women with Pap smear changes (P = 0.0002). Conclusion: These observations show a strong and significant association between inflammatory Pap smears, infections in the reproductive tract, depleted lactobacilli, and conception. It is advisable that a Pap smear should be done in all cases of infertility to look for infections and inflammation, and a follow-up with high vaginal swab culture should be done in cases where inflammation is detected in a Pap smear. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge, Practice-based learning and improvement.

Prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis among patients suspected of sexually transmitted infections in Evercare Hospital Dhaka during 2015 to 2022

Background Sexually Transmitted Infections (STIs) are often diagnosed by clinical symptoms and signs due to lack of sensitive laboratory methods. Most of the time pathogens are not identified and antibiotics are used empirically. The purpose of our study is to find out the STI pathogens detected by sensitive multiplex PCR done routinely in a tertiary care hospital.
 Materials and methods A total of 578 samples were tested from February 2015 to July 2022. Urine, prostatic secretion, urethral swab, high vaginal swab, semen, throat swabs were collected from symptomatic patients for the routine test. DNA was extracted and Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis were screened by using CE-IVD approved multiplex Real Time PCR kit.
 Result Out of 578 cases, 76 (13.15%) were positive for at least one pathogen and 5 were co-infections. Out of 76 positive cases, Chlamydia trachomatis was found 41 (53.9%), Neisseria gonorrhoeae was 13 (17.1%), Mycoplasma genitalium was 12 (15.8%), and Trichomonas vaginalis 5 (6.6%) and co-infections with Neisseria gonorrhoeae and Chlamydia trachomatis was 5 (6.6%). Positivity rate was remarkably higher in male (77.6%) than female (22.4%) and predominant age group was 19-40 years.
 Conclusion The predominant STIs pathogen found in our cohort is Chlamydia trachomatis followed by Neisseria gonorrhoeae. Multiplex PCR is a wide-ranging diagnostic method for the detection of multiple pathogens simultaneously which allows early and accurate diagnosis of STIs.
 Pulse Volume 12-14 2020-2022 p.34-39

Prevalence of Trichomonas vaginalis Infection among Women of Reproductive Age in Anambra State, South Eastern, Nigeria

Aim: This study was undertaken to determine the prevalence of Trichomonas vaginalis infection among women of reproductive age in some selected hospitals in Awka, Anambra State, Nigeria.
 Methods: This study, conducted from October to December 2021, involved 200 women aged 20 years and above as participants. Prior to specimen collection, informed consent was obtained from each woman by qualified medical personnel. High vaginal swab sticks, labeled and sterile, were used to meticulously and aseptically collect specimens from the high vaginal area. A few drops of normal saline were added to each swab stick, and within 30 minutes of collection, a wet mount examination was performed to ensure optimal results. For the wet preparation of vaginal discharge, a drop from the sample was applied to a clean glass slide with a cover slip, avoiding the trapping of air bubbles. The wet smear was then examined under a microscope using a low-power objective (x10) followed by a high-power objective (x40) to detect motile T. vaginalis. The vaginal secretion was characterized by the presence of epithelial cells, white blood cells, and red blood cells. The T. vaginalis trophozoite was identified based on its oval shape, flagellation, and distinct jerky movement.
 Results: The study area had an overall prevalence rate of 11.0% for T. vaginalis infection. Among the selected hospitals, COOUTH had the highest prevalence at 13.24%, while Rock Foundation Hospital had the lowest at 6.67%. Prevalence varied across age groups, with the highest rate of 16.42% found in the 30-39 years age group, and the lowest rate of 5.0% in the 20-29 years age group. Divorced women had the highest prevalence at 60.0%, while singles had the lowest at 4.7% among the marital groups. Among different occupations, traders had the highest prevalence at 12.24%, whereas students and civil servants had the lowest rates at 4.0% and 7.72%, respectively. T. vaginalis infection was only observed in non-pregnant women, with a prevalence rate of 13.3%.
 Conclusion: T. vaginalis infection is prevalent among sexually active women of reproductive age in the study area. The findings highlight the importance of practicing good personal hygiene and being faithful to a single sexual partner. It is recommended to raise public awareness regarding the prevention and control of T. vaginalis in order to reduce its prevalence among women in the study area.

Prevalence and Risk Factors of Trichomonas vaginalis Infection among Female Students of Prince Abubakar Audu University, Nigeria

Objective: This study aimed to determine the prevalence rate and associated risk factors of Trichomonas vaginalis infection among undergraduate female students at Prince Abubakar Audu University, Anyigba, Kogi State, Nigeria.
 Methods: This cross-sectional and institutional-based study involved female students who consented to screening. A total of four hundred (400) high vaginal swab samples were randomly collected from consenting female students and analyzed by wet mount preparation. Demographic and clinical information about the participants was obtained using prepared questionnaires.
 Results: It was observed that the overall prevalence of T. vaginalis infection among the 400 female participants was 170 (42.5%). The age ranges 14–18 and 24-28 had the highest prevalence of 50%, while the age range 19–23 had the least prevalence of 41.2%. The Ebira tribe had the highest prevalence of 60%, while the lowest prevalence was 0.0% among Hausa and others. Islam had the highest prevalence of 66.7%, while Christianity had the lowest prevalence of 40.5%. Students at the 100 level had the highest prevalence of 50%, and those at the 200 level had the least prevalence of 38.5%. There was no significant association between T. vaginalis infection and predisposing factors such as douching, sanitation, and sexual habits. However, the study did find that females who did not use sanitary pads were at a significantly higher risk of infection, while females who did not douche their vagina with antiseptic or deodorant products had a slightly higher risk of infection.
 Conclusion: It is clear from the results of the present study that Prince Abubakar Audu University's undergraduate female students are at a high prevalence of 42.5% for Trichomonas vaginalis infection. The study offers crucial information about the incidence of T. vaginalis infection and the risk factors connected to it among female participants in the study area. The high prevalence of infection highlights the need for increased awareness and education about the infection and its prevention in the study area.

Prevalence of Bacterial Vaginosis in Preterm Labour and Its Fetal and Maternal Outcome

Introduction: Preterm births accounts for about 11.1 % of births worldwide. Infection accounts for 20% – 40% of these cases and Bacterial vaginosis has been found in 15 % of preterm labor group.
 Objective: To find the prevalence of Bacterial vaginosis among the cases who presented with preterm labour and to determine its maternal and neonatal outcome.
 Methodology: A prospective cross- sectional analytical study on 100 preterm labour cases conducted over a year in the obstetric ward in Manipal Teaching Hospital. Three high vaginal swabs from posterior fornix were taken and tested in Microbiology laboratory. The maternal and neonatal outcome of women with preterm labour due to bacterial vaginosis were noted. The data were analyzed using SPSS 21. Chi2 test was used for comparing maternal and neonatal complications positive or negative with Bacterial Vaginosis.
 Results: In the study period, 584 women had preterm deliveries. The total deliveries during that period was 2,531. The prevalence of Bacterial vaginosis in PTB was found to be 17 %.The accuracy of Gram stain was found to be 90% (sensitivity-57%, specificity-92%, PPV-36%, NPV-96%). The accuracy of wet mount was 90 % (sensitivity-42.85%, specificity-93.5%, PPV-33.3%, NPV95.6%). There were increased cases of chorioamnionitis among women who were BV positive (p-value=0.02). Newborn born to women with BV positive had increased chance of poor Apgar score at 5 minutes (p-value <0.05).
 Conclusion: Maternal and neonatal complications were more common in women with preterm labour associated with Bacterial Vaginosis. Gram stain and wet mount are fairly accurate and can be used as an adjunct to culture for the diagnosis of Bacterial Vaginosis.

Microbial Isolates And Antibiotic Sensitivity Among Pregnant Women With Abnormal Vaginal Discharge At Nuhu Bamalli Maternity Hospital, Kano

Background: Abnormal vaginal discharge in a pregnant woman increases risk of complications such as abortion, premature rupture of fetal membranes, low birth weight and transmission of HIV to the fetus. Objective: To determine the microbial isolates and antimicrobial sensitivity pattern of abnormal vaginal discharge in pregnant women in Nuhu Bamali maternity hospital Kano. Methods: This was a cross-sectional descriptive study where semi structured interviewer administered questionnaires were employed to a sample of 200 respondents using a simple random sampling technique. High vaginal swab samples were collected from pregnant women with abnormal vaginal discharge at the antenatal clinic. Result: Prevalence of abnormal vaginal discharge among pregnant women in this study was 5.25%. Young maternal age, low parity, lack of western education and unemployment were found to be associated with risk of abnormal vaginal discharge (p˂0.001). The prevalence of positive culture was 83.5% in women with abnormal vaginal discharge; C. albicans (33%), E. coli (23%), S. aureus (17.5%), Klebseilla sp. (7.5%), and Streptococcus sp. (2.5%). Eighty-three percent of microorganism were sensitive to Augmentin, 79% to erythromycin, 62% to Ofloxacin and 41% to gentamicin. Most of the organisms were resistant to amoxicillin and ampicillin. Conclusion: The prevalence of abnormal vaginal discharge in pregnancy is 5.25% with C. albicans and E. coli being the commonest causes. Most of the organisms are sensitive to Augmentin and Erythromycin. Both antibiotics are safe in pregnancy.

Efficacy of tablet metronidazole and clindamycin in management of bacterial vaginosis in a tertiary care hospital in Chengalpattu district

BV is a common disorder, yet poorly understood poly-microbial vaginal infection. It is more commonly seen in women in reproductive age group. It has high prevalence in African women specially those in sub-Saharan Africa. Approximately 50-69% of women with BV are not symptomatic and women who presents with symptoms varies from Gray-white offensive vaginal discharge intensified after sexual intercourse and during menstruation, lower abdominal pain and dyspareunia. BV is diagnosed by two different criteria such as Amsel’s and Nugent’s. After the diagnosis according to the above criteria, CDC & ACOG recommended either orally or Intravaginally Metronidazole or Clindamycin is given to treat BV. To study the effectiveness of Clindamycin on Bacterial Vaginosis and compare with commonly used Metronidazole. A randomized control study was done after approval from Institute Ethical committee on patients who came to Gynaecology OPD in Shri Sathya Sai Medical College and Research Institute after taking written and informed consent.All study subjects were examined in the OPD. Under aseptic precautions a high vaginal swab was taken and sent to microbiology lab for culture and sensitivity and using the criterias mentioned below such as Amsel’s and Nugent’s, diagnosis will be noted and treated accordingly.Clindamycin is better than Metronidazole with respect to Amsel’s criteria and Nugent’s after treatment (P<0.05) and with respect to the culture results after treatment (P<0.05).Oral Clindamycin may be preferable to Oral Metronidazole because of its broader spectrum of activity.

ASYMPTOMATIC URINARY TRACT INFECTION IN PREGNANT WOMEN WITH BACTERIAL VAGINOSIS ATTENDING TERTIARY CARE HOSPITAL, VISAKHAPATNAM

Objective: Determining the prevalence of bacterial vaginosis and asymptomatic bacteriuria in pregnant women who were prenatal outpatients and inpatients at a tertiary care hospital was the goal of the current investigation.
 Methods: During a one-year period, a total of 234 prenatal women from the OP and IP (GYN and OBG dept.) department representing various age and parity groups and gestational ages attended tertiary care teaching hospital. The samples were subjected to standard microbiological techniques for identification of microorganisms. Amsel's criteria and Nugent scoring system were applied for diagnosis of bacterial vaginosis.
 Results: Out of 234 study subjects, Increased homogenous vaginal discharge was found in 132 patients (56.4%), whiff’s test positive was seen in 59 patients (25.2%), clue cells were observed in 48 patients (20.5%) and pH greater than 4.5 was seen in 115 patient high vaginal swabs (49.1%). Maximum numbers of cases 109 were reported in the Nugent’s score 7-10 (80.7%) out of 135 cases. Among 234 urine samples subjected to microbiological analysis, 82 urine samples showed microbial growth. The major isolate was E. coli 34 (41.4%) followed by Proteus species 18 (21.9%).
 Conclusion: In order to avoid pregnancy difficulties, it is advised that antenatal health care institutions examine pregnant women for vaginitis. Moreover, women with BV should get a UTI screening. Antibiotic usage should be promoted responsibly, while misuse of antibiotics should be discouraged. Douching and having several sexual partners are risk factors for BV, hence precautions should be done.

Comparative analysis of vaginal microbiota sampling using menstrual cups and high vaginal swabs in pregnant women living with HIV-1 infection.

Menstrual cups (MCs) are increasingly used to collect cervicovaginal secretions to characterise vaginal mucosal immunology, in conjunction with high vaginal swabs (HVS) for metataxonomics, particularly in HIV transmission studies. We hypothesised that both methods of collecting bacterial biomass are equivalent for 16S rRNA gene sequencing. Cervicovaginal fluid (CVF) samples from 16 pregnant women with HIV-1 (PWWH) were included to represent the major vaginal bacterial community state types (CST I-V). Women underwent sampling during the second trimester by liquid amies HVS followed by a MC (Soft disc™) and samples were stored at -80°C. Bacterial cell pellets obtained from swab elution and MC (500 µL, 1 in 10 dilution) were resuspended in 120 µL PBS for DNA extraction. Bacterial 16S rRNA gene sequencing was performed using V1-V2 primers and were analysed using MOTHUR. Paired total DNA, bacterial load, amplicon read counts, diversity matrices and bacterial taxa were compared by sampling method using MicrobiomeAnalyst, SPSS and R. The total DNA eluted from one aliquot of diluted CVF from an MC was similar to that of a HVS (993ng and 609ng, p=0.18); the mean bacterial loads were also comparable for both methods (MC: 8.0 log10 16S rRNA gene copies versus HVS: 7.9 log10 16S rRNA gene copies, p=0.27). The mean number of sequence reads generated from MC samples was lower than from HVS (MC: 12730; HVS:14830, p=0.05). The α-diversity metrices were similar for both techniques; MC Species Observed: 41 (range 12-96) versus HVS: 47 (range 16-96), p=0.15; MC Inverse Simpson Index: 1.98 (range 1.0-4.0) versus HVS: 0.48 (range 1.0-4.4), p=0.22). The three most abundant species observed were: Lactobacillus iners, Lactobacillus crispatus and Gardnerella vaginalis. Hierarchical clustering of relative abundance data showed that samples obtained using different techniques in an individual clustered in the same CST group. These data demonstrate that despite sampling slightly different areas of the lower genital tract, there was no difference in bacterial load or composition between methods. Both are suitable for characterisation of vaginal microbiota in PWWH. The MC offers advantages, including a higher volume of sample available for DNA extraction and complimentary assays.

Detection of biofilm formation in multi-drug resistant Staphylococcus aureus among clinical isolates in Zaria metropolis, Kaduna, Nigeria

Antimicrobial resistance are associated with several virulence factors such as biofilm. The biofilm formation ability of S. aureus complicates effective therapeutic management of infections. In this research, we intend to observe biofilm formation in S. aureus using two in vitro phenotypic methods: tissue culture plate and Congo red agar as well as biofilm associated genes Ica A B & D and 16SrRNA. A total of 150 presumptive coagulase positive staphylococcal isolates from all specimens (blood, urine, high vaginal swab, wound swab, ear swab, endocervical swab) submitted to the microbiology laboratory of the selected hospitals were collected. Seventy-three (73) or 48.7% of the isolates were identified as coagulase positive Staphylococcus using microbiology standard methods (tube coagulase test, growth on mannitol salt agar & Dnase agar). Using microgen staph identification kit, the isolates were further characterized into various Staph spp. Disc agar diffusion method was used for eleven (11) antibiotics susceptibility test while vancomycin screening agar and BMD (Broth Micro dilution) MIC test was used for vancomycin susceptibility evaluation. Indirect observation of biofilm was performed using congo red agar (CRA) and Microtitre plate assay method. PCR and sequencing were conducted on the isolates to molecularly detect the presence of 16SrRNA, IcaA, IcaB, IcaD genes. Susceptibility of S aureus (21%) isolates tested against 12 different categories of antibiotics shows 4(27%) not multidrug resistant (MDR), 7(47%) were MDR and 4 (27%) were extensively drug resistant (XDR). High percentage (74%) of Multiple antibiotic resistant index at ≥0.3 suggested that the isolates originated from an environment where antibiotics are often used. Biofilm assessment of MDR S aureus isolates revealed that 9(82%) and 11 (100%) of the isolates were biofilm formers using Congo Red Agar method and Microtiter plate assay respectively. All isolates amplified with 16SrRNA primer signifying all are S. aureus, 100% of the isolates amplified with IcaA, 90% isolates amplified with IcaD, and 50% isolates amplified with IcaB. We can conclude that there is high prevalence of Biofilm forming S. aureus strains in the hospitals studied. This result should be born in mind by clinicians while prescribing medication for S. aureus positive conditions. Hospital managements should be proactive in preventing the preservation of the biofilm formers in their hospital environment through adequate sanitary and disinfection protocols. It is also necessary for clinician to note that nitrofurantoin, linezolid and vancomycin were most effective against the biofilm producing S. aureus and microtitre plate assay method was observed to be most reliable assay in the study of biofilm.

Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors.

Although child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors. We screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy. Our results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection. Our study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed.

Prevalence of Staphylococcus aureus among Female Patients Attending Rivers State University Teaching Hospital (RSUTH) in Port Harcourt, Nigeria

Objectives: To isolate, identify and determine the prevalence of Staphylococcus aureus among Female Patients attending Rivers State University Teaching Hospital in Port Harcourt using High Vaginal Swab samples.
 Methods: A cross-sectional study was carried out on total of 103 female patients attending the outpatients department and Antenatal clinic of Rivers State University Teaching Hospital. High Vaginal Swab samples were aseptically collected from 55 non-pregnant and 48 six weeks postpartum women. These were then analysed in the Microbiology Laboratory of the Hospital, following standard microbiological procedures. Questions on age, number of sexual partners, knowledge of vaginal infection, symptomatic case, History of previous infection and treatments was responded to by each participant through the completing of questionnaires. Mannitol Salt Agar (MSA) was used for the isolation of the organism and their phenotypic traits were determined based on their cultural and biochemical characteristics.
 Results: The study revealed that 25 (24.3%) consisting of 20 (36.4%) non-pregnant women and 5 (10.4%) Postpartum women were positive for Staphylococcus aureus infection. The prevalence of S. aureus among different groups was statistically significant, (P= .002). The highest percentage of S. aureus isolation (36.4%) was found in non-pregnant population. Prevalence of S. aureus was found highest 10 (18.2%) in 21-25 age group among non-pregnant women and none in 26-30 age group among postpartum women. Data obtained from the questionnaires returned showed that 10 (40%) that tested positive for the organism were asymptomatic as at the time of sample collection, had history of previous reproductive tract infection and had previously undergone treatment. 
 Conclusion: The high rate of vaginal Staphylococcal colonisation observed and the positive correlation between Staphylococus aureus prevalence and age, Child delivery status as well as treatment of previous reproductive tract infection seen in the study suggests the need for awareness on the importance of personal hygiene, proper antibiotic usage and regular screening of females within reproductive age.

Phylogenetic variants of Mycoplasma hominis from pregnant women and women presenting with infertility in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Background: Much controversies have been associated with the pathogenicity of Mycoplasma hominis but little has been done to unravel the mystery behind the different views. This study aimed at investigating the genetic variants abounding within M. hominis and the distribution of the virulent genes among the variants.
 Methodology: Twenty (20) M. hominis isolates from high vaginal swabs of women (11 from pregnant women and 9 from women presenting with infertility) attending the Obstetrics and Gynaecology clinics of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were sequenced using 16S rRNA universal gene target for the purpose of phylogenetic analysis and epidemiological typing. The isolates were also screened for the presence of M. hominis variable adherence antigen (vaa) and p120 virulent genes using primer constructs from the respective genes in a conventional PCR protocol.
 Results: Of the 20 M. hominis vaginal isolates, 4 phylogenetic strains were detected; strain MHS43 constituted 10/20 (50.0%) [2/9 (22.2%) from infertile women and 8/11 (72.7%) from pregnant women]; strain MHBS constituted 3/20 (15%) [3/9 (33.3%) from infertile women and 0/11 (0%) from pregnant women]; strain MHSWP2 constituted 4/20 (20.0%) [3/9 (33.3%) from infertile women and 1/11 (9.1%) from pregnant women]; while strain MHKC87 constituted 3/20 (15%) [1/9 (11.1%) from infertile women and 2/11 (18.2%) from pregnant women]. Each of vaa and p120 genes was detected in 14 of 20 isolates, while 6 isolates did not carry the genes. A 2-way ANOVA test showed that none of the genes was significantly associated with a particular strain (p=0.8641).
 Conclusions: The different views regarding the pathogenicity of M. hominis may be linked to the heterogeneity within the species and lack of omogeneity in the virulent genes as witnessed both in the intra species and intra strain levels.

Identification and pattern of antifungal susceptibility of Candida species isolated from cases of vaginitis in a tertiary care hospital in India.

Vulvovaginal candidiasis (VVC) is one of the most frequent reasons for gynecological consultations. Candida albicans is responsible in the majority of cases. Lately, VVC caused by non-albicans Candida spp. (NAC), which are resistant to routinely used antifungals, is on the rise. This study was designed to determine the prevalence of Candida in patients suffering from vaginitis and to assess the predisposing factors along with identification of Candida species and evaluation of their susceptibility profile. High vaginal swabs were collected from 225 women. Sample processing consisted of Gram stain and culture onto Sabouraud's dextrose agar and HiChrom Candida Differential agar. Isolates were identified and speciated using VITEK2 Compact System. Susceptibility testing was done using VITEK2 AST-Y S08 cards and disc diffusion. Candida spp. were isolated from 94 (41.8%) of the cases. C. albicans was the predominant species (71.6%) followed by other NAC spp. (28.4%). Pregnancy and diabetes were the most frequently implicated risk factors (67.1% and 44.4%). High resistance was observed in NAC spp. as opposed to C. albicans to all antifungal agents tested. Empirical therapy with routinely used antifungals can be initiated for C. albicans. In the case of NAC spp., identification should be followed by susceptibility testing.

Trichomonas vaginalis Among Women in Sulaimania Governorate-Iraq

Trichomonas vaginalis infection is one of the sexually transmitted diseases. It is a health problem all over the world, including Iraq. The parasite usually infected in the vagina and urethra, but could involve the endocervix. Aim: This study aim to show the prevalence of Trichomonas vagina/is in the women that have vaginal discharge. The study included ( 600) women attended the gynecological out patient clinic in Sulaimania obstetrical and gynecological teaching hospital and rozhan out patient clinic tlu·ough the period from January 2007 till September 2007. Per vaginal examination was performed for each patient using a sterile cuscos speculum. Two high vaginal swabs were obtained from each patient one for direct microscopic examination and other for Trichomonas vagina/is culture. The prevalence of T. vaginalis was 1 0( 1. 66%) The infection rate between pregnant women was 8(1.77%) higher than that of non-pregnant women 2(1.33%). The highest is found in women at the age group (26-3 5) years in which the infection rate was 5(2.48%). The rate of infection was higher among uneducated women 9(1.5%) than educated ones. The higher rate of T. vaginalis was obtained from women with white to gray (frothy discharge) 6(1.57%) and with yellow to green discharge 4(1.81 %) and those with bad odor was 8(2.02%) was higher than odourless discharge 2(0.97%). In positive cases of T. vagina/is , 6(60%) had white to gray vaginal discharge, and the rate of bad odour (80%) and without bad odour (20%). The rate of infection among illiterate women was higher than those with school education and no positive cases were detected among those with college education. In cultures the rate ofT. vagina/is was (5%) while in direct wet mount examination was (1.66%). Candida albicans were detected in 167(83.5%) in selected culture media ofT. vaginalis

IMPROVING NEONATAL OUTCOME BY STUDYING THE INCIDENCE OF MATERNAL GROUP B STREPTOCOCCUS (GBS) COLONIZATION AMONGST PREGNANT WOMEN: A PROSPECTIVE OBSERVATIONAL STUDY

Background And Objectives: Group B streptococcus (GBS) colonization during pregnancy can lead to invasive infections in neonates including meningitis or sepsis. The major risk factor for the neonatal disease is the rectovaginal colonization of GBS during pregnancy and delivery. The objectives of this study were as follows: 1) To screen antenatal patients at 35-37 weeks of gestation for GBS colonization. 2) To determine the prevalence of GBS among pregnant women. 3) To formulate an antibiotic policy with respect to antepartum antibiotic prophylaxis and empiric choice of antibiotics for early-onset neonatal sepsis. 4) To ascertain the maternal and neonatal outcomes in pregnant women with GBS colonization. Methods: A prospective observational study was conducted among 50 obstetric patients at 35-37 weeks of gestation attending the outpatient and inpatient departments of a tertiary care hospital. High vaginal and rectal swabs were collected and sent for culture and sensitivity testing using the standard culture methods. The incidence of positive cultures was noted and was taken up as a reference for statistical calculations. Results: Out of the 50 vaginal samples, 1 sample showed GBS positivity having a prevalence of 2%. Rectal swabs did not grow GBS for all samples. The mother and the newborn did not show any symptoms or signs due to GBS. GBS grown in vaginal culture was highly sensitive to Penicillin's, Cephalosporins, Clindamycin, Daptomycin, Vancomycin, Meropenem, and Linezolid. Conclusion:Based on our ndings, screening patients with routine rectovaginal swabs may not be necessary for our population. Also, empiric treatment with antibiotics for GBS in symptomatic mothers cannot be justied and hence GBS should be considered an insignicant pathogen

AN OBSERVATIONAL STUDY ON THE RELATIONSHIP BETWEEN UROGENITAL INFECTIONS AND PREMATURE RUPTURE OF MEMBRANES.

Introduction: Urogenital infections are common causes of premature rupture of membranes (prom). The present study was aimed at correlating the colonization of the organisms and possible infections in the vagina and urinary tract of mothers presenting with premature rupture of membranes. 96 high vag Materials And Methods: inal swabs and urine of patients with premature rupture of membranes were subjected to bacteriological studies according to the recommended procedures. Out of 56 and 40 cases of PROM and PPROM, 25% and 32.5% had vaginal infect Results: ion respectively (Table 1) & 16.1%and 27.5% showed urinary tract infection respectively (Table 2). The most common organism isolated from high vaginal swab culture was Candida followed by Enterococcus and E.Coli. The most common organism isolated from urine culture was E.Coli, followed by Enterococcus in both PROM and PPROM cases. Uroge Conclusion: nital infections constitute major risk factors for premature rupture of membrane

Candidiasis profile at the outpatient department of the university of cape coast hospital in the central region of Ghana: a retrospective study

IntroductionVulvovaginal candidiasis (VVC) is a public health problem with an estimated 138 million women globally experiencing recurrent VVC annually. The microscopic diagnosis of VVC has low sensitivity, but it remains an essential tool for diagnosis as the microbiological culture methods are limited to advanced clinical microbiology laboratories in developing countries. The study retrospectively analyzed the presence of red blood cells (RBCs), epithelial cells (ECs), pus cells (PCs) and Candida albicans positive in wet mount preparation of urine or high vaginal swabs (HVS) samples to test for their sensitivity and specificity for the diagnosis of candidiasis.MethodsThe study is a retrospective analysis at the Outpatient Department of the University of Cape Coast between 2013 and 2020. All urine and high vagina swabs (HVS) cultures samples using Sabourauds dextrose agar with wet mount data were analyzed. 2 × 2 contingency diagnostic test was used to ascertain the diagnostic accuracy of red blood cells (RBCs), epithelial cells (ECs), pus cells (PCs), and Candida albicans positive in wet mount preparation of urine or high vaginal swabs (HVS) samples for the diagnosis of candidiasis. The association of candidiasis among patients' demographics was analyzed using relative risk (RR) analysis.ResultsThe high prevalence of candida infection was among female subjects 97.1% (831/856) compared to males 2.9% (25/856). The microscopic profiles which characterized candida infection were pus cells 96.4% (825/856), epithelial cells 98.7% (845/856), red blood cells (RBCs) 7.6% (65/856) and Candida albicans positive 63.2% (541/856). There was a lower risk of Candida infections among male patients compared to female patients RR (95% CI) = 0.061 (0.041–0.088). The sensitivity (95%) for detecting Candida albicans positive and red blood cells (0.62 (0.59–0.65)), Candida albicans positive and pus cells (0.75 (0.72–0.78)) and Candida albicans positive and epithelial cells (0.95 (0.92–0.96)) with corresponding specificity (95% CI) of 0.63 (0.60–0.67), 0.69 (0.66–0.72) and 0.74 (0.71–0.76) were detected among the high vaginal swab samples.ConclusionIn conclusion, the study has shown that the presence of PCs, ECs, RBCs or ratio of RBCs/ECs and RBCs/PCs in the wet mount preparation from urine or HVS can enhance microscopic diagnosis of VVC cases.