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Microbiological aspects of vulvovaginitis in prepubertal girls

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Abstract

This study aimed to establish the vaginal introitus microbial flora in girls with and without symptoms of vulvovaginitis, and to present the distribution of isolated microorganisms by age groups in girls with vulvovaginitis. We enrolled 500 girls with vulvovaginitis symptoms, aged 2–12 years, referred by their pediatricians for microbiological examination of the vaginal introitus swabs, and 30 age-matched asymptomatic girls. Similar microbial flora was isolated in both groups, but the symptomatic girls had significantly more common positive microbiological findings compared to controls (p < 0.001). In symptomatic girls, the following pathogenic bacteria were isolated: Streptococcus pyogenes (4.2%), Haemophilus influenzae (0.4%), and Staphylococcus aureus (5.8%). Bacteria of fecal origin were found in vaginal introitus swabs in 33.8% of cases, most commonly Proteus mirabilis (14.4%), Enterococcus faecalis (12.2%), and Escherichia coli (7.0%). The finding of fecal flora was more common compared to controls, reaching a statistical significance (p < 0.05), as well as in girls aged up to 6 years (p < 0.001). Candida species were found in 2.4% of girls with vulvovaginitis symptoms. Conclusion: The microbial ecosystem in girls with clinical signs of vulvovaginitis is complex and variable, and the presence of a microorganism does not necessarily imply that it is the cause of infection. The diagnosis of vulvovaginitis in prepubertal girls requires a complex and comprehensive approach, and microbiological findings should be interpreted in the context of clinical findings.

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Conflict of interest

The authors did not receive any financial or other support for their study.

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Authors and Affiliations

  1. Faculty of Medicine, University of Niš, Bulevar dr Zorana Đinđića 81, 18000, Niš, Serbia

    Gordana Ranđelović, Suzana Otašević & Milena Bogdanović

  2. Center of Microbiology, Institute of Public Health Niš, Niš, Serbia

    Vesna Mladenović, Ljiljana Ristić & Snežana Mladenović-Antić

  3. Department of Pediatrics, Health Care Center Niš, Niš, Serbia

    Sofija Branković

  4. Center of Informatics and Biostatistic in Healthcare, Institute of Public Health, Niš, Serbia

    Dragan Bogdanović

Authors
  1. Gordana Ranđelović
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  2. Vesna Mladenović
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  3. Ljiljana Ristić
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  4. Suzana Otašević
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  5. Sofija Branković
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  6. Snežana Mladenović-Antić
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  7. Milena Bogdanović
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  8. Dragan Bogdanović
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Correspondence to Gordana Ranđelović.

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Ranđelović, G., Mladenović, V., Ristić, L. et al. Microbiological aspects of vulvovaginitis in prepubertal girls. Eur J Pediatr 171, 1203–1208 (2012). https://doi.org/10.1007/s00431-012-1705-9

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  • DOI: https://doi.org/10.1007/s00431-012-1705-9

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