Etiology of vaginal infections and antimicrobial resistance pattern of aerobic bacterial isolates in women of reproductive age group attending a tertiary care hospital

Abstract

Background: The vaginal flora is a complicated environment containing dozens of microbiological species in variable quantities and
relative proportions. Many women with vaginitis may remain undiagnosed and such forms of abnormal vaginal neither considered as
normal nor can be called bacterial vaginosis and are termed as “intermediate flora” and its management probably differs from that of
bacterial vaginosis. It is of crucial importance in pregnant females at risk of preterm delivery. Materials and Methods: Six hundred
and ten high vaginal swabs both from indoor and outdoor patients were collected and cultured, and their susceptibility to various
antimicrobials was determined by standard methods. Result: Significant growth was obtained in 357 (58.5%) samples. Among
the positive samples, 314 were positive for aerobic bacterial isolates, and 43 showed the growth of Candida species. The common
aerobic isolates were Escherichia coli (24.92%), Klebsiella pneumoniae (23.50%), Staphylococcus aureus (16.52%), Enterococcus
species (8.40%), and coagulase-negative Staphylococcus (6.44%). About two-third of the positive samples (71.0%) were from
outdoor patients, while one-third (29%) were from indoor patients. The highest frequency of infection was observed at 25-30 years
followed by 31-35 years of age group. The prevalence of aerobic vaginitis cases was higher among nonpregnant compared to pregnant
cases. The Gram-positive organisms showed maximum resistance to ampicillin, followed by aminoglycosides, and ciprofloxacin.
The Gram-negative isolates showed maximum resistance to ciprofloxacin followed by ceftriaxone, ceftazidime, gentamicin, and
amikacin. Conclusion: The high prevalence of gynecological infections demands that the patients with gynecological symptoms
be investigated thoroughly. As the culture provides, the identification of causative microorganisms, it must invariably be done.