ABSRACT
The vagina contains dozens of microbiological species in variable quantities and is, therefore, considered a complex environment. Among the microorganisms, bacteria have important repercussions on women’s health. The present study was conducted to elucidate this type of vaginal isolates and their sensitivity towards currently used antibiotics. Infections of the reproductive tract are a major problem of women’s sexual health. They are commonly seen in women of reproductive age and usually present with vaginal discharge , which they include sexually transmitted infections (STI), bacterial vaginosis (BV) and candidiasis. The microbial flora of vagina is a complicated environment, comprising of many microbiological species in variable proportions. The normal vaginal flora is usually well maintained by a complex balance of organisms.
Bacterial vaginitis can occur in any age group but more commonly diagnosed in females of reproductive age group. Diagnosis and treatment can be misleading if based only on clinical symptoms and signs. Candida spp. are normal flora of the vagina that eventually become pathogenic under some prevailing conditions, and thus present as a common etiology of vulvovaginitis. When prompt recognition and laboratory confirmation is not achieved, this could lead to devastating genital discomfort and a major reason for frequent hospital visits. It is a source of great physical and psychological discomfort as well as suffering. Vaginal discharge in women is sometimes caused by Candida and Bacterial vaginosis like Escherichia coli, Staphylococcus aureus, Klebsiella and Pseudomonas aeroginosa. Culture and sensitivity testing are done from high vaginal swab (HVS) specimen collected from female students in MOUAU of vaginal discharge.
This study tends to evaluate the microbial and antibiotic sensitivity pattern of high vaginal swab. This study evaluates vaginal candidiasis and bacterial vaginosis among female student in MOUAU, Abia state. A total of 100 samples of high vaginal swab were aseptically collected from the student. Standard microbiological methods were used to isolate and identify organisms in vaginal swabs. The bacterial isolates include Lactobacillus, Staphylococcus epidermis, Staphylococcus aureus, Klebsiella, Proteus and Pseudomonas aeruginosa with Lactobacillus having the highest percentage occurrence 56.0% followed by Staphylococcus epidermis 53.0%. The fungi isolates include Candida albican, having the highest level of percentage frequency.
TABLE
OF CONTENTS
CHAPTER ONE
1.1.
Introduction 1
1.2.
Aim of this study 2
1.3.
Objectives 3
CHAPTER TWO
2.0
LITERATURE REVIEW 4
2.1
what is vaginal infection 4
2.2
Types of vaginitis 5
2.3
A protective flora to maintain the vaginal 5
2.4
Physiology and pathology of vaginal flora 6
2.5
Epidemiological of vaginal candida infection 7
2.5.1 Candida species that affect the high
vaginal 8
2.5.2
Candida diagnosis 10
2.5.3
Symptoms 10
2.5.4
Treatment 11
2.6
Epidemiological study of bacteria vaginosis 11
2.6.1
Bacteria species 13
2.6.2
Bacterial vaginosis associated bacteria 14
2.6.3
Gardnerella vaginalis 14
2.6.4
The human microbiome 15
2.6.5
Problem of bacteria vaginosis 17
2.6.6
Causes of bacteria vaginosis 18
2.6.7
Symptoms 18
2.6.8
Prevention 19
CHAPTER THREE
3.1.
Sample Collection 20
3.2.
Wet mount preparation 20
3.3.
Media preparation 21
3.4.
Sterilization 21
3.5.
Isolation of high vaginal swab microorganisms
22
3.5.1.
Culture for fungi 22
3.6.0.
Characterization of isolates 23
3.6.1
Colony features 23
3.6.2.
Microscopic examination 23
3.6.2.1. Gram staining 23
3.6.2.2.
Germ tube test 24
3.7.0.
Biochemical test 25
3.7.1.
Catalase test 25
3.7.2.
Coagulase test 25
3.7.3.
Indole test 26
3.7.4.
Citrate utilization 26
3.7. 5.
Motility test 26
CHAPTER FOUR
4.0 RESULTS
CHAPTER FIVE
5.0 Discussion, conclusion
and Recommendation
5.1 Discussion
32
5.2 Conclusion
34
5.2 Recommendation 34
Reference
LIST
OF TABLE
Figure Title Page
1 Occurrence
of bacterial species obtained from students 28
2 Occurrence
of candida albican obtained from students using confirmatory germ tube test 29
3 Antibiotics
sensitivity of Hvs bacterial isolates 30
CHAPTER ONE
1.0 INTRODUCTION
The normal vagina is characterized by
dynamic inter relationships between Lactobacillus
acidophilus and other endogenous flora, estrogen, glycogen, vaginal pH, and
metabolic by-products of these microbiomes. L.
acidophilus produces hydrogen peroxide (as a by-product of metabolism),
which is toxic to pathogens and keeps the healthy vaginal pH acidic. Vaginitis occurs when the vaginal microflora have
been altered by invading pathogens or biochemical changes in the environment
(Tindall et al., 1988).
Abnormal vaginal discharge also
predisposes to significant morbidity in the form of pelvic inflammatory
diseases, infertility, endometriosis, cuff cellulitis, urethral syndrome,
pregnancy loss, preterm labour, increase susceptibility to sexually transmitted
infections (STI), including HIV and to be associated with low birth weight and
preterm birth (Masand et al., 2015). Females are more prone to urinary and
vaginal infections because of the anatomical and functional proximity to the
anal canal and due to the short urethra (Swamy et al., 2015).
The vagina could be infected by a variety of
pathogens including bacteria, fungi, viruses, and parasites (Abdelaziz et
al., 2014). The causative organisms can be endogenous, sexually transmitted
(Swamy et al., 2015). But, many women believe that such infections are
normal and part of the female experience and do not seek care due to shame or
lack of information (Swamy et al., 2015).
(Adeyba et al., 2003) the
symptomatic infections as outlined earlier but as clinical manifestation and
observed a number of asymptomatic vaginal infections as well. The author also
observed that Candida infection is
one of the most frequent infections to women and up to 75% of adult women will
have a least one episodes of vaginitis by Candida
during their life time.
Reports also show that Bacterial Vaginosis is high in women of reproductive age and is
characterized by raises vaginal replacement of normal bacteria fears (Lactobacilli) by mixed flora of
aerobics, anaerobic and micro aerobic species. Vaginitis occurs when the
vaginal microflora have been altered by invading pathogens or biochemical
changes in the environment. (Odds et al.,
1988) Changes in the vaginal environment encourage the Candida population,
enhance their adherence to vaginal epithelial cells, and facilitate germination
of daughter yeast cells. (Sobel et al., 1998)These
changes may transform asymptomatic colonization into symptomatic Candida
infection. VVC, like many vulvar diseases, has the potential to cause great
psychological distress and negatively impact a patient’s quality of life.
1.1 AIM OF THIS STUDY
To determine the bacteria and Candida species associated with High
vaginal swabs and their sensitivity.
1.2. OBJECTIVES
To isolate, characterize and identify
bacteria specie in high vaginal specimens.
To isolate, characterize and identify
Candida species in High vaginal
specimens using standard antimicrobial drugs.
To establish an antibiogram of all
isolate from the high vaginal specimens.
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