BACTERIA AND CANDIDA SPECIES ASSOCIATED WITH HIGH VAGINAL SWABS AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PROFILE

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Product Code: 00009054

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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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