Clinical and Microbiological Findings of Vulvovaginitis in Prepubertal Girls
Kristina Jarienė1, Eglė Drejerienė1, Algirdas Jaras2
1Obstetrics and Gynecology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Insights
Genital microbiological findings were similar in prepubertal girls with vulvovaginitis and healthy controls. Most cases of vulvovaginitis were nonspecific, with clinical symptoms more frequent when a pathogen was identified.
Area of Science:
- Pediatric Gynecology
- Microbiology
- Infectious Diseases
Background:
- Vulvovaginitis is common in prepubertal girls.
- Understanding the microbiological landscape is crucial for diagnosis and treatment.
Purpose of the Study:
- To compare genital microbiological findings between prepubertal girls with vulvovaginitis and healthy controls.
- To identify potential causative agents of vulvovaginitis in this age group.
Main Methods:
- Prospective case-control study involving 52 girls with vulvovaginitis and 42 healthy controls (aged 1-9 years).
- Vaginal and introitus samples collected for microbiological culture.
- Analysis of bacterial type and growth intensity.
Main Results:
- Bacterial growth was common in both groups (90.4% in cases vs. 80.9% in controls).
- Potential causative agents were identified in 30.8% of cases and 21.4% of controls.
- Streptococcus pyogenes was the most frequent pathogen in the vulvovaginitis group.
Conclusions:
- Vaginal bacterial cultures are frequently positive in prepubertal girls, irrespective of vulvovaginitis diagnosis.
- Nonspecific vulvovaginitis is more common than that caused by a specific pathogen.
- Clinical symptoms correlated with the identification of a potential infectious agent.
Study Objective:
To evaluate genital microbiological findings in prepubertal girls with vulvovaginitis and in healthy controls.
Design:
Prospective case-control study.
Setting:
Pediatric Outpatient unit of the Department of Pediatrics of the Hospital of the Lithuanian University of Health Sciences Kauno Klinikos from November 2014 to May 2017.
Participants:
Fifty-two prepubertal girls aged 1-9 years diagnosed with vulvovaginitis, and 42 age-matched healthy controls.
Interventions And Main Outcome Measures:
Samples for microbiological culture were collected using sterile cotton swabs from the introitus and the lower third of the vagina from all study participants. Microbiological findings were analyzed according to bacteria type and intensity of growth.
Results:
Most of the vaginal microbiological swab results were positive for bacterial growth: 47 (90.4%) and 34 (80.9%) were similar in the study and control groups, respectively (P = .24). Sixteen (30.8%) and 9 (21.4%) of the microbiological traits results in the case and control groups, respectively, were regarded as potential causative agents (P = .27). Streptococcus pyogenes was the most frequent pathogen in the study group (P = .03); all other microorganisms detected as either a pure or dominant growth in the control group, were considered opportunistic.
Conclusions:
Vaginal bacterial culture results were positive in prepubertal girls with vulvovaginitis and in healthy controls. Nonspecific vulvovaginitis without a dominant/isolated pathogen was seen to be more common than vulvovaginitis with a potential causative agent. Clinical symptoms were more frequent among girls when the potential infectious agent was identified.
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