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Microbiology of the vagina in children: normal and potentially pathogenic organisms
Insights
Vaginal microbiota in healthy girls aged 2 months to 15 years revealed common colonization by Corynebacterium vaginale, yeast, and genital mycoplasmas without symptoms. Pathogenic bacteria like Neisseria gonorrhoeae and Trichomonas vaginalis were occasionally found, alongside Chlamydia trachomatis.
Area of Science:
- Microbiology
- Pediatric Gynecology
- Vaginal Microbiome Research
Background:
- The vaginal microbiome composition and its potential pathogens in healthy prepubertal and adolescent girls are not fully characterized.
- Understanding normal vaginal flora is crucial for diagnosing and managing gynecological infections in pediatric populations.
Purpose of the Study:
- To investigate the prevalence of normal and potentially pathogenic microorganisms in the vaginal flora of healthy girls.
- To determine the association between microbial colonization and the presence or absence of vaginitis symptoms.
Main Methods:
- Vaginal cultures were performed on 100 healthy girls aged 2 months to 15 years.
- Cultures were analyzed for Corynebacterium vaginale, yeast species, genital mycoplasmas, Neisseria gonorrhoeae, Trichomonas vaginalis, and Chlamydia trachomatis.
- Aerobic and facultatively anaerobic bacteria were assessed in a subset of 59 girls.
Main Results:
- Corynebacterium vaginale, yeast, and genital mycoplasmas were isolated from 13.5%, 28%, and 28% of girls, respectively, without associated symptoms.
- Neisseria gonorrhoeae and Trichomonas vaginalis were identified in symptomatic cases, while Chlamydia trachomatis was detected in both symptomatic and asymptomatic girls.
- Diphtheroids and Staphylococcus epidermidis were common among aerobic/facultative bacteria; Lactobacilli predominated in older girls, and enteric organisms in younger girls.
Conclusions:
- The study identified common microbial inhabitants of the healthy pediatric vagina, including Corynebacterium vaginale, yeast, and mycoplasmas, often without clinical significance.
- Rare isolation of pathogens like Neisseria gonorrhoeae, Trichomonas vaginalis, and Chlamydia trachomatis highlights the importance of targeted testing.
- Age-related variations in bacterial flora, with a shift towards Lactobacilli in older girls, suggest developmental changes in the vaginal microbiome.
Abstract:
Vaginal cultures from 100 healthy girls, 2 months to 15 years of age, were examined for the presence of normal and potentially pathogenic microorganisms. Corynebacterium vaginale, yeast species, and genital mycoplasmas were isolated from vaginal cultures from 13.5 %, 28%, and 28% of the girls examined, respectively. Colonization with these organisms was not associated with signs or symptoms of vaginitis. Neisseria gonorrhoeae was isolated from a 4-year-old with purulent vaginitis. Trichomonas vaginalis was recovered from two 13-year-olds, both of whom had an abnormal vaginal discharge. Vaginal antibody to Chlamydia trachomatis was found in two girls 4 and 13 years of age. In neither girl was the organism recovered from the vaginal culture. Chlamydia trachomatis was recovered from the vaginal culture of another 4-year-old who had no abnormal findings on examination. Cultures from 59 of the girls were examined for aerobic and facultatively anaerobic bacteria. Diphtheroids and Staphylococcus epidermidis were the most frequently isolated organisms. Lactobacilli were isolated most frequently from the older girls, whereas enteric organisms were isolated most frequently from the younger girls.