European Journal of Pediatrics

, Volume 171, Issue 8, pp 1203–1208

Microbiological aspects of vulvovaginitis in prepubertal girls

  • Gordana Ranđelović
  • Vesna Mladenović
  • Ljiljana Ristić
  • Suzana Otašević
  • Sofija Branković
  • Snežana Mladenović-Antić
  • Milena Bogdanović
  • Dragan Bogdanović
Original Article

DOI: 10.1007/s00431-012-1705-9

Cite this article as:
Ranđelović, G., Mladenović, V., Ristić, L. et al. Eur J Pediatr (2012) 171: 1203. doi:10.1007/s00431-012-1705-9

Abstract

This study aimed to establish the vaginal introitus microbial flora in girls with and without symptoms of vulvovaginitis, and to present the distribution of isolated microorganisms by age groups in girls with vulvovaginitis. We enrolled 500 girls with vulvovaginitis symptoms, aged 2–12 years, referred by their pediatricians for microbiological examination of the vaginal introitus swabs, and 30 age-matched asymptomatic girls. Similar microbial flora was isolated in both groups, but the symptomatic girls had significantly more common positive microbiological findings compared to controls (p < 0.001). In symptomatic girls, the following pathogenic bacteria were isolated: Streptococcus pyogenes (4.2%), Haemophilus influenzae (0.4%), and Staphylococcus aureus (5.8%). Bacteria of fecal origin were found in vaginal introitus swabs in 33.8% of cases, most commonly Proteus mirabilis (14.4%), Enterococcus faecalis (12.2%), and Escherichia coli (7.0%). The finding of fecal flora was more common compared to controls, reaching a statistical significance (p < 0.05), as well as in girls aged up to 6 years (p < 0.001). Candida species were found in 2.4% of girls with vulvovaginitis symptoms. Conclusion: The microbial ecosystem in girls with clinical signs of vulvovaginitis is complex and variable, and the presence of a microorganism does not necessarily imply that it is the cause of infection. The diagnosis of vulvovaginitis in prepubertal girls requires a complex and comprehensive approach, and microbiological findings should be interpreted in the context of clinical findings.

Keywords

Prepubertal girlsVulvovaginitisInfectionsMicrobiological findings

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Gordana Ranđelović
    • 1
  • Vesna Mladenović
    • 2
  • Ljiljana Ristić
    • 2
  • Suzana Otašević
    • 1
  • Sofija Branković
    • 3
  • Snežana Mladenović-Antić
    • 2
  • Milena Bogdanović
    • 1
  • Dragan Bogdanović
    • 4
  1. 1.Faculty of MedicineUniversity of NišNišSerbia
  2. 2.Center of MicrobiologyInstitute of Public Health NišNišSerbia
  3. 3.Department of PediatricsHealth Care Center NišNišSerbia
  4. 4.Center of Informatics and Biostatistic in HealthcareInstitute of Public HealthNišSerbia