Antibiotic Susceptibility Profile of Bacteria Causing Aerobic Vaginitis in Women in Iraq

by Selleckchem | Oct 06 2023

Aerobic vaginitis (AV) is a vaginal infectious condition characterized by abnormal vaginal discharge, high inflammatory response, signs of epithelial atrophy, an increase in aerobic bacteria of intestinal origin and a decrease in the normal flora, especially Lactobacillus spp.. It is one of the most common reproductive tract infections among women. This study aimed to analyze the antimicrobial susceptibility levels of the dominant bacterial species found in the vaginae of women infected with AV. A total of 89 high vaginal swabs (HVS) were collected from women aged (18-50) years old attending some hospitals and private gynaecology clinics in Baghdad City. All obtained swabs were cultured on different culture media, and the primary diagnosis was performed according to standard laboratory diagnosis protocols. To confirm the diagnosis and to determine the antibiotic susceptibility profile of bacterial isolates, VITEK 2 Compact Automated System GP and GN colourimetric identification cards and AST GN and AST GP cards were used according to Manufacturer Company constructions (BioMérieux / France). Out of 89swabs, ninety-five pathogenic strains were obtained, including 62 isolates (65.2%), Grampositive and 33 isolates (34.7%), Gram-negative bacteria. Staphylococcus spp. (46.3%) The most represented active strain was Escherichia coli (15.7%). All Gram-positive bacterial strains displayed the highest resistance rates (100%) toward penicillins and cephalosporins, while the highest sensitivity rates were toward daptomycin, followed by vancomycin and gentamicin (P=0.001). Gram-negative bacteria displayed the highest resistance rates toward penicillins, beta-lactam combination, monobactam and cephalosporins, while the highest sensitivity rates were toward amikacin followed by imipenem meropenem and gentamicin (P=0.001). It is worth mentioning that Gram-positive bacteria showed 100% sensitivity toward tigecycline. Thirty-eight (40 %) of all obtained bacterial strains were extensively drug-resistant XDR, 57 (60%) were multidrug resistance MDR and no pan-drug resistance PDR was reported. Gram-positive bacteria include 21% XDR and 44.2% MDR strains, while Gram-negative bacteria include 18.9% XDR and 15.7% MDR strains.

Comments:

The study aimed to analyze the antimicrobial susceptibility levels of the dominant bacterial species found in the vaginas of women infected with aerobic vaginitis (AV). A total of 89 high vaginal swabs were collected from women aged 18-50 years old attending hospitals and private gynecology clinics in Baghdad City.

The swabs were cultured on different culture media, and the primary diagnosis was performed according to standard laboratory diagnosis protocols. To confirm the diagnosis and determine the antibiotic susceptibility profile of bacterial isolates, the researchers used the VITEK 2 Compact Automated System and specific identification and antibiotic susceptibility cards.

Out of the 89 swabs, 95 pathogenic strains were obtained. Among these, 62 isolates (65.2%) were Gram-positive bacteria, and 33 isolates (34.7%) were Gram-negative bacteria. The most prevalent Gram-positive strain was Staphylococcus spp. (46.3%), while Escherichia coli was the most represented Gram-negative strain (15.7%).

The Gram-positive bacterial strains exhibited a high resistance rate (100%) toward penicillins and cephalosporins. However, they showed high sensitivity rates toward daptomycin, vancomycin, and gentamicin. Gram-negative bacteria displayed high resistance rates toward penicillins, beta-lactam combinations, monobactam, and cephalosporins. On the other hand, they showed high sensitivity rates toward amikacin, imipenem, meropenem, and gentamicin.

It's important to note that all Gram-positive bacteria showed 100% sensitivity toward tigecycline. Among the obtained bacterial strains, 38 (40%) were extensively drug-resistant (XDR), 57 (60%) were multidrug-resistant (MDR), and no pan-drug-resistant (PDR) strains were reported. Among the Gram-positive bacteria, 21% were XDR, and 44.2% were MDR strains. Among the Gram-negative bacteria, 18.9% were XDR, and 15.7% were MDR strains.

These findings indicate a high prevalence of antimicrobial resistance among bacterial isolates from women with AV. The Gram-positive bacteria showed resistance to commonly used antibiotics, while the Gram-negative bacteria exhibited resistance to various classes of antibiotics. The study highlights the importance of judicious antibiotic use and the need for alternative treatment options for AV to combat the growing problem of antimicrobial resistance.