A associação dos Streptococcus agalactiae com inflamação vaginal em mulheres atendidas nos laboratórios públicos de Maceió

• Autor(a) principal: Rodrigues, Mônica Meira Leite [UNIFESP]
• Data de Publicação: 2010
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/8806
• topic: Streptococcus agalactiae; Women; Public laboratories; Vaginal inflammatory process; Streptococcus agalactiae; Vaginitis; Laboratories; Estreptococo do grupo B; Inflamação vaginal; Laboratórios públicos; Mulheres; Streptococcus agalactiae; Vaginite; Laboratórios

Introduction - Streptococcus agalactiae are bacteria considered as members of vagina, superior aerial tract, and intestinal tract microbiota, but it is growing in importance as a human pathogen throughout the last years. When it is present in vagina, it can bring serious consequences to the woman, and can be associated to infertility, improving risk of premature rupture of membrane, leading to chorioamnionitis, endometritis, etc. and from mother vaginal colonization there may be contamination of neonates during delivery. Objective - Objective of this study was to determine the association of Streptococcus agalactiae with vaginal inflammatory process in women attended in public laboratories of Maceió. Material and methods – It has been collected material in the distal medium third of the vagina of 1014 women from 18 to 49 years. One of the swabs has been used to bacterioscopic examination procedures and the other two swabs had been used for culture procedures of Streptococcus agalactiae (put in Todd-Hewitt broth) and other microorganisms, beyond the fresh direct examination. The identification of the microorganisms has been made according to literature. Results – The frequency of vaginal colonization by Streptococcus agalactiae found in this study has been of 13,9%, being 98 (9,7%) positive cultures only for this microorganism and 43 (4,2%) associated with other microorganisms. Among women with positive culture only to streptococcus, 18,9% presented inflammatory reaction, while only 6,7% didn’t have inflammation. The proportion of inflammatory reactions observed in women colonized by the streptococcus has been comparable to that of other pathogens commonly found in vagina as: Candida spp., G. vaginalis and Trichomonas spp.. In relation to the degree of association of those microorganisms with vaginal inflammatory processes, it has been verified a Relative Risk of 2,80 for Streptococcus agalactiae, 2,01 for Candida spp., 0,55 for Gardnerella vaginalis and 19,03 for Trichomonas spp. Those data have been confirmed by the multivariant analysis using Forward Stepwise method (Wald). It has been verified that pregnancy does not constitute a risk factor, nor age, number of partners, frequency of intercourse, abortions and previous pregnancies. Conclusion – B group streptococcus, when it is present in vagina showed to be an inflammatory process promoting agent, as for example other microorganisms, like Candida spp and Trichomonas spp, that are always valued when they are found in that site. This fact shows that this bacteria that is still considered as part of vaginal biota, should be considered so much pathogenic as other microorganisms, thus existing the necessity of differenciating between a state of simple colonization or otherwise if the bacteria is being an infectious process agent.