بررسی فراوانی گونه های پرووتلا در زنان با عفونت واژینوز باکتریائی و تعیین مقاومت دارویی آنها

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه میکروبیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی همدان

2 کارشناس مامایی، دانشکده پرستاری و مامائی،‌ دانشگاه علوم پزشکی همدان

چکیده

مقدمه: اخیرا مقاومت دارویی در سه گونه پرووتلا شامل بیویا، دیسینس و ملانینوژنیکوس که در ایجاد عفونتهای دستگاه تناسلی زنان نقش دارند،‌ دیده شد. این تحقیق با هدف بررسی فراوانی واژینوز باکتریائی و تعیین مقاومت دارویی گونه های پرووتلا انجام شد.
روش کار: این مطالعه توصیفی بر310 بیمار مبتلا به ترشحات واژنی مراجعه کننده به درمانگاه زنان بیمارستان فاطمی همدان در سال 1383-1384 در تشخیص واژینوز باکتریائی بر اساس 4 شاخص آزمایشگاهی بررسی ترشحات واژن از نظر هموژن یا غیر هموژن بودن، تست ویف، مشاهده کلوسل در اسمیر و تعیین pH صورت گرفت. برای تعیین مقاومت دارویی باکتریها در مورد 9 آنتی بیوتیک روش کربی بائر انجام شد. اطلاعات در پرسشنامه جمع آوری و توسط نرم افزار آماری spssمورد تجزیه و تحلیل قرار گرفت.
نتایج: از310 نمونه کلینیکی، 7/65% بیماران دارای واژینوز باکتریائی بودند که 4/47% کلوسل، 2/66% تست ویف مثبت، 1/87% pH بالاتر از 5/4 و 7/67% ترشحات غیر هموژن دیده شد. همچنین در کل تعداد 60 سویه (3/19%) پرووتلا به دست آمد که در80% پرووتلا بیویا، 6/11% پرووتلا دیسینس و 3/8% پرووتلا ملانینوژنیکوس بود. این باکتریها به همراه 4 باکتری رفرانس نسبت به پنی سیلین 100% و نسبت به وانکومایسین و کانامایسین بیش از 60% مقاومت نشان دادند، در حالی که مقاومت نسبت به سفوکستین، کلیندامایسین، مترونیدازول و سیپروفلوکساسین کمتر از 10% بود.
نتیجه گیری: فراوانی ابتلا به واژینوز باکتریایی در این بیماران نسبتاً بالاست. شایعترین گونه جدا شده، پرووتلا بیویا و مؤثرترین آنتی بیوتیک بر آن سفوکستین، کلیندامایسین، مترونیدازول و سیپروفلوکساسین بود.

کلیدواژه‌ها


عنوان مقاله [English]

The Frequency of Prevotella Species in Women with Bacterial Vaginosis and Detection of the Drug Resistance

نویسندگان [English]

  • Rasoul Yousefi Mashouf 1
  • Marzieh Otougara 2
1 Midwife, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
2 Midwife, Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
چکیده [English]

Introduction: Recently drug resistance to three species of Prevatella (P.bivia, P. melaninogemcus, P. disicns) is seen. The aim of this study was to evaluate the frequency of bacterial vaginosis and detection of drugs resistance of Prevotella species.
Materials and Methods: This descriptive study performed from 2004 to 2005 at Fatemi Hospital of Hamadan, Iran, on 310 female patients with vaginal discharge. This study was approved by the local committee of medical ethics. Laboratory diagnosis of bacterial vaginosis was based on 4 criteria including study of the homogenesity of the discharges, performing of whiff test, search for clue cell in smear and determination of pH of the discharge. Antibiogram test was performed by method of Kirby-Bauer and 9 commonly used antibiotics were applied. The data collected in a questionnaire and analyzed, using spss software.
 
Results: Of 310 patients with discharge, 65.7% were diagnosed as bacterial vaginosis that 47.4% of them had clue cells, 66.2% were whiff test positive, pH of 87.1% of the discharge were more than 4.5 and 76.7% had non-homogenous discharge. Out of 310 samples, 60 (19.3%) Prevotella species isolated in which 80% was P.bivia, 11.6%P.disiens and 8.3% P.melaninogenicus.These isolates and 4 references strains were resistant to penicillin (100%) and to vancomycin, kanamycin (> 60%). Resistance to cefoxcetin, clindamycin, metronidazole and ciprofloxacin were less than 10%.
 
Conclusion: The frequency of bacterial vaginosis in our patients was relatively high. The most frequent isolated strain was P.bivia and also the most effective antibiotics against Prevotella isolates were ciprofloxacin, cefoxcetin, clindamycin and metronidazole.

کلیدواژه‌ها [English]

  • Prevotella species
  • Bacterial vaginosis
  • Antibiotic
  • Drugs resistance
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