In this prospective study of 303 pregnant women C. albicans was found in 50 patients (16.5 per cent) but only once was it isolated from the healthy vagina. The majority of isolates (84 per cent) were associated with signs of vaginitis or vulvovaginitis. In the remainder, isolation of the fungus was associated with discharge or other sign of morbidity. Discharge and irritation were not specifically associated with isolation of the thrush fungus, but 85 per cent of women with vaginitis during pregnancy had precipitins in their serum, or C. albicans in the vagina. Candida albicans was isolated from 23 of 28 women with vulvitis, and from 11 out of 16 women with vaginal plaques or a cheesy appearance of the vaginal epithelium.
MATERIALS AND METHODS Preparation of antigensThree antigens derived from a strain of Candida albicans, group A (London School of Hygiene and Tropical Medicine no. 3153), were produced in bulk to minimise batch variation and stored in the freeze-dried state.(a) Mickle-disintegrated cytoplasmic antigen. A modification of the methods of Stallybrass (1964) and Taschdjian et al. (1964a) was used. The fungus was grown in shaken culture at 37°C for 48 hr. The culture medium was modified Sabouraud's glucose broth (peptone
SYNOPSIS Nineteen genera and groups of micro-organisms were isolated from the lower genital tract of 280 women at their first antenatal visit. Chlamydia, viruses, and T-strain mycoplasmas were not sought, and only routine methods of anaerobic culture were used. Growth was recorded as scanty, moderate or heavy. The population studied was grouped according to age, parity, gestational stage at booking, presence and degree of severity of lower genital tract morbidity, past history of vulvovaginitis, and suspicion of lower genital tract morbidity as evidenced by a request for a report on the microbiological findings. The frequency of isolation of the various microbes in health and in disease is given.The grading of Gram-stained smears bore no relation to the isolation rates of lactobacilli, but there was a significant increase (p <0.001) in the isolation rates of each of the following: Mycoplasma hominis, Bacteroides spp., Trichomonas vaginalis, Gram-variable cocco-bacilli, and anaerobic streptococci in those patients with smears in which lactobacilli were adjudged to be absent.The isolation of faecal streptococci was increased (p <0 001) in women aged more than 34 years. Escherichia coli (p <0 05) and anaerobic and microaerophilic streptococci (p <0-02) were isolated more frequently from those booking after the 25th week of pregnancy. The incidence of M. hominis (p <0'02) and of anaerobic streptococci (p <0-05) increased between the first and third trimesters.No significant positive correlations were established between the isolation rates of the various microbes and objective assessment of lower genital tract morbidity or the demonstration of pus cells, but lactobacilli were isolated less frequently (p <0 01) from those with morbidity. The isolation of Candida albicans (p <0 02), T. vaginalis (p <0'05), and M. hominis (p <0 05) was increased in patients in whom vulvovaginitis was suspected, and that of T. vaginalis (p <0 05) was increased in those with a past history of vulvovaginitis.The study indicates that, other than the pathogens T. vaginalis and C. albicans, only M. hominis could be suspected, on statistical grounds, of being associated with disease of the lower genital tract during early pregnancy.Although many papers deal with the isolation of genital tract during pregnancy and to seek relationparticular pathogens, or potential pathogens, from ships that may exist between signs or symptoms of the vagina, there have been few attempts at more morbidity and the isolation of particular microbes, comprehensive studies (Edmunds, 1959; Slotnick et as a basis for further study. Viruses, Chlamydia, andGordon et al 1966). The literature T-strain mycoplasmas were not sought. is briefly reviewed by Hurley et al (1974), who disThe microbiological studies were made on 280 cuss the factors that may influence the microflora pregnant women, of whom 80% were Caucasian, and comment on the difficulty of attempting clinico-89 % were married, and 89% were aged between 18 pathological correlations. The present investigation and 3...
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