Streptococcus agalactiae: a vaginal pathogen?

Abstract

The significance of Streptococcus agalactiae as an aetiological agent in vaginitis was evaluated. A total of 6226 samples from women who presented with vaginal symptoms was examined. The presence of >10 leucocyteshigh-power field (h.p.f.) was taken to be the criterion of active infection. S. agalactiae was isolated from 10.1% of these samples. The isolation rates of other common pathogens such as Candida spp., Gardnerella vaginalis and Trichomonas spp. were 54.1%, 27.2% and 4.2%, respectively, in the same group of patients. In contrast, the isolation rates of these micro-organisms in the group of patients who had no infection ( 4 0 1eucocytesh.p.f.) were 4.2%, 38.3%, 33% and 0.5%, respectively. In the majority of samples from which S. agalactiae was isolated, it was the sole pathogen isolated (83%) and its presence was associated with an inflammatory response in 80% of patients. Furthermore, the relative risk of vaginal infection with S. agalactiae (2.38) in patients with purulent vaginal discharge was greater than that of Candida spp. infection (1.41) and lower than that of Trichomonas spp. infection (8.32). These data suggest that S. agalactiae in symptomatic women with microscopic evidence of inflammation should be considered a causative agent of vaginitis.

Avaliação Clínica e Laboratorial de Crianças e Adolescentes com Queixas Vulvovaginais

“…Em nosso trabalho, os agentes específicos mais comumente observados na secreção vaginal foram cocos sp, cândida sp e Gardnerella (12,4%, 9.5% e 6,7%, respectivamente), semelhante ao observado por Koumantakis et al 8 e por Maniatis et al 6 . Contudo, quando analisamos somente as pacientes com vida sexual ativa, verificamos que a Gardnerella passa a ser o agente mais freqüente na secreção vaginal (22,6%), seguido pela cândida sp (19,4%) e pelos cocos sp (16,1%), como relatado em vários outros trabalhos [11][12][13] , em que a vaginose bacteriana foi a causa mais comum de corrimento vaginal em mulheres sexualmente ativas.…”

Nontrichomonal purulent vaginitis: Clinical approach

“…Numerous case reports have described a causal relationship between S. agalactiae and sporadic purulent vaginitis [5]; description of the resolution of signs and symptoms of vaginitis following penicillin therapy has even been reported [6]. Unfortunately, virtually all of these reports lack one or more components of evidence necessary to fulfill all of Koch's postulates to prove a cause-effect relationship.…”

Diversité étiologique des vaginites

“…Pour de nombreux auteurs, la pré sence de streptocoque B dans les sé cré tions vaginales ne doit pas conduire à un traitement antibiotique [12,13], mais plutô t à un traitement du dé sé quilibre de la flore vaginale [13]. Les seuls critè res de pathogé nicité du streptocoque B chez la femme non enceinte atteinte d'une vaginite clinique sont la pré sence de nombreux polynuclé aires alté ré s et une culture pure avec de nombreuses colonies [14,15].…”