Microbiological Findings of Symptomatic Vulvovaginitis in Chinese Prepubertal Girls

Abstract

Study objective: To study the bacteria and fungi causing vulvovaginitis in prepubertal girls.

Design: Swabs from vaginal introitus were collected from patients with vulvovaginitis in 2018, and cultured for the identification of microorganisms with standard microbiological techniques.

Setting: A children's hospital in Hangzhou, East China.

Participants: A total of 1235 Chinese prepubertal girls diagnosed with vulvovaginitis.

Main outcome measure: Bacteria or fungi in pure cultures or as the predominant organism were defined as pathogens.

Results: A total of 1235 cases were diagnosed as vulvovaginitis, and 515 isolates were identified from 494 patients (40%, 494/1235). The most common pathogen was Streptococcus pyogenes (27.6%,142/515), followed by Haemophilus influenzae (27.2%,140/515), Candida albicans (22.3%,115/515), Staphylococcus aureus (5.8%, 30/515) and Escherichia coli (4.7%,24/515). All S pyogenes isolates were sensitive to penicillin, whereas 53.7% (73/136) of H influenzae isolates were sensitive to ampicillin, and 70.4% (19/27) of S aureus isolates were sensitive to oxacillin.

Conclusion: S pyogenes and H influenzae were the 2 most commonly identified pathogenic bacteria found in prepubertal girls with vulvovaginitis. Vulvovaginitis in prepubertal girls caused by C albicans may be more common in older children.

Keywords: Bacterium; Fungus; Girl; Prepubertal; Vulvovaginitis.