Vrednost bakterijske kulture vaginalnog brisa u dijagnozi vaginalne infekcije
Sažetak
Uvod/Cilj. U postojećim uslovima rada u kliničkoj praksi zastupljeno je korišćenje skupog testa kulture cervikovaginalnog brisa i pored postojanja bržih i jednostavnih metoda u otkrivanju vaginalnih infekcija. Cilj ove studije bio je da se pokaže da uvođenje jednostavnih i brzih dijagnostičkih postupaka: mikroskopski pregled nativnog preparata vaginalnog sekreta (MPNPVS), pH vagine i test sa kalijumom hidoksidom (KOH) test omogućava bolju procenu stanja vaginalne flore od standardne mikrobiološke kulture koja se često koristi u Srbiji. Metode. Ovim prospektivnim istraživanjem obuhvaćeno je 505 asimptomatskih trudnica kod kojih je rađen MPNPVS, test sa 10% KOH, određivan pH vagine i standardna kultura cervikovaginalnog brisa. Kombinujući rezultate ovih procedura postavljana je dijagnoza bakterijske vaginoze (BV) i vaginitisa. Istovremeno određivan je broj polimorfonuklearnih leukocita (PMN) u svakom uzorku i analiziran zajedno sa ostalim nalazima. Na osnovu mikroskopskog nalaza potvrđivana je ili isključivana infekcija Candidom albicans i Trichomonas vaginalisom. Rezultati. Kod 36 (6%) trudnica kulturom cervikovaginalnog brisa dobijeno je nekoliko vrsta aeroba i fakultativnih anaeroba, dok je kod 52 (11%) žena izolovana Candidia albicans. Na osnovu MPNPVS i kliničkih kriterijuma 96 (19%) žena imalo je BV, 19 (4%) vaginitis, i 72% (14%) kandidijazu. Od 115 trudnica sa BV i vaginitisom, pH 4,5 nađen je kod 5, a od 390 trudnica sa normalnim nalazom njih 83 (21%) imalo je pH 4,5. Povećan broj PMN nađen je kod 154 (30%) žena, a kod njih 83 (54%) MPNPVS bio je normalan. Specifičnost i senzitivnost KOH testa i pH vagine u proceni stanja vaginalne flore iznosili su 95% i 81%, odnosno 79% i 91%. Zaključak. Kultura cervikovaginalnog brisa je skup i najčešće nekoristan test u kliničkoj praksi. Upotreba jednostavnih i bržih metoda kao što su mikroskopski pregled nativnog preparata vaginalnog sekreta, test sa KOH i određivanje pH vagine daju bolje rezultate u dijagnozi, kao i prevenciji i lečenju posledica do kojih vaginalne infekcije mogu da dovedu.
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