Non-spesifik vajinosis olgularından Gardnerella Vaginalis'in izolasyonu ve idantifikasyonu
Başlık çevirisi mevcut değil.
- Tez No: 111541
- Danışmanlar: PROF.DR. KURTULUŞ TÖRECİ
- Tez Türü: Doktora
- Konular: Mikrobiyoloji, Microbiology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 1992
- Dil: Türkçe
- Üniversite: İstanbul Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Mikrobiyoloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 82
Özet
- 61 - ÖZET VE SONUÇLAR Bu çalışmada 586'sı İ Ü İstanbul Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'na vajinit şikayeti ile başvuran kadınlardan, 55'i ise strilite nedeniyle aynı Fakültenin Tıbbi Genetik Bilim Dalı'nca incelenen kadınlardan alınan toplam 641 vajina salgısı G. vaginalis yönünden incelenmiştir. İncelemeye aldığımız vajina salgılarının tümünden iki preparasyon hazırlanarak biri Gram diğeri metilen mavisi ile boyanmış, kültür için insan kanlı Columbia jelozuna ekim yapılmış tır. Ekilen besiyerleri %5 -10 CO 2 sağlamak amacıyla mumlu kavanozda 37°C'de inkübe edilmiştir. Tüm vajina salgılarından U.urealyticum da aranmış ve istenilenlerden C. trachomatis antijenle ri ve T. vaginalis incelemesi yapılmıştır. Vajina salgılarından hazırlanan preparasyonlardan 31' inde tipik kanıt hücreleri görülmüş, 20 'sinde kanıt hücresi görülmemekle beraber polimorf nükleuslu lökositler ve laktobasillerin bulunmama sı, buna karşılık Gram labil çomakların görülmesiyle G. vaginalis infeksiyonunu düşündüren görünüm saptanmıştır. Mikroskopik muayene ile G. vaginalis infeksiyonu ön tanısı konan bu 51 vajina salgısının 46'sından insan kanlı Columbia jelozunda G. vaginalis izole edilmiştir. Mikroskop muayenesinde G. vaginalis infeksiyonunu düşündüren bir görünüm elde edilmeyen 590 vajina salgısından ise 49'unda pozitif kültür sonucu alınmıştır. Bu şekilde preparasyon ve kültür sonuçları arasındaki uyumun ileri derecede anlamlı- 62 - olduğu (p
Özet (Çeviri)
64 - SUMMARY AND RESULTS In this study, a total of 641 vaginal secretions were investigated for the presence of G. vaginalis. Specimens were obtained from 586 women who had referred with complaints of vaginitis to the Department of Obstetric and Gynecology in the Istanbul Medical School of the Istanbul University and 55 women who were examined for sterility by the Genetic Department of the same Faculty. Two preparations were prepared from each specimens, one of which was stained by Gram method and the other by methylen blue. All specimens were inoculated on Columbia agar supplemented with 5% human blood. Inoculated media were incubated at 37°C in candle jar to produce on atmosphere with 5-10% C0“. U.urealyticum was also investigated in all vaginal secretions, and C. trachomatis antigens and T. vaginalis were investigated in case of demand. In the preparations from 31 secretions typical clue-cells were observed. In addition, in preparations from 20 specimens, the presence of Gram labile rods and the absence of polymorphonuc lear leukocytes and lactobacilli suggested G. vaginalis infection although no clue-cell was traced. G. vaginalis could be isolated in human blood Columbia agar in 46 of these 51 vaginal secretions in which a preliminary diagnosis of G. vaginalis infection was established by microscopical examination. Out of 590 vaginal secretions in which no appearence could be obtained which suggested an infection of G. vaginalis in microscopical examination, positive- 65 - cultures were obtained in 49. Thus, it was concluded that the correlation between preparations and culture results were highly significant (p < 0.001); that the cases yielded a negative result in culture also gave negative result in preparations with 99.1% ratio; that in only 48.4% of the cases with positive culture results had a preliminary diagnosis in microscopic examination. In summary, the specificity of microscopic examination was found to be high but its sensitivity was found to be low. Nintyfive G. vaginalis strains were isolated on human blood Columbia agar. All of these strains were Gram labile cocobacilli, produced beta-hemolysis in human blood, could be cultivated only in the presence of 5-10% CO*, produced alpha-hemolysis in sheep blood,- were ineffective on mannitol, raffinose, inositol, rhamnose, salicin and sorbitol, and were oxidase and catalase negative. Glucose was fermented by 87, maltose by 90, dextrine by 80 strains. Hippurate and starch hydrolysis were found to be positive in 85 and 88 strains, respectively. The growth inhibition was observed in 88 strains by H_0”and in 93 strains by pneumococci. Sixtysix strains were found to be identical with the control strain with which they were compared in all of their characteristics except some differences in sugar fermentations which are not significant in identification. When more important characteristics were evaluated, 13 strains were found to be different from the control strain in only one feature, 9 strains in 2 features, 5 strains in 3 features, and 2 strains in 4 features. In spite of these differences, they were also accepted as G. vaginalis due to the unevenly importance given by many authors on these criteria. Furthermore, no bacterial genus were found with more resemblence to these strains than Gardnerella. All strains were found to be metronidazole resistant with disks of 5 ug. Thirtyeight of our isolates and the control strain were also found to be resistant when the disks containing 50 ug metronidazole were used. In vitro sensitivity of all strains to various chemotherapeutics were also investigated.- 66 - In the studies to develop a medium that could be prepared more easily in our country's conditions, the medium containing 0.1% corn starch, 0.5% yeast extract, 0.3% glucose, 0.005% cystin, 0.4% K HPO,, 0.1% KH-PO,, 0.5% NaCl, 2% agar and 5% human blood, or the medium containing 0.1% corn starch, 0.5% yeast extract, 1% peptone, 0.0001% vitamin K., 0.5% NaCl, 1.5% agar and 5% human blood were found as media that could be as much successfully used as human blood Columbia agar to cultivate G. vaginalis at least for subcultures. Whether these media will be successfully to the same extent in the first isolation remains to be investigated by a new study.
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