مقاومت آنتي بيوتيكي گاردنرلاواژيناليس در بيماران مبتلا به واژينوز باكتريايي نسبت به 2 آنتي بيوتيك مترونيدازول و كليندامايسين

Gardnerella vaginalis Antibiotic Resistance Rate in Patient with Bacterial Vaginosis

Background and objective: Bacterial vaginosis (BV) is one of the most prevalent forms of vaginal infections. The disease was originally referred to as "non-specific vaginosis" so as to differentiate it from fungal and trichomonas diseases. BV is caused by Gardnerella vaginalis in synergy with Bacteroids and/or Mycoplasma spp. Woman are more prone to acquiring BV during pregnancy. Metronidazole and Clindamycin are the two drugs of choice for BV treatment. However , recent cases of drug resistant Gardnerella have been observed. Material and methods: In this survey , 200 symptomatic woman were tested for BV affliction by four different criteria. The pH of vaginal secretions , Whiff test, Clue cell observation on direct smear , and culture upon selective Colombia agar containing Gentamicin , Nalidixic acid and Amphotericin B were preformed. Any bacterial growth on the selective medium was confirmed to be Gardenerella vaginalis by a series of biochemical tests. The antibiotic susceptibility patterns of the bacterial isolated against Metronidazole and Clindamycin was determined by standard disk diffusion technique. Results: Of the 200 symptomatic woman tested for this study , 14 had clear laboratory signs of BV infection. Antibiotic susceptibility tests performed on the 14 Gardnerella vaginalis isolates indicated that 4 were resistant to Metronidazole (28.5%) and 2 were resistant to Clindamycin (14.2%). Conclusion:Due to the higher Metronidazol resistance rate , in relation to Clindomycin resistance , observed in this study ; Clindamycin seems to be a more effective antibiotic choice for BV treatment. In light of the significant resistance observed against both of these drugs that are now routinely used for BV , it goes without saying that it is of paramount importance for clinics to first culture the causative bacteria on selective Colombia agar and then perform of elevated drug resistance , other antibiotics that are known to be effective against Gardnerella vaginalis should be considered for therapy.