Frequency of microorganisms in vaginal discharges of high-risk pregnant women from a hospital in Caruaru, Pernambuco, Brazil

ABSTRACT Introduction: During pregnancy, estrogen and progesterone levels may favor vaginal colonization by pathogenic microorganisms that can be associated with obstetric complications and neonatal infections. These pathogens include Candida spp., Trichomonas vaginalis, Gardnerella vaginalis and Streptococcus agalactiae. Objective: To determine the frequency of such microorganisms amongst high-risk pregnant women receiving prenatal care at a hospital in Caruaru, Pernambuco. Material and method: Analytical study in which samples of vaginal discharge were collected from women experiencing high-risk pregnancies, without restriction of age or gestational period. The samples were submitted to Gram-stained direct smear, as well as to fresh wet-mount examination and to cultures in Sabouraud and blood agar. Results: From May to December 2018, 92 patients were selected for sampling. The frequency of Candida spp. was found to be 31.52%. Concerning Gardnerella vaginalis, the frequency was 1.25%. The rate of colonization by Streptococcus agalactiae was 3.23%. No cases of Trichomonas vaginalis were found in this study. Discussion: The frequency of Candida that was found corroborates the literature, as it is a common infection during pregnancy due to hormonal increase. However, the frequencies of colonization by G. vaginalis, T. vaginalis and S. agalactiae were lower than those found in other studies. Conclusion: Due to the risks that these microorganisms can bring to a pregnant woman and a fetus, health professionals should be alert to signs and symptoms, requesting the screening of these pathogens, as well as treating gestating women when necessary.摘要 引言：妊娠期间，雌激素与孕激素水平升高可能促使阴道定植致病微生物，此类微生物可引发产科并发症及新生儿感染，涵盖假丝酵母菌属（Candida spp.）、阴道毛滴虫（Trichomonas vaginalis）、阴道加德纳菌（Gardnerella vaginalis）及无乳链球菌（Streptococcus agalactiae）。 研究目的：明确巴西伯南布哥州卡鲁阿鲁市某医院接受产前保健的高危妊娠孕妇中，上述致病微生物的定植频率。 材料与方法：本研究为分析性研究，纳入无年龄及孕周限制的高危妊娠女性，采集其阴道分泌物样本。样本依次接受革兰染色直接涂片检查、新鲜湿片镜检，以及沙氏琼脂（Sabouraud）与血琼脂培养。 结果：2018年5月至12月期间，共纳入92例患者完成样本采集。假丝酵母菌属（Candida spp.）定植频率为31.52%；阴道加德纳菌（Gardnerella vaginalis）定植频率为1.25%；无乳链球菌（Streptococcus agalactiae）定植率为3.23%；本研究未检出阴道毛滴虫（Trichomonas vaginalis）病例。 讨论：本次检测到的假丝酵母菌属定植频率与现有文献相符，妊娠期间因激素水平升高，该感染较为常见。然而，阴道加德纳菌、阴道毛滴虫及无乳链球菌的定植频率均低于其他同类研究结果。 结论：鉴于此类微生物可对孕妇及胎儿带来健康风险，医护人员应警惕相关体征与症状，需对上述病原体开展筛查，并在必要时对妊娠女性进行干预治疗。