Gebe Kadınların Vajinal Akıntılarından Üretilen Mikroorganizmaları›n Dağılımı ve Antibakteriyellere Duyarlılıkları Antibiyotik Direnci

Vajinanin asit ortami cesitli fizyolojik ve patolojik faktorlerin etkinligi ile bozulabilmekte, olusan alkalen ortama bakteriler ve mayalar yerleserek, vajina iltihaplari (colpit-vajinit) ortaya cikmaktadir. Vajinal akinti ve kasinti gibi degisik belirtiler veren vajinitin klinik tablosunun gelisiminde degisik mikroorganizmalar etken olmaktadir. Normal vajen florasinda da bulunabilen Candida'lar, vulvovajinitli olgularda onemli bir etken olma ozelligini gunumuzde de korumaktadir. Bu calismada vajinal akinti sorunu bulunan, 18-40 yas diliminden, farkli gebelik haftasi icinde olan 310 kadinin, vajinal suruntu orneklerinden kultur yapilarak etken mikroorganizmalarin dagilimi ve bunlarin antibakteriyellere duyarliligi disk-difuzyon yontemi ile incelendi. Akinti ornekleri koyun kanli agar ve Mac Conkey agara aktarilarak 37 °C'de bir hafta bekletildikten sonra degerlendirim yapildi. Bu amacla koloni morfolojisi, boyanma, hareket, biyokimyasal niteliklerle birlikte, ureaz aktivitesi arastirildi. Calisma gurubundaki 310 olgudan 103'unde ya hicbir etken uremesi olmamis, ya da sadece Koagulaz Negatif staphylococcus (KNS) veya lactobacillus uremesi gozlenmistir. Geriye kalan 207 olguya ait vajinal akinti kulturlerinin bir kisminda bir cesit, bir kisminda birden fazla cesit (mikst) mikroorganizma uredigi belirlenmistir. Calismamizda vajinal akinti kulturlerinden 66'sinda mikst, 141'inde bir cesit mikroorganizma uretilmistir. Candida (%39.8), alfa hemolitik streptokok (%21.2), Staphylococcus aureus (%16.8) ve E. coli (%12.4) ilk siralari alan patojenler olarak not edilmistir. S.aureus'un Vankomisin, Siprofloksazin ve Kloramfenikol'e, E. colflerin ise Seftriakson, Gentamisin, Piperasilin ve Siprofloksasin'e duyarli oldugu anlasilmistir. Kulturde ureyen diger bakterilerin de antibiyotik duyarliliklari ayrica belirlenmistir. The Distribution of Microorganisms Growing in Vaginal Discharges of Pregnant Women and Their Antibiotic Susceptibilities The acidic environment of the vagen could be impaired by several physical and pathologic factors, thus new forming alkali environment is appropriate for growing bacteria and yeasts, and cause colpitis-vaginitis. Several microorganisms cause vaginitis, with the symptoms of vaginal discharge, itching etc. Candida spp. who are the member of the normal vagen microflora, are significant agents of vulvovaginitis. In present study vaginal swabs of 310 pregnant women, were cultivated 18-40 years of ages in different weeks of pregnancies, then investigated the distribution of microorganisms and their antibiotic susceptilities by disc-diffusion method. The specimens were cultivated in sheep blood agar and Mac Conkey agar fob a night at 37 °C, and Sabouraud's dextrose agar, one of them at room temperature and the other at 37 °C for one week.. Colony morpholgy, gram stain, motilty, biochemical caracteristics and urease were evaluated. In 103 of 310 cases either no growing or only KNS or lactobacillus, were observed one part of vaginal cultures of remaining 207 cases, one kind of microrganisms and in the other part mixed microrganisms were growed. Among all vaginal cultures, 66 mixed and 141 only one kind of microrganism have been cultivated. Candida (39.8%), alpha haemolitic streptococcus (21.2%), Stapylococcus aureus (16.8%) and E. coli (12.4%) were the leading microrganisms. S.aureus was sensitive to Vancomycin, Ciprofloxacin and Chloramphenicol; E. colis were sensitive to Seftriakson, Gentamicin, Piperasilin and Siprofloksasin. The antibiotic susceptibilities of the other bacteria that have been cultivated were also determined.