Chromobacterium and recurrent vaginal discharge--论文代写范文精选

虽然感染源并不很清晰,也许土壤和水的污染可以作为假设因素。监测与改进诊断设施可以通过增加卫生保健意识。适当的系统性感染抗菌疗法停止感染进展是必须的。下面的report代写范文将进行探讨。

Abstract
Seven hundred and two high vaginal swab samples of apparently healthy adult females with recurrent vaginal discharge were collected and analyzed at Searchlight Medical Diagnostic Centre, Ekpoma between July 2003 and August 2005. Isolation, identification and antibiogram of isolates were done using standard Microbiological techniques. Randomized Block Design and Completely Randomized Design at (α = 0.1) were used to test the statistical significance of results. While occupational distribution of isolates was not statistically significant, age and response of bacterial isolates to antibiotics used were statistically significant. Total number and percentage prevalence of bacteria isolated include: 297(42.4%) Chromobacterium violaceum, 156 (22.2%) Escherichia coli and 139 (19.8%) Staphylococcus aureus. Chromobacterium violaceum was 81.8% sensitive to ofloxacin, and 12.8% to Ceftriazone. Escherichia coli and S. aureus were 70.5% and 71.9% sensitive to sparfloxacin respectively.

Though source of infection of C. violaceum in Ekpoma was not very clear, soil and water contamination and other risk factors were hypothesized. A high index of suspicion is required for diagnosis. Surveillance with improved diagnostic facilities can increase awareness among health care providers on this form of infection. Appropriate systemic antimicrobial therapy to halt progression of infection is mandatory, even when the infection appears to be localized. Key Words: Chromobacterium violaceum, Recurrent vaginal discharge, Ekpoma.

Introduction
The rising episodes of recurrent vaginal discharge among apparently healthy females are increasingly becoming a cause for concern for health care providers in Ekpoma. Vaginal discharge may be due to infection of the vagina, cervix or uterus. Three types of vaginal discharge which had been described1 include: purulent vaginal discharge attributed to Trichomonas vaginalis, white odourless discharge attributed to Candida albicans, and a thin grayishwhite discharge with a characteristic ammoniacal fishy odour attributed to Gardnerella vaginalis. Chromobacterium violaceum, a saprophytic bacterium, was first discovered in water buffalo by Wooley in 1905.2 It is unique to tropical and subtropical climates and is found between latitudes 350N and 35 0S. This includes Malaysia, where this facultative anaerobic gram-negative rod bacterium was first seen in humans in 1927.

It has also been isolated from soil and water from Trinidad, Brazil, India, Malaysia, Thailand and Vietnam. There have been fewer than 40 cases of human infection reported, and several have come from the southeastern United States, primarily Florida.4 The organism is a well-known inhabitant of soil and water - particularly stagnant or slow-moving water sources. An underlying defect in host defense, especially that of neutrophils, seems to predispose to infection and of the cases reported in the United States, 73% have ended in death.5 Most reported infection by Chromobacterium violaceum is associated with bacteremia but very little genitor-urinary infection has also been reported though not in sub-Saharan Africa.

Ethical considerations
Informed consent on this investigation was sought and obtained verbally from each subject and in writing from the ethics committee of SMDC, before commencement of this study. Those who could not read or write in English language gave their verbal approval after the aims and benefits of this investigation were explained to them in their local language.

Sample collection and inclusion criteria
Seven hundred and two (702) High Vaginal Swab (HVS) samples of apparently healthy adult females with recurrent vaginal discharge were collected and analyzed at Searchlight Medical Diagnostic Centre (SMDC), Ekpoma over a two year period between July 2003 and August 2005. All samples were collected with a sterile swab stick and with the aid of a sterile vaginal speculum used to bypass the vagina to get a HVS sample. The nature of the discharge ranged from yellowish green purulent, white odourless, and greyish offensive smelling discharges respectively, and also their pH ranged from 5 to 6.5

In conclusion, human infections caused by C. violaceum are rare but when they occur, are usually fatal. Surveillance with improved diagnostic facilities can increase awareness among health care providers on this form of infection. A high index of suspicion is required for diagnosis, especially in the presence of a history of outdoor activities. Appropriate systemic antimicrobial therapy to halt progression of infection is mandatory, even when the infection appears to be localized in the genital tract.

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