THE PREVALENCE OF BACTERIAL VAGINOSIS AND CANDIDIASIS IN POSTMENOPAUSAL WOMEN Ivanka Hadji Petrusheva Meloska1, Konstantin Icev1, Branko Jaglikovski1, Anica Hadji-Petrusheva Jankijevikj2, Biljana Curcic-Trajkovska2. 1Avicena Laboratory, Skopje, Macedonia.; 2Clinical Hospital Acibadem Sistina, Skopje, Macedonia Graph 3. Nugent‘s score among different age groups INTRODUCTION MATERIAL AND METHODS RESULTS The prevalence of BV (assessed as a Bacterial vaginosis (BV) is the most A total of 750 vaginal and cervical 500 NS of >or=7) in postmenopausal common cause of vaginal symptoms swabs, collected from 450 women was low (5,6% - 42 cases) and 400 characterized by a change of vaginal postmenopausal women age 40-69 350 NS1-4 GV was isolated in most of those 300 flora from years, were examined. BV was NS 4-6 cases. A high percentage (51.0% - 383) 250 predominant Lactobacillus to diagnosed microscopically by 200 NS>7 of postmenopausal women (NS of 1-4) 150 replacement with anaerobes such as Nugent's score (NS), the presence of had decreased number of lactobacilli 100 Gardnerella vaginalis (GV). Bacterial leukocytes in the slides was noted and no BV -associated 50 0 vaginosis occurs when the normal too. Detection of aerobic and microorganisms. In this category there age 40-49 age 50-59 age 60-69 lactobacilli of the vagina are replaced anaerobic bacteria and fungi was were 35 cases with leukocytes in the Graph 4. Microbiology findings by mostly anaerobic bacteria. performed by conventional vaginal smear, where cultures 60 p<0.05 Diagnosis is commonly made using microbiological methods. revealed presence of enterobacteriaceae and gram positive 50 the Nugent criteria, which include 40 cocci. The rest 325 cases were with vaginal pH greater than 4.5, positive Image 1. Wet mount – Nugent‘s scoring 30 NS>7 NS 4-6. Almost 10% of them had 20 whiff test, milky discharge, and the NS 4-6 leukocytes in the smear and positive 10 NS1-4 presence of clue cells on bacteriology findings. The most 0 microscopic examination of vaginal dominant isolates were E.coli, fluid. In postmenopausal women, followed by Enterococcus spp, with the decrease of estrogen, the Klebsiella spp, Str agalactiae vaginal environment changes. and Bacteroides. CONCLUSION Atrophic vaginitis, a form of vaginitis Candida, predominately C albicans, The decrease of women's hormones in caused by estrogen deficiency, was isolated in 9.5%, 5,2% and 13,5%, menopause leads towards changes of from smears with NS >=7, NS 4-6, NS produces symptoms of vaginal normal vaginal flora which is followed 1-4, respectively. There were dryness, itching, irritation, discharge, with changes of the vaginal mucosa statistically significant pH. Those changes rarely lead to more and dyspareunia. Microbial change is more Candida isolates in women towards decrease in the normal flora Graph 1. Distribution of patients serious bacterial infections and BV. without normal vaginal flora compared However, in our examined population, which raises the vulnerability of according the age to those who had lactobacilli (p<0.05) there was significant influence of the vaginal mucosa to colonization with 459 500 Graph 2. Distribution of patients deficit of lactobacilli which favoured other bacteria and yeasts. 450 400 according the Nugent's score colonization with Candida. Hormone 350 replacement therapy is not common in 300 42 188 AIM 250 our country and it can not be 200 103 Our aim was to evaluate the presence 150 NS>7 determined weather it influences the 383 325 100 NS 4-6 occurrence of BV of BV and Candida in our population 50 NS1-4 0 of postmenopausal women. 40-49 50-59 60-69 Contact details: Ivanka Hadji- Petrusheva Meloska, MD, MSc Address: Avicena Laboratory, Skopje, Macedonia Web: www.avicenalab.com.mk e-mail: [email protected], [email protected]. .