Transcript Vaginal discharge culture 1

VAGINAL DISCHARGE
CULTURE
Specimen processing for Vaginal swab
Vaginitis
Inflammation of the vaginal mucosa called vaginitis.
Women who present with vaginal symptoms often complain
of an abnormal discharge and possibly other symptoms such
as offensive odor and itching.
The three most common cause of vaginitis in premenopausal
women are vaginal candidiasis, bacterial vaginosis and
trichomoniasis.
Bacterial vaginosis
BV is caused by an imbalance of naturally occurring bacterial
flora of vagina.
Bacterial Vaginosis
Non-cultural diagnosis can be made by detection at least
three of the following four characteristics:
I.
Thin, homogeneous discharge adhering to the vaginal wall.
II.
pH greater than 4.5.
III. Fishy odor intensified on addition of 10% potassium
hydroxide.
IV. Presence of clue cells by microscopic examination of the
discharge.
Bacterial Vaginosis
A Whiff test Several drops of 10 % a potassium hydroxide
(KOH) solution may also be added to a sample of the vaginal
discharge to test for any resultant strong fishy (amine) odor
from the mix, which would indicate bacterial vaginosis.
pH measuring by using litmus papers, Normal vaginal pH is
between 3.8-4.5 pH.
Bacterial Vaginosis
Bacterial Vaginosis
At least 10–20 high power (1000× oil immersion) fields are
counted and an average determined.
Clue cells
Clue cells are vaginal squamous epithelial cells coated with
coccobacilli gram variable Gardnerella vaginalis adhering to
their surface and sometimes obscuring their borders.
Clue cells indicate bacterial vaginosis.
I.
Mix a drop of vaginal fluid with a drop of saline on a glass
slide.
II. Place a coverslip over the suspension and examine the
preparation microscopically at x 400 magnification.
III. Clue cells are squamous epithelial cells covered with many
small coccobacillary organisms ,giving a stippled, granular
aspect the edges of these epithelia cells are not clearly
defined , owing to the large number of bacteria present .
Clue cells Wet mount
Clue cells Gram Stain
Normal Vaginal Gram Stain
Bacterial Vaginosis Garm Stain
Candidiasis or Candida Vaginitis
Diagnosis is confirmed either by a simple wet mount, or
better, a 10% potassium hydroxide wet mount microscopy
and culture.
Candida albicans is the major cause accounting for 85%
of the isolates.
Wet mount and KOH smear
KOH slide A sample of the vaginal discharge is placed on a slide
and mixed with a solution of 10% potassium hydroxide (KOH). The
KOH kills bacteria and cells from the vagina, leaving only yeast for
easier detection of a yeast infection.
Sabouraud Dextrose agar
Ingredients:
I. Digest of casein.
II. Digest of animal tissue.
III. Dextrose. 4 %
IV. Agar 1.5 %
Final pH 5.6 ± 0.2 at 25°C
Sabouraud Dextrose agar is used for the isolation, cultivation,
and maintenance of saprophytic and pathogenic fungi.
It supplies peptone as the protein source and dextrose as the
carbohydrate source for nourishment .
Bacterial suppression occur due to the low pH (5.6) pH.
Note: chloramphenicol may use to inhibit growth of bacteria.
Candida albicans on Sab. agar
Candida appears as large, round,
white or cream (albicans is from latin
meaning 'whitish') colonies with a
yeasty odor on agar plates.
Trichomoniasis or Trichomonas Vaginitis
Trichomonas vaginalis