| Microbiological and clinical characteristics of vulvovaginitis in premenarcheal and postmenarcheal girls in a tertiary center in South Korea |
Soo Jin Park1, Ki Wook Yun2,3, Ji Yeon Han1, Sung Woo Kim1,6, Jae Hyeon Park4, Hoon Kim1,5,6, Eun Hwa Choi2,3, Seung-Yup Ku1,5,6 
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1Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
2Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
3Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
4Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
5Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
6Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, Korea |
Correspondence:
Seung-Yup Ku,
Email: jyhsyk@snu.ac.kr
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Received: 4 August 2024 • Revised: 12 December 2024 • Accepted: 2 February 2025 |
| Abstract |
Objective
To analyze the microbiological and clinical characteristics of vulvovaginitis in girls, distinguishing between the premenarcheal and postmenarcheal groups in a tertiary center in South Korea.
Methods
This retrospective cohort study included 195 patients under 20 years of age diagnosed with vulvovaginitis at a tertiary hospital between 2014 and 2023. The patients were categorized into premenarcheal (n=95) and postmenarcheal (n=100) groups. Data on initial symptoms, microbial cultures, and treatment methods were analyzed.
Results
The most common initial symptom was vaginal discharge, reported in 63.1% of cases. Culture results showed a 51.3% positivity rate for any microorganism, with a prevalence of gram-negative rods (32.8%) and gram-positive cocci (14.4%). The most frequently isolated microorganisms were Escherichia coli (17.9%), Candida albicans (7.7%), and Enterococcus faecalis (6.7%). Gram-negative rods were more common in the premenarcheal group (37.1% vs. 25.0%; P=0.01). No significant differences were observed in the prevalence of gram-positive cocci and Candida species between the two groups (16.8% vs. 12.0%, P=0.22; 6.3% vs. 13.0%, P=0.09; respectively). The susceptibilities of grampositive microorganisms to penicillin, oxacillin, clindamycin, vancomycin, and tetracycline were 58.8%, 58.3%, 94.7%, 100.0%, and 73.7%, respectively. The susceptibilities of gram-negative microorganisms to amoxicillin/clavulanic acid, ciprofloxacin, ceftriaxone, and nitrofurantoin were 89.3%, 85.3%, 76.0%, and 100.0%, respectively.
Conclusion
This study identified differences in the microbial profiles associated with vulvovaginitis between premenarcheal and postmenarcheal girls. Age-specific and history-based clinical approaches tailored to menarcheal status are warranted to improve the management and outcomes of pediatric and adolescent vulvovaginitis. |
| Key Words:
Vulvovaginitis, Microbial sensitivity tests, Menarche, Adolescent |
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