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韓國婦人의 膣內菌叢에 關한 硏究

Studies on Vaginal Flora of Korean Women

최신의학 1963년 6권 10호 p.81 ~ 104
Hahn Byung-Du,
소속 상세정보
 ( Hahn Byung-Du ) - Kyungpook University School of medicine Taegu Presbyterian Mission Hospital Department of Obstetrics and Gyneciology Department of Bacteriology

Abstract


The vaginal flora of 933 cases of obstetrical and gynecological patients were studied during the period of 19611962.
The vaginal pH ranged between 4 and 7 in the control group of uterine hypoplasia. The pH ranged between 5 and 8 in the other groups of various diseases, and the largest number of patients showed a range between 6 and 7 The pH value of the cervical canal showed neutral in almost all cases.
The vaginal cleanliness was studied in abnormal groups as well as in the control group. Irrespective of clinical diagnosis, the majority of patients belonged to grade III of Maunu of Heurlin´s classification which is similar to the grade II of Schr6der´s classification.
The distribution of streptococcus, staphylococcus, Escherichia coli, and yeast showed very little relation to vaginal cleanliness. Diphtheroid and hemophilus showed that the higher the grade, the more organisms present. Lactobacillus was constantly isolated in highest incidence in grade I and pH. 5. Streptococcus, staphylococcus, and hemophilus showed very little relation to vaginal pH in the incidence. Yeast was frequently isolated in aciduric vagina, whereas E.coli and diphtheroid were isolated more frequently in alkaline.
The most frequently isolated organism was streptococcus, followed by staphylococcus, hemophilus, diphtheroid, lacto-bacillus, E.coli and yeast in decreasing order. The other bacilli, gonococcus and pneumococcus, were found to be less than. 2%.
The comparative study disclosed the markedly increased incidence of streptococcus and hemophilus in chronic cervicitis as compared with the control group.Gonococcu:- and pneum-
ococcus were isolated only in 2 cases of chronic cervicitis among the various diseases. A few numbers of organisms were isolated in grade I and at pH 8.
In vaginitis, the incidence of streptococcus and hemophilus shoved an increase as compared with the control group, while staphylococcus, lactobacillus and diphtheroid showed a decrease in incidence.
In carcinoma of the cervix, streptococcus and diphtheroid showed an increase in incidence while staphylococcus, lactobacillus and hemophilus showed a decrease. Yeast showed the lowest incidence among the diseases listed.
In pregnancy, the incidence of streptococcus showed no significant relationship to vaginal cleanliness. Streptococcus was the only organism which showed higher incidence than the control, while all the other organisms showed some decrease. E. coli and hemophilus were isolated only in grade II and grade III, respectively, and showed the lowest incidence among the diseases listed.
In post-abortive cases, Streptococcus, E. col:, diphtheroid, yeast and paracolon bacillus showed highest incidence, and lactobacillusshowed a marked decrease. Coagulase positi` staphylococcus was isolated predominantly this group. =-
Staphylococcus was isolated in 35.9% fr ´` 933 cases. Among the isolated staphylococcus;; 43 strains were coagulase positive, and these, consisted of 41 strains of aureus and 2 strains of albus.
The study on the co-existence of various organisms in the same vagina showed that streptococcus and staphylococcus were the most frequently co-existing organisms with other organisms, irrespective of clinical diagnosis.
The results of this study showed generally somewhat lower incidence of various organisms as compared with other reports. This may be attributed to the abuse of antibiotics before visiting the out-patient clinic for the appropraite diagnosis and treatment.

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