Aerobic vaginitis: antibiotic resistance trend and future actions of antimicrobial diagnostic stewardship

• Published in: The New microbiologica Vol. 47; no. 2; p. 164
• Main Authors: Foglia, Francesco, Della Rocca, Maria Teresa, Montella, Fortunato, Vasco, Maria, Chianese, Annalisa, Zannella, Carla, De Filippis, Anna, Finamore, Emiliana, Galdiero, Massimiliano
• Format: Journal Article
• Language: English
• Published: Italy 01.07.2024
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antimicrobial Stewardship; Drug Resistance, Bacterial; Female; Humans; Microbial Sensitivity Tests; Middle Aged; Vaginitis - drug therapy; Vaginitis - microbiology; Vaginosis, Bacterial - diagnosis; Vaginosis, Bacterial - drug therapy; Vaginosis, Bacterial - microbiology; Young Adult; reproductive-aged women; one health; Aerobic vaginitis; antibiotic resistance; antimicrobial diagnostic stewardship
• ISSN: 1121-7138

The study objective is to examine epidemiological and microbiological aspects of aerobic vaginitis in female patients admitted to University Hospital of Campania "L. Vanvitelli" over five years. The most represented strains were E. coli (n = 153), Citrobacter spp. increasing from 2020, E. faecalis (n = 149), S. haemolitycus (n = 61), and Candida albicans (n = 87). The susceptibility patterns of a selection of gram-negative and gram-positive representative bacterial isolates were examined. Carbapenems, aminoglycosides, and fosfomycin were most effective against gram-negative bacteria, whereas vancomycin, daptomycin, and linezolid exhibited greater efficacy against gram-positive bacteria. None of the E. coli and Citrobacter spp. isolates produced extended-spectrum beta-lactamases, and the S. haemolyticus strains were methicillin-resistant. In gram-positive isolates, gentamicin susceptibility increased in 2020 and 2021 compared to clindamycin; erythromycin showed high resistance rates in 2020. Our findings indicate that integrating proper microbiological cultures into clinical practice could improve the management of aerobic vaginitis. Moreover, they highlight the necessity of establishing a nationwide surveillance guideline to mitigate antimicrobial resistance. Improvement actions in antimicrobial diagnostic stewardship must be considered when seeking the appropriate diagnosis and treatment for aerobic vaginitis.