The goal of our research was to determine the presence of bacterial vaginosis in sexually active women in Tuzla Canton area. Diagnosis determination for bacterial vaginosis was conducted on the basis of three out of four internationally accepted criteria according to Amsel and isolation and identification of Gardnerella vaginalis (G. vaginalis) by standard microbiological procedures. Bacterial vaginosis was diagnosed in 20,5 % (41/200) women who asked for gynaecologist's help due to their personal discomfort, since significantly higher percentage of diagnosed bacterial vaginosis of 48,80% (41/84) was determined in women with personal discomfort typical for this disease. All relevant factors, according to available literature, for genesis of bacterial vaginosis were processed in this research. In respect to the obtained outputs, bacterial vaginosis is significantly more frequent occurrence in women who are not married, since the number of sexual partners, the time of the first sexual intercourse, the use of intrauterine contraceptive device and smoking do not cause the genesis of bacterial vaginosis. According to Nugent, an increased vaginal discharge with unpleasant odour after sexual discourse, its pH>4,5, a positive amino odour test, an occurrence of clue cells in a direct microscopic concoction of vaginal discharge and assessment of the state of vaginal flora for bacterial vaginosis are significantly more frequent occurrences in women with individual discomforts. It was proved that G. vaginalis is a dominant micro organism in 95% of women with clinical signs of vaginosis although it was isolated from vaginal discharge in 40 to 50% of healthy women. In our research, G. vaginalis was isolated in 63,41% of examined women with all signs of bacterial vaginosis, in 36,59% of examined women with one or more clinical signs of bacterial vaginosis and in 2,58% of examined women of control group without clinical signs.
The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.
The problem of the lack of good quality and quantity of water for all purposes has been increasing due to the war damage to water supply plants, the effects of the unique phenomena of subsidence of the area as well as flooding caused by recent heavy rain in the area of Tuzla Canton. The flood has resulted in pollution of the drinking water and, in the light of this emergency we carried out a study to determine drinking water quality by two methods: traditional tests required by law and specific laboratory tests. The aims of the microbiological analysis of water were: to detect evidence of excretal biological pollution as a result of the flooding in the area of Tuzla Canton in 2002; to evaluate the required laboratorial procedures in Bosnia and Herzegovina for the detection of potent pathogens in the drinking water. The study included the examination of 99 samples of water: 48 samples from municipal water supplies; 13 from closed sources and 38 from open sources. Samples of water were tested by routine bacteriological, parasitological and biological methods. Reverse transcription -polymerase chain reaction (RT-PCR) was applied for the detection of viruses. Microorganisms were absent in four (4.04%) of the 99 samples of water. Out of 95 samples of water, 240 micro-organisms were isolated as follows: 114 strains of bacteria, 56 viruses, 52 bacteriophages (19 coliphages and 33 Salmonella enteritidis phage), 2 nematodes, 16 algae. According to traditional tests required by law, water from 35.35% (35/99) sources was found suitable for drinking but using specific laboratory tests, only 10.10% (10/99) of samples were in compliance with the law. There was a significant difference in water quality (p<0.01). These results call for a revision of water quality guidelines based only on indicator organisms without also making reference to the absence of viruses. We have pointed out the importance of all the parameters, which should be applied during emergencies such as the recent flooding. We also suggest that, along with routine examination of drinking water there should be periodically (per month or per year) incorporated into the current protocol extra measures for detection of enteroviruses and bacteriophages.
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