Study of the pathogenicity and associated microorganisms of vaginal trichomoniasis in Baghdad

Vaginal swabs were collected from 220 female patients suffering from vaginal discharge, attending two medical centers in Baghdad, from September 1994 to June 1995. T.vaginalis was isolated from 40 patients with a prevalence rate of (18.2%). The prevalence rates of most common microorganisms were: Candida species (22.7%), G.vaginalis (10.5%), and St. agalactiae (7.3%). The highest infection rate (20.6%) was observed in patients of the age group (30-39) years, and the lowest rate (14.3%) was found in age group (50-59) years. The effect of mean temperature per month on vaginal infection was studied, there was a positive linear relationship between the number of vaginal infections and positive cases of trichomoniasis with the moan of temperature, of a regression coefficient (0.22), (0.13), respectively.
The most frequent microorganism associated with T.vaginalis was G.vaginatis (25%), which was double the rate (12.8%) of the 180 patients without trichomoniasis. But the rate of Candida species (12.5%) associated with trichomoniasis was lower than the rate (27.8%) of 180 patients without. The third most common microorganism was St.agalactiae (12.5%). However, Lactobacillus species, St.aureus, E.coli were drastically decreased in patients with trichomoniasis than those without. The beta-hemolytic activity phenomenon was studied, and according to the degree of hemolysis, the 40 isolates were divided into four groups. This result may indicate that there is an intraspecific variation among these isolates, and possibly may suggest that there is more than one strain of T.vaginalis in Baghdad. Wet mount examination, culture methods of Diamond's medium and modified Diamond's medium were used for diagnosis and maintenance of the parasite. The second medium was more efficient to keep the growth of T.vaginalis (7 days) than the original Diamond's medium (3 days). The dot-blot immunobinding assay for detection of anti-IgG in serum (95%) was found to be more sensitive than the anti-IgG (65%) and anti-IgA (25%) in vaginal secretion. While the specificities were 100%, 86.7% and 95%, respectively. There was significant difference between the culture and the detection of the immunoglobulius classes in sera and vaginal secretions.