Bacterial colonization in suspected sexually abused children.

Objective: Previous studies concluded that symptomatic prepubertal children with Gardnerella vaginalis infection should be investigated for child sexual abuse. Gardnerella vaginalis is only one out of a group of organism that cause bacterial vaginosis. The aim of the study was to report the frequency of bacterial colonization as well as sexually transmitted diseases and to correlate these data with patient characteristics.

Methods: Data were collected from 1996 to 2006. Medical records of 180 girls, median age at first sexual abuse 7.44 years (range 1-16, SD 3.937), have been evaluated retrospectively. SPSS software 12.0 has been used for statistical analysis.

Results: Only 18.3% of patients complained of vaginal discharge or pruritus. Sexually transmitted diseases were documented: Gonorrhoea 1 (1.8%, 56 tested), Chlamydia trachomatis 1 (1.6%, 62 tested), Syphilis 0 (0%, 5 tested), Trichomonas vaginalis 1 (0.7%, 136 tested) and HIV 0 (0%, 27 tested). Bacterial colonization were documented (121 tested): Gardnerella vaginalis 29 (24%), Enterobacteriaceae 50 (41.3%), Haemophilus influenzae 11 (9.1%), Streptococcus a haemolyticus 35 (28.9%), Streptococcus Group B 8 (6.6%), Staphylococcus Koag neg. 37 (30.6%), Staphylococcus aureus 10 (8.3%), Pseudomonas aeruginosa 4 (4.1%), Bacteroides 19 (15.7%), Prevotella 24 (19.8%), Klebsiella 4 (3.3%), Corynebacteria 20 (16.5%) and Ureaplasma 9 (7.4%).

Conclusions: Sexually transmitted diseases are infrequent in children suspected for child sexual abuse. Bacterial colonization is common, however, not correlated with clinical symptoms (except for Bacteroides) and hymenal/vaginal injuries.