Research in Child Abuse and Neglect: Bacterial Colonization in Suspected Sexually Abused Children (2007)

Part of our ongoing survey as to what the child abuse and neglect literature says about perpetrators. Perpetrator data is highlighted in bold. To access earlier posts on the child abuse and neglect literature, go to the statistics tab below.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W68-4PN7KJH-7&_user=4558894&_coverDate=10%2F31%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000063405&_version=1&_urlVersion=0&_userid=4558894&md5=fed49b54b3398625faecd9753a5636a2

North American Society for Pediatric and Adolescent Gynecology Published by Elsevier Inc.
Original Studies
Bacterial Colonization In Suspected Sexually Abused Children
Petra Kohlberger MD, a, and Dagmar Bancher-Todesca MDa

aDepartment of Gynaecology and Obstetrics, Medical University Vienna, Vienna, Austria

Available online 13 September 2007.

Abstract
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.

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Results
The perpetrator was a member of the family, e.g. the father or stepfather, in 38.3% of the cases. Of the examined victims, 76.1% showed no hymenal-vaginal tear and 91.1% no signs of extra-genital injuries. 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 haem. 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%).