The proximity of the anus and vagina can cause
contamination by fecal bacteria. Also, prepubertal girls lack
protective labial fat pads and pubic hair. In addition, one
effect of estrogen in puberty is to thicken the vaginal mucosa and thus reduce the incidence of potential infections
and vaginitis.2e7
Approximately 75% cases of vaginitis in prepuberty are
nonspecific vaginitis.7 In cases of nonspecific vaginitis,
coliform bacteria, Escherichia coli, enterococci, anaerobic
diphtheroids, and microorganisms such as bacteria that
suggest fecal contamination are the most common
microorganisms. Many scientists think that inadequate
hygiene and tight clothing (nylon underwear, tights, and
plastic-coated paper diapers) might have a role in the
development of nonspecific vaginitis. Another common
factor is exposure to irritants such as perfumed cleaning
supplies in laundry and bathing, and in soap (vigorously
rubbing the genital area with soap). Thus, mildly irritating
chemicals deposited at the entrance of the vagina cause
chemical vaginitis and/or irritant vaginitis. Then, superinfection with local microorganisms can develop.8e10
The aim of this study was to determine and compare the
clinical and microbiological features of vulvovaginitis and to
clarify the contribution of clinical and environmental factors and infection to the etiology of vulvovaginitis in prepubertal girls.