Has the COVID-19 pandemic affected Vulvovaginitis in Prepuberty and Adolescent Females in China? A retrospective study of 4 644 cases during 2018-2021.

Objective: Vulvovaginitis (VV) is one of the most common gynecologic complaints in prepubertal and adolescent girls. However, data on the impact of the COVID-19 pandemic on VV in this population are limited. This study aimed to explore changes in the epidemiology, pathogenic patterns, and antibiotic susceptibility of VV in girls before and during the COVID-19 pandemic in China.

Methods: A retrospective study was conducted in girls aged 0-18 years who were diagnosed with VV from January 2018 to December 2021.

Results: A total of 4 644 cases of VV were identified, including 2 427 cases from 2018-2019 (before the COVID-19 pandemic) and 2 217 cases from 2020-2021 (during the COVID-19 pandemic). The proportion of VV cases in the 0-6-year age group decreased significantly from 40.2% to 31.3%, whereas the proportion in the 10-18-year age group increased from 30.1% to 39.6%. The major pathogens identified from 2020-2021 were similar to those detected from 2018-2019. The detection rates of Haemophilus influenzae, Streptococcus pyogenes, and Streptococcus pneumoniae decreased during the COVID-19 pandemic. In contrast, the detection rates of Escherichia coli, Klebsiella pneumoniae, and Candida albicans increased. Antibiotic susceptibility testing revealed that the sensitivity of Haemophilus influenzae to ampicillin/sulbactam and amoxicillin/clavulanate increased by 5.6% and 13.4%, respectively, after the pandemic. In contrast, levofloxacin sensitivity in Escherichia coli decreased by 20.3% after the pandemic.

Conclusion: Our findings provide evidence-based guidance for appropriate antibiotic use and facilitate the optimization of therapeutic strategies and lifestyle recommendations for prepubertal and adolescent girls with VV.