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Vaginal gonococcal cultures in sexual abuse evaluations: evaluation of selective criteria for preteenaged girls.
Pediatrics 1997; 99(6):E8Ped

Abstract

OBJECTIVE

Accurate selective criteria could limit the number of vaginal cultures for Neisseria gonorrhoeae performed on preteenaged girls as part of their sexual abuse evaluations. This study was performed to determine whether the published selective criteria by the American Academy of Pediatrics (AAP) Committee on Child Abuse and Neglect and by Siegel et al would have accurately detected all cases of vaginal gonococcal infections in our large study population.

METHODS

We prospectively studied girls, ages 1 to 12 years, who were referred to our Child Sexual Abuse Team (CSAT) at Wake Medical Center in Raleigh, NC, between July 1, 1976 to July 1, 1996, for sexual abuse evaluations which were performed using a protocol that included collecting historical information, a sexual abuse interview, and a detailed genital examination which included a vaginal culture for N gonorrhoeae.

RESULTS

Our study population consisted of 2898 girls of whom 2731 (94%) had vaginal cultures successfully performed for N gonorrhoeae. There were 84 girls with vaginal gonococcal infections, 80 of whom had a vaginal discharge. The four girls without a vaginal discharge included two with a history of having vaginal intercourse with an alleged perpetrator with gonorrhea, one with N gonorrhoeae isolated from a urine culture, and one whose preteenaged sister had gonorrhea. All of the 84 girls would have been identified using the selective culturing criteria of the AAP Committee on Child Abuse and Neglect: culturing when epidemiologically indicated (interpreted as the girl having another sexually transmitted disease [STD], a child sibling, child household member, a close child associate or a perpetrator with a known STD) or when the history and/or physical findings suggest the possibility of oral, genital, or rectal contact, or Siegel et al's more selective criteria: only culturing prepubertal girls for N gonorrhoeae if there is a vaginal discharge at the time of presentation or if there is a high risk for STD acquisition, defined as having a STD diagnosed, a sibling with a STD, contact with a perpetrator known to have a STD, contact with multiple perpetrators, or Tanner stage III or above.

CONCLUSION

Both the selective criteria of the AAP Committee on Child Abuse and Neglect and the more selective criteria of Siegel et al as we interpreted them were accurate when applied to identifying girls with vaginal gonococcal infections in our study population.

Authors+Show Affiliations

The Area Health Education Center, Wake Medical Center, Raleigh, NC 27610, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9164804

Citation

Ingram, D L., et al. "Vaginal Gonococcal Cultures in Sexual Abuse Evaluations: Evaluation of Selective Criteria for Preteenaged Girls." Pediatrics, vol. 99, no. 6, 1997, pp. E8.
Ingram DL, Everett VD, Flick LA, et al. Vaginal gonococcal cultures in sexual abuse evaluations: evaluation of selective criteria for preteenaged girls. Pediatrics. 1997;99(6):E8.
Ingram, D. L., Everett, V. D., Flick, L. A., Russell, T. A., & White-Sims, S. T. (1997). Vaginal gonococcal cultures in sexual abuse evaluations: evaluation of selective criteria for preteenaged girls. Pediatrics, 99(6), pp. E8.
Ingram DL, et al. Vaginal Gonococcal Cultures in Sexual Abuse Evaluations: Evaluation of Selective Criteria for Preteenaged Girls. Pediatrics. 1997;99(6):E8. PubMed PMID: 9164804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal gonococcal cultures in sexual abuse evaluations: evaluation of selective criteria for preteenaged girls. AU - Ingram,D L, AU - Everett,V D, AU - Flick,L A, AU - Russell,T A, AU - White-Sims,S T, PY - 1997/6/1/pubmed PY - 1998/4/3/medline PY - 1997/6/1/entrez SP - E8 EP - E8 JF - Pediatrics JO - Pediatrics VL - 99 IS - 6 N2 - OBJECTIVE: Accurate selective criteria could limit the number of vaginal cultures for Neisseria gonorrhoeae performed on preteenaged girls as part of their sexual abuse evaluations. This study was performed to determine whether the published selective criteria by the American Academy of Pediatrics (AAP) Committee on Child Abuse and Neglect and by Siegel et al would have accurately detected all cases of vaginal gonococcal infections in our large study population. METHODS: We prospectively studied girls, ages 1 to 12 years, who were referred to our Child Sexual Abuse Team (CSAT) at Wake Medical Center in Raleigh, NC, between July 1, 1976 to July 1, 1996, for sexual abuse evaluations which were performed using a protocol that included collecting historical information, a sexual abuse interview, and a detailed genital examination which included a vaginal culture for N gonorrhoeae. RESULTS: Our study population consisted of 2898 girls of whom 2731 (94%) had vaginal cultures successfully performed for N gonorrhoeae. There were 84 girls with vaginal gonococcal infections, 80 of whom had a vaginal discharge. The four girls without a vaginal discharge included two with a history of having vaginal intercourse with an alleged perpetrator with gonorrhea, one with N gonorrhoeae isolated from a urine culture, and one whose preteenaged sister had gonorrhea. All of the 84 girls would have been identified using the selective culturing criteria of the AAP Committee on Child Abuse and Neglect: culturing when epidemiologically indicated (interpreted as the girl having another sexually transmitted disease [STD], a child sibling, child household member, a close child associate or a perpetrator with a known STD) or when the history and/or physical findings suggest the possibility of oral, genital, or rectal contact, or Siegel et al's more selective criteria: only culturing prepubertal girls for N gonorrhoeae if there is a vaginal discharge at the time of presentation or if there is a high risk for STD acquisition, defined as having a STD diagnosed, a sibling with a STD, contact with a perpetrator known to have a STD, contact with multiple perpetrators, or Tanner stage III or above. CONCLUSION: Both the selective criteria of the AAP Committee on Child Abuse and Neglect and the more selective criteria of Siegel et al as we interpreted them were accurate when applied to identifying girls with vaginal gonococcal infections in our study population. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/9164804/Vaginal_gonococcal_cultures_in_sexual_abuse_evaluations:_evaluation_of_selective_criteria_for_preteenaged_girls_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=9164804 DB - PRIME DP - Unbound Medicine ER -