Medline ® Abstracts for References 44-46

of 'Bacterial vaginosis'

44
TI
Validity of the vaginal gram stain for the diagnosis of bacterial vaginosis.
AU
Schwebke JR, Hillier SL, Sobel JD, McGregor JA, Sweet RL
SO
Obstet Gynecol. 1996;88(4 Pt 1):573.
 
OBJECTIVE: To determine the sensitivity and specificity of vaginal Gram stain as interpreted by the Nugent criteria for the diagnosis of bacterial vaginosis, and to consider the use of Gram stain as the criterion standard for the diagnosis of bacterial vaginosis.
METHODS: A multicenter study was conducted of women attending gynecology or sexually transmitted disease clinics. Clinical data consisting of vaginal pH, "whiff test," clue cells, and appearance of the vaginal discharge (Amsel criteria) were compared with the vaginal fluid Gram stain (Nugent criteria) for the diagnosis of bacterial vaginosis.
RESULTS: The sensitivity and specificity of the Gram stain compared with the Amsel criteria were 89 and 83%, respectively. There was significant variation in the specificity values by geographic site. If the Gram stain was considered the criterion standard for the diagnosis of bacterial vaginosis, the sensitivity and specificity of the Amsel criteria were 70 and 94%, respectively.
CONCLUSION: The vaginal Gram stain (Nugent criteria) is a sensitive method for the diagnosis of bacterial vaginosis. The 83% specificity suggests that the currently used Amsel criteria may lead to the underdiagnosis of bacterial vaginosis.
AD
Department of Medicine, University of Alabama at Birmingham, USA.
PMID
45
TI
Gram stain method shows better sensitivity than clinical criteria for detection of bacterial vaginosis in surveillance of pregnant, low-income women in a clinical setting.
AU
Tam MT, Yungbluth M, Myles T
SO
Infect Dis Obstet Gynecol. 1998;6(5):204.
 
OBJECTIVE: The purpose of the study is to determine whether the Gram stain method is superior to the clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen in a resident clinic setting. The clinical criteria is the current diagnostic method employed to diagnose bacterial vaginosis.
STUDY DESIGN: In this study, 51 pregnant women with vaginal discharge were prospectively evaluated. All were screened using the clinical criteria, Gram stain method, and culture of the discharge. The modified scoring system instituted by Nugent et al. (J Clin Microbiol 29:297-301, 1991) was employed in reading the Gram stain smears. The clinical criteria were then compared with the Gram stain method. Isolation of moderate to many Gardnerella vaginalis growth by culture was used as the confirmatory finding.
RESULTS: Sensitivity of the Gram stain method (91%) was significantly higher than that of the clinical criteria (46%), (sign test P = 0.0023,<0.01). The Gram stain method also has both a low false-negative (4%) and high negative predictive value (96%), makingit an ideal diagnostic test.
CONCLUSION: The Gram stain method is a rapid and cost-effective test that is also highly reproducible and readily available in many laboratories. These features make the Gram stain method a more desirable screening procedure for bacterial vaginosis in a clinic population.
AD
Department of Obstetrics and Gynecology, St. Joseph Hospital, Chicago, IL, USA.
PMID
46
TI
Prevalence of bacterial vaginosis and correlation of clinical to Gram stain diagnostic criteria in low risk pregnant women.
AU
Gratacós E, Figueras F, Barranco M, Ros R, Andreu A, Alonso PL, Cararach V
SO
Eur J Epidemiol. 1999;15(10):913.
 
The present study aimed to evaluate the prevalence of bacterial vaginosis, and the correlation of clinical Amsel criteria with Gram Nugent criteria for the diagnosis of bacterial vaginosis in a low risk population of pregnant women. Pregnant women under 28 weeks of gestation who were followed in the low risk clinics at two centers were evaluated for the presence of bacterial vaginosis using the Amsel clinical criteria, and underwent vaginal samples for Gram staining. Gram smears were examined for the diagnosis of bacterial vaginosis on the basis of Nugent's criteria. A total of 492 women were included in the study. Bacterial vaginosis was diagnosed in 1.6% (8/492) women on the basis of clinical criteria, and in 4.5% (22/492) according to Gram stain. The sensitivity and specificity of Amsel criteria compared with Gram stain were 35% and 99%, respectively. In accordance with other recent reports, the prevalence of bacterial vaginosis appears to be much lower in certain areas than figures previously suggested. In these populations, the correlation of composite clinical criteria defined in groups with high prevalence of bacterial vaginosis appears to be also poor.
AD
Departament d-Obstetrícia i Ginecologia, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Spain. egratacos@meditex.es
PMID