Correlação entre critérios clínicos e critérios laboratoriais no diagnóstico de vaginose bacteriana

Abstract

Bacterial vaginosis may be defined either by clinica! or microbiological variables. Amsers criteria al/ow for the diagnosis ofbacterial vaginosis when three out of the following four criteria are detected. 1). Vaginal pH > 4.5: 2); Positive amine test with KOH 10%.3); Presence of clue cells: 4) Presence ofa white. thin and homogeneous vaginal discharge This work's objective was to compare Amse/'s criteria efficiency against Nugent's gradient on bacterial vaginosis diagnosis. Evaluation was performed on 100 samples of patients with signs and clinicai symptoms of vaginal infection between September of 1999 and October of 2000 at the gynecology and obstetrics unit of the Hospital de Clinicas. The patients were submifted to gynecological examinations in order to verify the mucous appearance and vaginal fluids. Samples were collected to measure the vaginal pH, perform the amine test, wet mount and stain Gram. The Nugent's gradient was determined and compared to the Amse/s criteria for the characterization of the bacterial vaginosis. The incidence of bacterial vaginosis among the studied subjects was 34% for the laboratorial criteria and 14% for the clinicai criteria. There was no meaningful concordance (Kappa = 0,47) between Amse/'s criteria and lhe Nugent gradient. This conclusion leads to a necessity for a discussion about the medicai gynecological routine, which characterizes baclerial vaginosis only through clinicai signs.