Criteria For Diagnosis Of Bacterial Vaginosis Research Articles

Different method for diagnosis bacterial vaginosis in married woman in Hilla city

Bacterial vaginosis (BV) is an ecological disorder of the vaginal microbiota that affects millions of women annually, and is associated with numerous adverse health outcomes including pre-term birth and the acquisition of sexually transmitted infections. This study aimed to compare between the different methods (Amsel's, Nugent's, Spiegel's and PAP smears) of BV diagnosis. The results revealed that from the 100 patients It was observed that 48 (48 %) were BV positive, they met three or four of Amsel's criteria . 56(56%) were diagnosed with BV and 45(45%) had normal vaginal flora based on Nugents' score . comparison between Nugent's score and Amsel's criteria for diagnosis of BV showed a sensitivity 81% and specificity 75% . when diagnosis bacterial vaginosis by Spiegel's criteria observed that 24 (24 %) of the 100 cases, were BV positive while 76 (76 %) cases were BV negative while 57 (57 %) cases were BV negative by using pap smear including presence of Bacterail vaginosis with Trichomonas & candida 16 (16%) , Bacterail vaginosis with Trichomonas 20(20%) and Bacterail vaginosis only 7 (7%) in BV positive cases. The comparison between Nugent's score and Pap smears for diagnosis of BV had a sensitivity of 62% and a specificity of 81% .

Bacterial vaginosis – a disturbed bacterial flora and treatment enigma

The syndrome bacterial vaginosis (BV) is characterized by a disturbed vaginal microflora in which the normally occurring lactobacilli yield quantitatively to an overgrowth of mainly anaerobic bacteria. As BV is a possible cause of obstetrics complications and gynaecological disease--as well as a nuisance to the affected women--there is a strong impetus to find a cure. In BV treatment studies, the diagnosis criteria for diagnosis of BV vary considerably and different methods are used for cure evaluation. The design of study protocols varies and there is no consensus respecting a suitable time for follow-up visits. For the purpose of this review, available data were recalculated for 4-week post treatment cure rates. For oral metronidazole the 4-week cure rate was found not to exceed 60-70%. Treatment regimens with topical clindamycin or topical metronidazole have the same cure rates. It can thus be said that no sound scientific basis exists for recommending any particular treatment. There is no evidence of beneficial effects on BV engendered by partner treatment, or by addition of probiotics or buffered gel. Long-term follow-up (longer than 4 weeks) shows a relapse rate of 70%. With a primary cure rate of 60-70%, and a similar relapse rate documented in the reviewed literature, clinicians simply do not have adequate data for determining treatment or designing clinical studies. This is unfortunate since--apart from the obvious patient benefits--clinical studies can often serve as a guide for more basic studies in the quest for underlying disease mechanisms. In the case of BV there is still a need for continued basic studies on the vaginal flora, local immunity to the flora and host-parasite interactions as an aid when designing informative clinical studies.

Direct Gram's stain of vaginal discharge as a means of diagnosing bacterial vaginosis

The diagnosis of bacterial vaginosis (BV) by direct gram-stained smear of vaginal discharge was evaluated in 90 consecutive patients. Vaginal secretions from 20 healthy female volunteers were also examined. All specimens were examined by culture for growth of Gardnerella vaginalis and Lactobacillus spp. Only 35 (38.9%) of the patients with vaginal discharge satisfied the clinical diagnosis of BV. The vaginal gram-stained smear from all these 35 patients contained typical gardnerella morphotypes characteristic of BV and G. vaginalis was isolated from all of them as well as from a further 10 patients who did not satisfy the criteria for diagnosis of BV. The semi-quantitative assessment of gardnerella morphotypes was found to correlate positively with the semi-quantitative assessment of G. vaginalis growth by culture (p less than 0.0001). There was a strong inverse relationship between the quantity of lactobacillus and gardnerella morphotypes. Direct gram-staining of smears should facilitate the diagnosis of BV for clinicians with minimum need for confirmation by culture, particularly in a third world setting with few or no laboratory facilities.