Comparison of the methods of diagnosis of bacterial vaginosis 498-501
Senior grade lecturer, Department of Microbiology, Kasturba
Medical College, Manipal University, Mangalore-575001, India.
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Background and Objective: Although Nugentâ€™s criterion is considered as the gold standard, routinely a combination of various methods is used for the diagnosis of bacterial vaginosis. In the present study we compared culture, Spiegelâ€™s criteria and Amselâ€™s criteria with Nugentâ€™s method for the diagnosis of bacterial vaginosis.
Materials and Methods: Five hundred and twenty seven women who attended the Government Maternity Hospital and a tertiary care centre in south India for antenatal care or forany other complaint formed the study population. Diagnosis of bacterial vaginosis was done by culture, Amselâ€™s, Nugentâ€™s and Spiegelâ€™s criteria. The positive predictive value, the negative predictive value and the sensitivity and specificity of these methods,in comparison with Nugentâ€™s criteria, by considering it as the gold standard, were calculated. Statistical analysis was doneby using the Chi Square test or the Fisherâ€™s exact test as was appropriate.
Results: In comparison with Nugentâ€™s criteria, the positive predictive value, negative predictive value and the sensitivity and specificity of Amselâ€™s criteria were 80.4%, 94.8%, 78% and 95.6% and that of Spiegelâ€™s criteria were 77.5%, 100%, 100% and 93.2%. The culture was 51% sensitive and 88.7% specific, the positive predictive value was 85.5% and the negative predictive value was 58%. We diagnosed 100 (19%) casesof bacterial vaginosisby Nugentâ€™s method,129 (24%) casesby Spiegelâ€™s method,97 (18%) cases by Amselâ€™s criteria and 88 (16.7%) cases by culturing.
Conclusion: Amselâ€™s and Spiegelâ€™s criteria were comparable with Nugentâ€™s criteria for the diagnosis of bacterial vaginosis. Diagnosis of bacterial vaginosis by culture was least sensitive method.