Correlation Between Cervical Cytologic Results and Gram Stain as Diagnostic Tests for Bacterial Vaginosis

Davis, J D; Connor, Erin E.; Clark, Penny; Wilkinson, Edward J.; Duff, Patrick

doi:10.1097/00128360-199804000-00022

Cited by 26 publications

(36 citation statements)

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“…Also, PlatzChristensen and colleagues reported the sensitivity as 90% and specificity as 97% after the comparison of Pap smear and clinical criteria, in a similar study performed in 1989 20 . Davis and colleagues 3 reported the sensitivity and specificity rates of Pap smear as 55 and 98% respectively, in a study in which the Gram stain results were accepted as the diagnostic standard. They reached their hypothesis because of lower rates of sensitivity.…”

Section: Resultsmentioning

confidence: 99%

“…In evaluation of Pap stain under´400 magnification, according to the method of Davis and colleagues 3 , cases with the presence of microorganisms other than lactobacilli in a thin film form, the presence of clue cells -which are formed by the covering of the cytoplasmic membranes of squamous cells by non-Lactobacillus microorganisms -and a predominance of nonLactobacillus bacteria in most areas, were accepted as BV-positive cases. Davis and colleagues reported the condition of absence of lactobacilli as a fourth diagnostic criterion, but the absence of lactobacilli is modified as predominance of non-Lactobacillus bacteria over lactobacilli in the present study.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Gram Stain and Pap Smear Procedures in theDiagnosis of Bacterial Vaginosis

Vardar

Maral²,

İnal³

et al. 2002

Infectious Diseases in Obstetrics and Gynecology

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Objective: The purpose of this study was to examine the characteristics of Gram stain versus Pap smear in diagnosis of bacterial vaginosis (BV). Methods: One-thousand and sixty women were enrolled in this study. All cases with symptoms of BV were determined by Amsel's criteria, which were accepted as the gold standard for diagnosis of BV. Pap smear and Gram stain evaluations were compared according to Amsel's criteria, without viewing the clinical results of the patients. Gram stain and Pap smear results were determined as negative or positive according to Amsel's criteria. Sensitivity, specifity and positive predictive values were calculated. Results: After accepting the cases that were diagnosed as BV according to Amsel's criteria as reference cases, the sensitivity of the Gram stain method was calculated as 97% and the sensitivity of the Pap smear method as 93%. Similar specificity rates were obtained with both methods in diagnosis of BV related to the clinical results. There were no statistically significant differences in diagnosis of BV between these two groups. Conclusion: If Amsel's criteria are accepted as the gold standard for diagnosis of BV, Gram stain and Pap smear methods will give similar results in diagnosis.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparison of Gram Stain and Pap Smear Procedures in theDiagnosis of Bacterial Vaginosis

Vardar

Maral²,

İnal³

et al. 2002

Infectious Diseases in Obstetrics and Gynecology

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“…Davis et al 14 reported that compared to the Gram stain, cervical cytologic test results had a sensitivity of 55%, specificity of 98%, a positive predictive value of 96%, and a negative predictive value of 78%.…”

Section: Discussionmentioning

confidence: 99%

Bacterial vaginosis: comparison of Pap smear and microbiological test results

et al. 2004

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“…For example, use of the cervical Pap smear instead of a vaginal specimen to diagnose bacterial vaginosis has been shown to be insensitive (7,12). Papanicolaou staining of a vaginal (rather than cervical) smear has better sensitivity for bacterial vaginosis (13).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Two Alternative Sample Transport and Fixation Methods in the Microbiological Diagnosis of Bacterial Vaginosis

Eason

Toye

Wells

et al. 2003

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND: The standard method for specimen collection and transport for microbiological diagnosis of bacterial vaginosis is an air-dried smear of vaginal secretions, promptly heat-or alcohol-fixed, Gram-stained and scored by Nugent's criteria. OBJECTIVE: Two alternative methods are evaluated: sending a swab in transport medium to be smeared and Gram-stained in the laboratory two days later; and sending a smear of vaginal secretions sprayed with cytological fixative to the laboratory for Gram staining seven days later. PATIENTS AND METHODS: One hundred fifty-two women aged 18 years and older who attended a hospital colposcopy clinic or a community healthy sexuality clinic were studied. This was a prospective study: three vaginal swabs were taken from each patient and handled as described above. Each slide was blindly and independently interpreted by two microbiology technologists. The sensitivity, specificity and coefficient of agreement of the transported swab and cytologically fixed methods were compared with the air-dried smear method. RESULTS: Smears from swabs in transport medium and cytologically fixed smears both had 90% sensitivity and 97% specificity for bacterial vaginosis compared with diagnosis from air-dried smears. Cohen's kappa was 0.88 (95% CI 0.79 to 0.97) for each method. Inter-rater reliability assessed over all slides (all sampling techniques) was excellent (kappa 0.94). CONCLUSIONS: For the diagnosis of bacterial vaginosis, both alternative techniques provide results equivalent to air-dried direct smears. A vaginal smear sprayed with cytological fixative provides immediate fixation of material to the slide, permits delays in swab transport and avoids the requirement for transport at a controlled temperature imposed by swabs. C linical diagnosis of bacterial vaginosis is based on Amsel et al's (1) criteria: homogenous watery discharge, amine odour with application of 10% potassium hydroxide, pH greater than 4.5 and clue cells on a wet mount of vaginal discharge. Clinical diagnosis without laboratory confirmation is accepted or even optimal (2,3). However, it requires a good microscope at hand, microscopy expertise, reagents, time and tolerance of the unpleasant odour produced; it is also subjective (3). In actual practice, laboratory diagnosis is widely used instead, because it is easier and more convenient for the ©2003 Pulsus Group Inc. All rights reserved ORIGINAL ARTICLE clinician (4) and provides an objective, reproducible result. The standard procedure for the microbiological test is to prepare a direct smear of vaginal discharge, air-dry the smear, and send it to a laboratory for heat or alcohol fixation, Gram staining and scoring of bacterial types by Nugent et al's (5) criteria. This technique correlates well with Amsel et al's clinical criteria (5,6).However, instead of sending an air-dried smear, clinicians commonly send a vaginal swab in transport medium to a laboratory for diagnosis of bacterial vaginosis. While this substitute for the direct smear of vaginal secretions is widel...

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Correlation Between Cervical Cytologic Results and Gram Stain as Diagnostic Tests for Bacterial Vaginosis

Cited by 26 publications

References 0 publications

Comparison of Gram Stain and Pap Smear Procedures in theDiagnosis of Bacterial Vaginosis

Comparison of Gram Stain and Pap Smear Procedures in theDiagnosis of Bacterial Vaginosis

Bacterial vaginosis: comparison of Pap smear and microbiological test results

Assessment of Two Alternative Sample Transport and Fixation Methods in the Microbiological Diagnosis of Bacterial Vaginosis

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