Diagnosis of bacterial vaginosis: Clinical or microscopic? A cross‐sectional study

Vieira‐Baptista, Pedro; Silva, Ana Rita; Costa, Marcela de Rezende; Figueiredo, Rita; Saldanha, Conceição; Sousa, Carlos

doi:10.1002/ijgo.13792

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…One of the Amsel criteria -'presence of thin, homogenous or milky vaginal discharge' has been evaluated as an independent diagnostic feature, but with inconsistent results possibly as a result of heterogeneity in the different study populations and/or variable clinical evaluation of discharge. 28,29 Bacterial vaginosis symptoms are usually the motivation for seeking healthcare. Symptoms can result in emotional stress, anxiety, feelings of 'dirtiness', and poor sexual relationships, 6 and from a patient perspective resolution of symptoms is of greatest importance, largely independent of any improvement in microscopy appearances.…”

Section: Discussionmentioning

confidence: 99%

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The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV

Ayinde¹,

Ross²

2023

Int J STD AIDS

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Background Bacterial vaginosis (BV) is a common condition, yet accurate diagnosis remains a challenge. We explored symptom and microscopy-based diagnosis of BV and assessed the influence of these diagnostic approaches on treatment response. Methods BV diagnosis based on patient-reported symptoms, and vaginal swab gram stain microscopy at local laboratories and a central laboratory were compared for women recruited into the VITA trial in England. Multivariable analysis was used to assess the association between the method of diagnosis and symptom resolution 2 weeks after metronidazole treatment. Results 517 women presenting with vaginal discharge (470/517 [91%]) and/or malodour (440/517 [85%]) were included. The accuracy of patients’ vaginal symptoms compared to local laboratory microscopy for BV diagnosis were —discharge, sensitivity 90% and specificity 5%; malodour, sensitivity 84% and specificity 12%, and compared to a central laboratory diagnosis were —discharge, sensitivity 91% and specificity 8%; malodour, sensitivity 88% and specificity 18%. 143/204 (70%) participants reported symptom resolution after treatment and this was associated with a positive baseline local laboratory diagnosis (adjusted relative risk—aRR 1.64 [1.02 to 2.64]), but not with a positive central laboratory diagnosis (aRR 1.14 [0.95 to 1.37]). Symptom resolution occurred in 75% (83/111) of women who were symptom positive/central laboratory BV positive compared to 65% (58/89) who were symptom positive/microscopy negative. Conclusion Symptoms correlated poorly with microscopy-based BV diagnosis but two-thirds of women with a symptom positive/microscopy negative diagnosis experienced symptom resolution following metronidazole treatment. Further studies are needed to determine the optimal investigation and treatment for microscopy-negative women with typical BV symptoms.

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Section: Discussionmentioning

confidence: 99%

“…One of the Amsel criteria —‘presence of thin, homogenous or milky vaginal discharge’ has been evaluated as an independent diagnostic feature, but with inconsistent results possibly as a result of heterogeneity in the different study populations and/or variable clinical evaluation of discharge. 28,29…”

Section: Discussionmentioning

confidence: 99%

The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV

Ayinde¹,

Ross²

2023

Int J STD AIDS

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“…Understanding the etiology of BV has important implications for improvements in diagnosis, treatment, and prevention of this common clinical condition. For example, in recent years, several highly sensitive and specific PCR assays, which use various combinations of bacteria, became available for the diagnosis of BV in symptomatic women, possibly replacing the currently used tests (Amsel criteria and Nugent score) 43–45 . These tests, some already commercially available, have been shown to be sensitive (>90%) and specific (near 90%).…”

Section: Discussionmentioning

confidence: 99%

The Vaginal Microbiome: II. Vaginal Dysbiotic Conditions

Lev‐Sagie

Seta

Verstraelen

et al. 2022

J Low Genit Tract Dis

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This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders.Materials and Methods: A search of PubMed database was performed, using the search terms "vaginal microbiome" with "dysbiosis," "bacterial vaginosis," "cytolytic vaginosis," "desquamative inflammatory vaginitis," and "aerobic vaginitis." Full article texts were reviewed. Reference lists were screened for additional articles. Results:The second article in this series focuses on vaginal dysbiotic conditions. Dysbiosis is a term describing imbalances in bacterial communities. Given that lactobacillus-dominated microbiota are thought to be the most optimal, vaginal dysbiosis is usually considered as lactobacilli-depleted VMB. Bacterial vaginosis (BV), the most common vaginal dysbiotic condition, is a polymicrobial disorder, considered the leading cause for vaginal discharge in women worldwide. In addition, we review the VMB in other vaginal conditions associated with lactobacilli depletion: desquamative inflammatory vaginitis and aerobic vaginitis. We also discuss the controversial diagnosis of cytolytic vaginosis, related with lactobacilli overgrowth.Conclusions: Bacterial vaginosis displays complex microbiology. The heterogeneity and diversity within the genus Gardnerella may impact the progression of BV. Bacterial biofilms may contribute to the etiology and persistence of BV, and various bacteria may affect its clinical presentation and pathogenicity. Lack of lactobacilli is not always accompanied by an overgrowth of anaerobes.

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“…Prueba de pH: Para determinar si su pH vaginal es alto (pH 4,5 o superior), mida su pH vaginal con una tira reactiva. Esto se debe a que la vaginosis bacteriana es común cuando el pH vaginal es alto (18).…”

Section: Diagnósticounclassified

Impacto en la salud materno fetal de embarazadas adolescentes con vaginosis bacteriana

Mina-Ortiz,

Franco-Macias,

Santana -Mariscal

et al. 2024

MQRInvestigar

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La vaginosis bacteriana, ha sido un factor de riesgo para el parto prematuro, la salpingitis aguda y las complicaciones neonatales y perinatales de parto pretérmino que constituye un importante motivo de consulta a la emergencia obstétrica. Objetivo: Analizar el impacto en la salud materna fetal durante el embarazo adolescente con vaginosis bacteriana. Diseño: El estudio fue diseño documental de tipo descriptivo basado principalmente en una revisión sistemática de la información a través de la técnica de lectura crítica de fuentes tales artículos originales y libros. Se logró acceder mediante buscadores científicos como PubMed; Elsevier; Scielo, Google académico. Criterios de inclusión: El estudio abarco artículos intercontinentales como España, nivel internacional como son México, Argentina, Colombia, Chile entre otros y a nivel del Ecuador. Las investigaciones que se tomaron a consideración para el estudio fueron desde el año 2019 hasta el 2024. Resultados: La epidemiologia más alta fue en Brasil en el año 2022 con un valor de 84%. En Senegal se obtuvo un 18,6 % en el 2021. Las complicaciones que se pueden presentar son parto prematuro, Aborto espontáneo, Celulitis pélvica, Absceso pélvico. Se recurre a métodos tradicionales de ensayo como son los criterios de Amsel, cultivos microbiológicos y la puntuación de Nugen, se describe como la Gold estándar. Conclusión: La detección precisa de la vaginosis bacteriana ha sido fundamental para combatir dicha infección y prevenir posibles complicaciones entre madre y feto. Las pruebas de laboratorio, incluida la observación de síntomas como olor a pescado, la presencia de flujo vaginal y la realización de un examen pélvico, pueden indicar la presencia de vaginosis bacteriana.

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Diagnosis of bacterial vaginosis: Clinical or microscopic? A cross‐sectional study

Cited by 6 publications

References 34 publications

The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV

The association between symptom or microscopy based diagnosis of bacterial vaginosis (BV) and response to treatment in women with recurrent BV

The Vaginal Microbiome: II. Vaginal Dysbiotic Conditions

Impacto en la salud materno fetal de embarazadas adolescentes con vaginosis bacteriana

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