Diagnosis of bacterial vaginosis in cases of abnormal vaginal discharge: comparison of clinical and microbiological criteria

Modak, Tamonud; Arora, Preeti; Agnes, Charan; Raja, R.; Goswami, Sudipta; Ghosh, Pramit; Das, Nilay Kanti

doi:10.3855/jidc.1153

Cited by 57 publications

(49 citation statements)

References 22 publications

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“…This could indicate that production of odor is a cooperative process depending on the particular microbiota composition. Indeed, odor is not universally detected in women who are BV-positive by Nugent score [40], and previous studies suggest that particular taxa are more associated with odor [3,41]. Symbiotic relationships may be common in the vaginal environment, as another has been described where G. vaginalis produces amino acids that promote the growth of Prevotella bivia [42].…”

Section: Resultsmentioning

confidence: 99%

Comparative meta-RNA-seq of the vaginal microbiota and differential expression by Lactobacillus iners in health and dysbiosis

et al. 2013

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BackgroundBacterial vaginosis (BV), the most common vaginal condition of reproductive-aged women, is associated with a highly diverse and heterogeneous microbiota. Here we present a proof-of-principle analysis to uncover the function of the microbiota using meta-RNA-seq to uncover genes and pathways that potentially differentiate healthy vaginal microbial communities from those in the dysbiotic state of bacterial vaginosis (BV).ResultsThe predominant organism, Lactobacillus iners, was present in both conditions and showed a differing expression profile in BV compared to healthy. Despite its minimal genome, L. iners differentially expressed over 10% of its gene complement. Notably, in a BV environment L. iners increased expression of a cholesterol-dependent cytolysin, and of mucin and glycerol transport and related metabolic enzymes. Genes belonging to a CRISPR system were greatly upregulated suggesting that bacteriophage influence the community. Reflective of L. iners, the bacterial community as a whole demonstrated a preference for glycogen and glycerol as carbon sources under BV conditions. The predicted end-products of metabolism under BV conditions include an abundance of succinate and other short-chain fatty-acids, while healthy conditions are predicted to largely contain lactic acid.ConclusionsOur study underscores the importance of understanding the functional activity of the bacterial community in addition to characterizing the population structure when investigating the human microbiome.

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Section: Resultsmentioning

confidence: 99%

Comparative meta-RNA-seq of the vaginal microbiota and differential expression by Lactobacillus iners in health and dysbiosis

et al. 2013

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“…Another investigator from Kolkata, India, has reported that the presence of clue cells correlates best with a positive diagnosis by Nugent's score [1]. This result indicates that by adding a score for the presence/absence of clue cells to each of these 2 methods, one can enhance the diagnosis of BV, which can be superior to the methods of Nugent et al and Hay et al…”

Section: Discussionmentioning

confidence: 97%

“…Accurate diagnosis of BV is somewhat challenging. In addition to scientific considerations, choosing a method for its diagnosis requires consideration of complexity, cost, and the frequency of un-interpretable specimens [1]. …”

Section: Discussionmentioning

confidence: 99%

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Comparison of Hay’s Criteria with Nugent’s Scoring System for Diagnosis of Bacterial Vaginosis

Chawla

Bhalla

Chadha

et al. 2013

BioMed Research International

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Although Nugent's criterion is considered as the gold standard for the diagnosis of bacterial vaginosis (BV), the method requires an experienced slide reader and considerable time and skill. In this study, we compared the method of Hay and Ison with Nugent's scoring criteria. Vaginal specimens were collected from a total of 213 women, presenting with or without the symptoms of vaginitis. Diagnosis of BV was done using Nugent' and Hay's method. Sensitivity, specificity, and predictive values for positive and negative test were calculated for Hay's method using Nugent's method as the gold standard. We diagnosed 70 cases (32.86%) of BV by Nugent's method and 87 (40.85%) cases by the Hay's method. Sensitivity, specificity, predictive value of positive result, predictive value of negative result, and Kappa value when evaluating Hay's criteria using Nugent's criteria as the gold standard were ≥97.2%, ≥88.1%, ≥80.4%, ≥97.1%, and ≥0.830, respectively, when Hay's grade II and/or Nugent's intermediate score were considered either as negative or positive or excluded. Using Nugent score for the intermediate group is the most difficult. Hay's method shows good agreement with the gold standard method of Nugent et al. and can be used as an alternative to Nugent's criteria in busy tertiary care hospitals.

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“…Bacterial vaginosis does not evolve from a commonly defined bacterial infection caused by one agent, but is a disorder of the vaginal microbiome. Therefore, the appropriate diagnosis of BV is demanding and the decision about the method of choice for its diagnosis requires a review of complexity, cost, and the constancy of samples difficult to interpret [18].…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnosis of bacterial vaginosis: Prevalence of Gardnerella vaginalis and Atopobium vaginae in pregnant women

et al. 2018

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Introduction/Objective Bacterial vaginosis (BV) is defined as disequilibrium of vaginal microbiota due to proliferation of Gram-negative/variable anaerobes and reduction/depletion of vaginal lactobacilli. Difficulties in interpreting microscopically categorized findings in diagnosis of BV need a molecular analysis of bacteria present in vaginal discharge of patients. In this regard, we performed real-time qPCR analysis of vaginal discharge samples with the goal to explore in which extent prevalence and amount of anaerobes, Gardnerella vaginalis and Atopobium vaginae, are related to findings obtained by microscopy. Methods This study enrolled 111 asymptomatic pregnant women between 24 and 28 weeks of pregnancy. Gram-stained vaginal smears were evaluated microscopically. Afterwards, DNA of bacteria was extracted from Gram slides and real-time qPCR was performed with the aim to detect and quantify G. vaginalis and A. vaginae. Results The data of our study showed that 53.2% of patients had normal results, while 20.7% and 26.1% of patients had intermediary (IMD) and BV results, respectively. G. vaginalis and A. vaginae were more frequently found in IMD and BV than in healthy patients; also, the average bacterial number of G. vaginalis and A. vaginae were significantly higher in BV and IMD than in the group with normal findings (p = 0.000). Comparing mutual relation of G. vaginalis and A. vaginae, the prevalence and number of G. vaginalis were in all groups significantly higher than A. vaginae. Conclusion The data of our study have shown that in distinguishing normal from BV findings, quantification of bacteria may be more important than just molecular detection of bacteria.

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Diagnosis of bacterial vaginosis in cases of abnormal vaginal discharge: comparison of clinical and microbiological criteria

Cited by 57 publications

References 22 publications

Comparative meta-RNA-seq of the vaginal microbiota and differential expression by Lactobacillus iners in health and dysbiosis

Comparative meta-RNA-seq of the vaginal microbiota and differential expression by Lactobacillus iners in health and dysbiosis

Comparison of Hay’s Criteria with Nugent’s Scoring System for Diagnosis of Bacterial Vaginosis

Molecular diagnosis of bacterial vaginosis: Prevalence of Gardnerella vaginalis and Atopobium vaginae in pregnant women

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