Reliability of interpretation of gram-stained vaginal smears by nugent's scoring system for diagnosis of bacterial vaginosis

Zarakolu, Pınar; Hodoglugil, Nuriye Nalan Sahin; Aydın, Faruk; Tosun, İlknur; Gözalan, Ayşegül; Ünal, Serhat

doi:10.1016/j.diagmicrobio.2003.09.001

Cited by 17 publications

(15 citation statements)

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“…The third criteria is high pH ( > 4.5). Many studies suggest that raised pH is recognized as the most sensitive but least specific criteria [8,17], which was also confirmed in our investigation (Table 3). In our study, high pH ( > 4.5) had higher sensitivity than the Amsel criteria (90.3%) but it was less specific (78.4%).…”

Section: Discussionsupporting

confidence: 79%

“…A fourth criterion is the Amine odor test (KOH test). Gutman et al suggested in their study that the KOH test was a highly sensitive and specific method [8]; however, our findings did not support this hypothesis. In our study the sensitivity of the KOH test was as good as that of Amsel criteria, but its specificity was accurate.…”

Section: Discussioncontrasting

confidence: 57%

“…Our results indicate that any individual criterion on its own is not sufficient to diagnose BV, but if we modify Amsel criteria by using a combination of any two criteria, there is decreased sensitivity and increased specificity. Previous studies also suggest making modifications in Amsel criteria, such as the combination of high pH ( > 4.5) and amine odor test [8], or clue cell and positive amine test [4] In our study, the specificity of each pair of criteria is more or less similar to that observed for Amsel criteria; however, the combination of high pH ( > 4.5) and amine odor tests has high sensitivity (88%) and high PPV (62%) as compared to Amsel criteria. Diagnostic accuracy of all combinations in our study is more or less equal to or higher than that of Amsel criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Amsel criteria [5] have four requirements, out of which at least three should be fulfilled for confirmation of diagnosis of BV: (1) thin white homogenous discharge; (2) clue cell on microscopy; (3) vaginal pH > 4.5; and (4) release of fishy odor on adding alkalies (10%KOH). In the laboratory, the Nugent scoring system [6] is a reliable, convenient, and cost-effective method for evaluation of cases of bacterial vaginosis [7,8] ]and is considered the gold standard test for diagnosing BV [7,8,9,10,11 ]. It has a scoring system of 0-10 and allows for intermediates between normal and abnormal.…”

Section: Introductionmentioning

confidence: 99%

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Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries

Mittal

Jain

Pradeep

2011

J Infect Dev Ctries

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Introduction: Bacterial vaginosis (BV) is the commonest cause of abnormal vaginal discharge in women of child-bearing age and is associated with increased susceptibility to HIV-AIDS and sexually transmitted diseases. In obstetrics, BV has been implicated in causing various complications. In clinical practice, BV is diagnosed using Amsel criteria and Nugent scoring. Using modified Amsel criteria, we determined that the fulfilling of any two instead of three criteria can be diagnostic of BV. Methodology: This prospective cross-sectional study involved pregnant females complaining of excessive vaginal discharge admitted in a tertiary health centre in central India. Four vaginal swabs were collected for the diagnosis of BV by Amsel criteria, modified Amsel criteria, and Nugent scoring on Gram stain. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of each individual criterion and combinations of criteria were calculated by using Nugent scoring as the gold standard and by chi square test. Results: In the present study overall prevalence of BV was 12%. The sensitivity of individual or a combination of two criteria was almost same or higher than that of Amsel criteria. Specificity of each combination of criteria was comparable to that of Amsel criteria. However, a combination of high pH and amine odor test had the highest sensitivity (88%) and highest PPV (62%). Diagnostic accuracy of all combinations in our study was equal to or slightly higher than that of Amsel criteria. Conclusion: Diagnostic accuracy of new modified Amsel criteria is as reliable as that of Amsel criteria.

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Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries

Mittal

Jain

Pradeep

2011

J Infect Dev Ctries

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“…Actualmente, el método considerado como estándar de oro para hacer el diagnóstico de VB y de uso común en países en vías de desarrollo, es el estudio del flujo vaginal aplicando los criterios de Amsel (8,9). Este método requiere del uso de reactivos con costo adicional al del recurso humano, que puede dificultar su utilización rutinaria en poblaciones económicamente deprimidas.…”

Section: Introductionunclassified

Validez Y Reproducibilidad Del Sistema De Puntuación De Nugent Para El Diagnóstico De Vaginosis Bacteriana en Mujeres Embarazadas

Arámbula

2009

Rev. chil. obstet. ginecol.

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a Médico Cirujano, magíster en Epidemiología.b Ingeniera de Sistemas, magíster en Bioestadística. c Bacterióloga, magíster en Microbiología.* Investigación financiada por la Universidad Industrial de Santander. RESUMENAntecedentes: La vaginosis bacteriana se encuentra entre 15 a 20% de las mujeres embarazadas y el método rutinario para diagnosticarla es el estudio del flujo vaginal aplicando los criterios de Amsel. Sin embargo, existen otros métodos diagnósticos como el sistema de Nugent, que ha mostrado adecuada validez a menor costo. Objetivo: Evaluar la validez y reproducibilidad del sistema de Nugent para el diagnóstico de vaginosis bacteriana en embarazadas. Método: Estudio de evaluación de pruebas diagnósticas. Se estudiaron 100 mujeres con embarazo de bajo riesgo. A cada paciente se le tomaron dos muestras de secreción de flujo vaginal y tres evaluadores examinaron cada muestra. Se evaluó la validez de los criterios de Nugent comparándolos con los de Amsel (prueba de oro) y se obtuvo el mejor punto de corte usando la curva del receptor-operador (ROC), para calcular la sensibilidad, especificidad y valores predictivos. La reproducibilidad se midió con el coeficiente Kappa. Resultados: El promedio de edad fue 25,6 años y edad gestacional 23 semanas. Un 19% había tenido infección vaginal previamente. La prevalencia actual de vaginosis bacteriana fue 16% (IC95%: 9,43%; 24,67%). El área bajo la curva ROC fue 0,98 (IC95%: 0,95; 1,00). La sensibilidad fue 1,00 (IC95%: 0,77; 1,00), especificidad 0,96 (IC95%: 0,90; 0,99), valor predictivo positivo 0,82 (IC95%: 0,57; 0,96) y valor predictivo negativo 1,00 (IC95%: 0,95; 1,00). Conclusión: El sistema de Nugent para el diagnóstico de vaginosis bacteriana en embarazadas es una prueba válida y reproducible para implementar rutinariamente durante el control prenatal.PALABRAS CLAVE: Vaginosis bacteriana, validez diagnóstica, reproducibilidad, prueba de Nugent SUMMARY Background:The bacterial vaginosis is found in 15% to 20% of the pregnant women and the study of the vaginal discharge using the Amsel criteria is the usual method to diagnose it. However, there are other diagnostic methods like the Nugent Score System which has shown to be accurate and less expensive. Objective: To evaluate the accuracy and reliability of the Nugent Score System for diagnosing bacterial vaginosis in pregnant women. Methods: This is a study for evaluating medical tests. We studied 100 women who had a low risk pregnancy. Two samples of the vaginal discharge were taken in each woman and three masked

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Genitourinary infection prevalence among women who used an intrauterine device or oral contraceptives

Demi̇rbağ

Köksal

Kaya

2013

Arch Gynecol Obstet

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Reliability of interpretation of gram-stained vaginal smears by nugent's scoring system for diagnosis of bacterial vaginosis

Cited by 17 publications

References 9 publications

Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries

Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries

Validez Y Reproducibilidad Del Sistema De Puntuación De Nugent Para El Diagnóstico De Vaginosis Bacteriana en Mujeres Embarazadas

Genitourinary infection prevalence among women who used an intrauterine device or oral contraceptives

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