Bacterial vaginosis laboratory findings
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Bacterial vaginosis Microchapters |
Diagnosis |
Treatment |
Case Studies |
Bacterial vaginosis laboratory findings On the Web |
American Roentgen Ray Society Images of Bacterial vaginosis laboratory findings |
Risk calculators and risk factors for Bacterial vaginosis laboratory findings |
Overview
Laboratory Findings
In clinical practice, the diagnosis of bacterial vaginosis is based on the presence of at least three Amsel criteria. Gram staining is usually reserved for research studies and can be used with the Hay/Ison criteria or the Nugent criteria.
Other Diagnostic Criteria
An alternative is to use a Gram stained vaginal smear, with the Hay/Ison criteria or the Nugent criteria.[2][3]
Hay/Ison Criteria
The Hay/Ison criteria are defined as follows: [4]
Grading | Definition |
---|---|
Grade 0 | No bacteria present |
Grade 1 | Lactobacillus morphotypes predominate |
Garde 2 | Mixed flora with (some lactobacilli, gardnerella,or mobiluncus morphotypes present) |
Garde 3 | Predominantly gardnerella and/or mobiluncus morphotypes (few or absent lactobacilli) |
Garde 4 | Gram-positive cocci predominate |
- Grade 3 is diagnostic
Nugent Criteria The standard for research are the Nugent Criteria.[3]
Score | 0 | 1 | 2 | 3 | 4 |
---|---|---|---|---|---|
Lactobacillus morphotypes | >30 | 15-30 | <14 | <1 (this is an average) | 0 |
Gardnerella/Bacteroides morphotypes | 0 | <1 (this is an average) | 1-4 | 5-30 | >30 |
Curved Gram variable rods | 0 | <5 | >5 |
In this scale a score of 0-10 is generated from combining three other scores. It is time consuming and requires trained staff but is has high interobserver reliability:
- 0–3 is considered negative for bacterial vaginosis
- 4–6 is considered intermediate
- 7+ is considered indicative of bacterial vaginosis
Cytology
The Papanicolaou smear is not reliable for diagnosis of bacterial vaginosis.[5]
Culture
Vaginal culture has no role in diagnosis of bacterial vaginosis.
References
- ↑ Center for Disease Control and prevention. Mortality and morbidity weekly reports. Sexually transmitted disease treatment guideline. (2015) https://www.cdc.gov/std/tg2015/tg-2015-print.pdf Accessed on October 20, 2016
- ↑ Ison, CA; Hay, PE (2002), "Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics", Sex Transm Infect, 78: 413–415
- ↑ 3.0 3.1 Nugent, R. P., M. A. Krohn, and S. L. Hillier (1991). "Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation". J. Clin. Microbiol. 29: 297&ndash, 301.
- ↑ Guideline Clearing House. "2002 national guideline for the management of bacterial vaginosis". Unknown parameter
|http://www.guideline.gov/summary/summary.aspx?ss=
ignored (help) - ↑ Greene JF, Kuehl TJ, Allen SR (2000). "The papanicolaou smear: inadequate screening test for bacterial vaginosis during pregnancy". Am J Obstet Gynecol. 182 (5): 1048–9. PMID 10819823.