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

2021; Elsevier BV; Volume: 156; Issue: 3 Linguagem: Inglês

10.1002/ijgo.13792

1879-3479

Pedro Vieira‐Baptista, Ana Rita Silva, Mariana Da Costa, Rita Figueiredo, Conceição Saldanha, Carlos Sousa,

Cervical Cancer and HPV Research

To compare the performance of the Amsel criteria, culture of Gardnerella spp., and wet mount microscopy (WMM) in the diagnosis of bacterial vaginosis.A cross-sectional cohort study was conducted, consisting of evaluating 749 consecutive women, regardless of symptoms. The Amsel criteria were evaluated, WMM microscopy and Gram staining were performed, and a swab was collected for culture. The gold standard for diagnosis was the Nugent score.The sensitivity and specificity for the different approaches were: Amsel criteria 41.3% (95% confidence interval [CI] 33.76-49.18) and 97.8% (95% CI 96.21-98.81); cultures 59.9% (95% CI 51.47-67.85) and 99.0% (95% CI 97.76-99.69); WMM 82.6% (95% CI 76.02-88.05) and 92.4% (95% CI 89.98-94.45), respectively. WMM performed equally well in symptomatic and asymptomatic women. Amsel criteria in scenarios where there is no use of a microscope had very poor sensitivity (22.8% [CI 16.63-29.87%]).The Amsel criteria have a poor performance for the diagnosis of bacterial vaginosis. WMM performs well but is not routinely used and should be the first approach for the diagnosis of vaginitis.