Gram Stain Method Shows Better Sensitivity ThanClinical Criteria for Detection of Bacterial Vaginosisin Surveillance of Pregnant, Low-Income Women in aClinical Setting

摘要

Objective:The purpose of the study is to determine whether the Gram stain method is superior tothe clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen ina resident clinic setting. The clinical criteria is the current diagnostic method employed to diagnosebacterial vaginosis.Study Design:In this study, 51 pregnant women with vaginal discharge were prospectivelyevaluated. All were screened using the clinical criteria, Gram stain method, and culture of thedischarge. The modified scoring system instituted by Nugent et al. (J Clin Microbiol 29:297–301,1991) was employed in reading the Gram stain smears. The clinical criteria were then comparedwith the Gram stain method. Isolation of moderate to manyGardnerella vaginalisgrowth by culturewas used as the confirmatory finding.Results:Sensitivity of the Gram stain method (91%) was significantly higher than that of theclinical criteria (46%), (sign testP= 0.0023, <0.01). The Gram stain method also has both a lowfalse-negative (4%) and high negative predictive value (96%), making it an ideal diagnostic test.Conclusion:The Gram stain method is a rapid and cost-effective test that is also highly reproducibleand readily available in many laboratories. These features make the Gram stain method amore desirable screening procedure for bacterial vaginosis in a clinic population.