Libman Michael D, Kramer Michael, Platt Robert
Department of Microbiology, McGill University, Montreal, Quebec, H3G 1A4, Canada.
Diagn Microbiol Infect Dis. 2006 Mar;54(3):197-201. doi: 10.1016/j.diagmicrobio.2005.09.017. Epub 2006 Jan 19.
Bacterial vaginosis (BV) is commonly diagnosed by using the Nugent score, a semiquantitative scoring system to evaluate bacterial morphotypes on Gram stain of vaginal secretions. Some authors have suggested using the Kopeloff modification of the Gram stain. Asymptomatic BV in pregnancy has been associated with adverse outcomes. We performed both stains on simultaneously collected vaginal smears from 2652 women at 24-26 weeks of gestation. Gram staining gave significantly higher (more abnormal) Nugent scores than Kopeloff staining. Compared to the Kopeloff stain, the number of specimens graded as indeterminate or consistent with BV by Gram stain increased by 29% (469 versus 364, P<.001). Interrater reliability of the Nugent score (n=413) for Kopeloff staining was significantly better than Gram staining (agreement=74% versus 63%, intraclass correlation coefficient=0.87 versus 0.79, P<.05, 95% confidence intervals 0.85-0.89 and 0.75-0.82, respectively).
细菌性阴道病（BV）通常采用 Nugent 评分进行诊断，这是一种半定量评分系统，用于评估阴道分泌物革兰氏染色后的细菌形态类型。一些作者建议使用革兰氏染色的 Kopeloff 改良法。妊娠期间的无症状 BV 与不良结局相关。我们对 2652 名妊娠 24 - 26 周的女性同时采集的阴道涂片进行了两种染色。革兰氏染色给出的 Nugent 评分显著更高（更异常），高于 Kopeloff 染色。与 Kopeloff 染色相比，革兰氏染色判定为不确定或符合 BV 的标本数量增加了 29%（469 例对 364 例，P <.001）。Kopeloff 染色的 Nugent 评分（n = 413）的评分者间可靠性显著优于革兰氏染色（一致性分别为 74%对 63%，组内相关系数分别为 0.87 对 0.79，P <.05，95%置信区间分别为 0.85 - 0.89 和 0.75 - 0.82）。
