Hoffman Matthew K, Bellad Mrutyunjaya B, Charantimath Umesh S, Kavi Avinash, Nagmoti Jyoti M, Nagmoti Mahantesh B, Mallapur Ashalata A, Katageri Geetanjali M, Ramadurg Umesh Y, Bannale Sheshidhar G, Revankar Amit P, Ganachari M S, Derman Richard J, Goudar Shivaprasad S
Department of Obstetrics & Gynecology, Christiana Care Health System, Newark, DE, USA.
KLE University Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Infect Dis Obstet Gynecol. 2017;2017:1040984. doi: 10.1155/2017/1040984. Epub 2017 Feb 15.
. A Nugent score > 7 has been defined as the gold standard for the diagnosis for bacterial vaginosis (BV), though it is resource intensive and impractical as point of care testing. We sought to determine if colorimetric assessment of vaginal pH can accurately predict the occurrence of BV. . We performed a planned subanalysis of 1,216 pregnant women between 13 0/7 and 19 6/7 weeks who underwent vaginal examination as part of a randomized controlled trial. Using a standardized technique, specimens were obtained for colorimetric assessment and two separate slides for Gram staining. These slides were subsequently evaluated by two independent blinded microbiologists for Nugent scoring. . Interrater reliability of the interpretation of the Nugent score was excellent (intraclass correlation-individual 0.93 (95 CI 0.92 to 0.94) and average 0.96 (95% CI 0.95 to 0.97)). The sensitivity of an elevated pH > 5 for a Nugent score > 7 was 21.9% while the specificity was 84.5%. The positive predictive value in our population was 33.7% with a negative predictive value of 75.0%. . Though the Nugent score is internally accurate, the prediction of BV using vaginal pH alone has poor sensitivity and specificity.
Nugent评分>7已被定义为细菌性阴道病（BV）诊断的金标准，尽管它资源消耗大且作为即时检测不切实际。我们试图确定阴道pH值的比色评估是否能准确预测BV的发生。我们对1216名孕13 0/7至19 6/7周的孕妇进行了一项计划中的亚分析，这些孕妇作为一项随机对照试验的一部分接受了阴道检查。使用标准化技术，获取标本进行比色评估，并制备两张单独的玻片用于革兰氏染色。随后，两名独立的盲法微生物学家对这些玻片进行Nugent评分评估。Nugent评分解读的评分者间信度极佳（组内相关系数——个体为0.93（95%CI 0.92至0.94），平均为0.96（95%CI 0.95至0.97））。pH>5对Nugent评分>7的敏感性为21.9%，而特异性为84.5%。在我们的研究人群中，阳性预测值为33.7%，阴性预测值为75.0%。尽管Nugent评分在内部是准确的，但仅使用阴道pH值预测BV的敏感性和特异性较差。
