Campisciano Giuseppina, Zanotta Nunzia, Petix Vincenzo, Giangreco Manuela, Ricci Giuseppe, Maso Gianpaolo, Comar Manola, De Seta Francesco
Advanced Laboratory of Translational Microbiology, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo"-Via dell'Istria 65, 34137 Trieste, Italy.
Institute for Maternal and Child Health-IRCCS "Burlo Garofolo"-Via dell'Istria 65/1, 34137 Trieste, Italy.
Diagnostics (Basel). 2021 Jan 28;11(2):191. doi: 10.3390/diagnostics11020191.
Bacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermediate microbiota, raising the problem of how to clinically handle it. We retrospectively analyzed cervicovaginal swabs from 985 immunocompetent non-pregnant symptomaticspp. women (vaginal discharge, burning, itching) by Nugent score and qPCR for BV, aerobic or fungal vaginitis, and STIs ( spp., , , and ). Nugent scores 0-3 and 7-10 were confirmed in 99.3% and 89.7% cases, respectively, by qPCR. Among Nugent scores 4-6 (partial BV), qPCR identified 46.1% of BV cases, with 37.3% of cases negative for BV, and only 16.7% of partial BV. Gram staining and qPCR were discordant ( value = 0.0001) mainly in the partial BV. Among the qPCR BV cases, the presence of aerobic vaginitis and STIs was identified, with a significant association ( < 0.0001) between the STIs and partial BV/overt BV. qPCR is more informative and accurate, and its use as an alternative or in combination with Gram staining could help clinicians in having an overview of the complex vaginal microbiota and in the interpretation of partial BV that can correspond to vaginitis and/or STIs.
细菌性阴道病（BV）影响着三分之一的育龄妇女，增加了获得性传播感染（STIs）的风险，并对生殖健康构成威胁。目前通过革兰氏染色（ Nugent评分）进行的诊断确定了一个名为部分BV或中间微生物群的过渡阶段，这就引发了如何在临床上处理它的问题。我们通过Nugent评分和qPCR对985名具有免疫能力的非妊娠有症状（阴道分泌物、烧灼感、瘙痒）妇女的宫颈阴道拭子进行回顾性分析，以检测BV、需氧菌或真菌性阴道炎以及性传播感染（ 、 、 、 和 ）。通过qPCR分别在99.3%和89.7%的病例中确认了Nugent评分为0 - 3分和7 - 10分的情况。在Nugent评分为4 - 6分（部分BV）的病例中，qPCR鉴定出46.1%的BV病例，37.3%的病例BV检测为阴性，只有16.7%为部分BV。革兰氏染色和qPCR主要在部分BV中不一致（ 值 = 0.0001）。在qPCR检测出BV的病例中，发现了需氧菌性阴道炎和性传播感染的存在，性传播感染与部分BV/显性BV之间存在显著关联（ < 0.0001）。qPCR提供的信息更多且更准确，将其作为革兰氏染色的替代方法或与之联合使用，有助于临床医生全面了解复杂的阴道微生物群，并对可能与阴道炎和/或性传播感染相关的部分BV进行解读。
