Mala Rajni, Sood Seema, Kapil Arti, Gupta Somesh, Singh Neeta
Department of Microbiology, AIIMS, New Delhi, India.
Department of Dermatology and Venereology, AIIMS, New Delhi, India.
Indian J Sex Transm Dis AIDS. 2022 Jan-Jun;43(1):56-58. doi: 10.4103/ijstd.ijstd_67_21. Epub 2022 Jun 7.
Bacterial vaginosis (BV) is the most common cause of vaginal discharge (VD) in women of reproductive age group. It is marked by displacement of beneficial sp. by polymicrobial flora. BV is becoming a major public health concern as it is associated with adverse birth outcomes and increased susceptibility to sexually transmitted infections (STIs). Diagnosis of BV is currently done using clinical criteria (Amsel's) and the microbiological criteria (Nugent's scoring), the latter being the gold standard. Many out patient settings lack in microscopy facility and also skilled microbiologists, so reliance is placed on findings of clinical examination.
The aim of the study was to correlate Amsel's criteria with low (7-8) versus high (9-10) positive Nugent's scores for better understanding on utility of clinical criteria.
Patients with self-reported symptoms of vaginal discharge, genital itching were included and their pelvic examination was performed. Two swab samples were collected from lateral wall of vagina and posterior fornix and tested for BV infection using both Amsel's criteria and Nugent's score.
Of the total 125 women, 29 (23.2%) were positive for BV by Amsel's criteria, whereas 34 (27.2%) were positive by Nugent's scoring. Amsel's criteria showed a sensitivity of 100% with high Nugent's scores and 81% with low scores, thereby implying very few cases of diseased individuals being missed.
This study demonstrates the continued utility of the Clinical criteria in outpatient setting as a screening test.
细菌性阴道病（BV）是育龄期女性阴道分泌物异常（VD）最常见的原因。其特征是有益菌被多种微生物菌群所取代。由于BV与不良分娩结局及性传播感染（STIs）易感性增加相关，它正成为一个主要的公共卫生问题。目前BV的诊断采用临床标准（阿姆塞尔标准）和微生物学标准（纽金特评分），后者是金标准。许多门诊机构缺乏显微镜设备以及专业的微生物学家，因此依赖临床检查结果。
本研究的目的是将阿姆塞尔标准与纽金特评分低（7 - 8分）和高（9 - 10分）的情况进行关联，以更好地理解临床标准的实用性。
纳入有自我报告的阴道分泌物症状、生殖器瘙痒的患者并进行盆腔检查。从阴道侧壁和后穹窿采集两份拭子样本，同时使用阿姆塞尔标准和纽金特评分检测BV感染情况。
在总共125名女性中，根据阿姆塞尔标准，29名（23.2%）BV呈阳性，而根据纽金特评分，34名（27.2%）呈阳性。阿姆塞尔标准对纽金特高评分的敏感性为100%，对低评分的敏感性为81%，这意味着极少有患病个体被漏诊。
本研究证明了临床标准在门诊环境中作为筛查试验仍具有实用性。
