Tam M T, Yungbluth M, Myles T
Department of Obstetrics and Gynecology, St. Joseph Hospital, Chicago, IL, USA.
Infect Dis Obstet Gynecol. 1998;6(5):204-8. doi: 10.1002/(SICI)1098-0997(1998)6:5<204::AID-IDOG3>3.0.CO;2-R.
The purpose of the study is to determine whether the Gram stain method is superior to the clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen in a resident clinic setting. The clinical criteria is the current diagnostic method employed to diagnose bacterial vaginosis.
In this study, 51 pregnant women with vaginal discharge were prospectively evaluated. All were screened using the clinical criteria, Gram stain method, and culture of the discharge. 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 compared with the Gram stain method. Isolation of moderate to many Gardnerella vaginalis growth by culture was used as the confirmatory finding.
Sensitivity of the Gram stain method (91%) was significantly higher than that of the clinical criteria (46%), (sign test P = 0.0023, < 0.01). The Gram stain method also has both a low false-negative (4%) and high negative predictive value (96%), making it an ideal diagnostic test.
The Gram stain method is a rapid and cost-effective test that is also highly reproducible and readily available in many laboratories. These features make the Gram stain method a more desirable screening procedure for bacterial vaginosis in a clinic population.
本研究旨在确定革兰氏染色法在诊断居民诊所中低收入孕妇细菌性阴道病方面是否优于临床诊断标准。临床诊断标准是目前用于诊断细菌性阴道病的方法。
在本研究中，对51名有阴道分泌物的孕妇进行了前瞻性评估。所有孕妇均采用临床诊断标准、革兰氏染色法和分泌物培养进行筛查。在解读革兰氏染色涂片时采用了Nugent等人（《临床微生物学杂志》29:297 - 301, 1991）制定的改良评分系统。然后将临床诊断标准与革兰氏染色法进行比较。通过培养分离出中度至大量阴道加德纳菌生长作为确诊依据。
革兰氏染色法的敏感性（91%）显著高于临床诊断标准（46%），（符号检验P = 0.0023，<0.01）。革兰氏染色法还具有低假阴性率（4%）和高阴性预测值（96%），使其成为理想的诊断测试。
革兰氏染色法是一种快速且经济高效的检测方法，具有高度可重复性，并且在许多实验室都易于获得。这些特性使革兰氏染色法成为诊所人群中细菌性阴道病更理想的筛查程序。
