scholarly journals Criteria for diagnosis of bacterial vaginosis using the test Femoflor-16

2017 ◽  
Vol 66 (4) ◽  
pp. 57-67 ◽  
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Ekaterina N. Gerasimova ◽  
Alevtina M. Savicheva
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Bacterial Load ◽  
Anaerobic Bacteria ◽  
Microscopic Investigation ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Adverse Pregnancy ◽  
Amsel Criteria

Background. Bacterial vaginosis is disturbance of the balance of the vaginal microflora, associated with a number of infectious diseases of the urogenital tract and adverse pregnancy outcomes. In this country, for the detection of vaginal dysbiotic conditions, the test Femoflor-16 (DNA-Technology, Moscow) is widely used, however interpretation algorithms of this test do not include the category of BV. Aim. The study aimed to elaborate diagnostic criteria for the detection of BV using Femoflor-16 test. Materials and methods. Women of reproductive age addressing a gynecologist with vaginal discharge were enrolled in the study. For clinical diagnosis of BV, the Amsel criteria were used, laboratory analysis for BV was performed via microscopic investigation of vaginal discharge using the Nugent score. Samples of vaginal discharge from all women were analyzed with the test Femoflor-16, intended for characterizing vaginal microbiocenosis using multiplex quantitative real-time PCR. Results. A total of 280 women were included in the study. BV was diagnosed in 86 women (31%) using the Amsel criteria, and in 81 women (29%) using the Nugent score. All groups of anaerobic bacteria included in Femoflor-16 test were shown to be associated with BV, with the exception of bacteria of the genus Mobiluncus, which are detected together with phylogenetically related but not BV-associated bacteria of the genus Corynebacterium. A low amount of lactobacilli (< 10% of total bacterial load) coupled with an elevated amount of Gardnerella vaginalis/Prevotella bivia/Porphyromonas (> 1%) and/or Eubacterium (> 2%) and/or Sneathia/Leptotrichia/Fusobacterium (> 0.1%) and/or Megasphaera/Veillonella/Dialister (> 0.1%) and/or Lachnobacterium/Clostridium (> 0.1%) and/or Peptostreptococcus (> 0.1%) and/or Atopobium vaginae (> 0.2%) detected BV with a sensitivity of 99% and specificity of 93%. Conclusions. Criteria for BV diagnosis using the test Femoflor-16 have been elaborated, which enable to detect BV or exclude it with a sensitivity of 99% and specificity of 93%. These criteria for BV and criteria of the test manufacturers for severe anaerobic dysbiosis determine to a large extent the same category of the vaginal microbiocenosis.

scholarly journals Bacterial communities forming the vaginal micro-ecosystem in norm and in bacterial vaginosis

2017 ◽  
Vol 66 (6) ◽  
pp. 30-43
Author(s):  
Veronika V. Nazarova ◽  
Elena V. Shipitsyna ◽  
Kira V. Shalepo ◽  
Alevtina M. Savicheva
Keyword(s):  
Cluster Analysis ◽  
Bacterial Vaginosis ◽  
Bacterial Communities ◽  
Wide Spectrum ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Nugent Score ◽  
Facultative Anaerobes ◽  
Normal Microflora ◽  
Cluster 2

Background. Bacterial vaginosis (BV) is disturbance of the vaginal microbiota, characterized by displacement of lactobacilli with anaerobic bacteria and capable of adversely affecting women’s reproductive health. In the development of BV, a wide spectrum of bacteria substantially differing in their properties is involved. Grouping vaginal bacterial communities into clusters, or types of microbiocenosis, might contribute to understanding of pathogenic mechanisms and elaboration of effective tools for diagnostics and therapy of the disease. Aim. Determination and comparative analysis of clusters of vaginal bacterial communities in norm and in BV. Materials and methods. Women of reproductive age were enrolled in the study. For the diagnosis of BV, the Nugent score was used. Vaginal swab samples from all women were analyzed with the test Femoflor-16, intended for evaluation of the vaginal microbiocenosis using multiplex quantitative real-time PCR. Two-step cluster analysis was applied for grouping bacterial communities. Differences between the clusters were evaluated using pairwise comparisons. Results. Of 280 women enrolled in the study, 172 had normal microflora, 27 – intermediate microflora, 81 – BV. In cluster analysis, 270 samples valid in PCR testing were included. All the vaginal bacterial communities were grouped into 4 clusters. Cluster 1 (n = 171) included cases when the vaginal microflora consisted mostly of lactobacilli. Cluster 2 (n = 11) encompassed cases of domination of aerobic microflora: Enterobacteriaceae, Streptococcus and Staphylococcus. Clusters 3 (n = 57) and 4 (n = 31) were connected with BV and included cases of prevailing of facultative anaerobes (Gardnerella vaginalis, Atopobium vaginae) and obligate anaerobes (Sneathia/Leptotrichia/Fusobacterium, Megasphaera/Veillonella/Dialister, Lachnobacterium/Clostridium), respectively. Nearly all cases of cluster 1 belonged to the category of normal microflora of the Nugent score. The majority of bacterial communities of cluster 2 matched intermediate microflora, cluster 3 – BV category with a score of 7 or 8, cluster 4 – BV category with a score of 9 or 10. The clusters differed significantly in vaginal рН, with the highest values observed for cluster 4. Conclusions. Vaginal bacterial communities are grouped into 4 main clusters, characterized by domination of lactobacilli, aerobes, facultative anaerobes or obligate anaerobes. The clusters belong to different categories of the Nugent score and differ significantly in vaginal pH.

Isolation, identification and susceptibility pattern of Gardnerella vaginalis in bacterial vaginosis

2013 ◽  
Vol 5 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Shameem Akhter ◽  
Humayun Sattar ◽  
Ruhul Amin Miah ◽  
Ahmed Abu Saleh ◽  
Sharmeen Ahmed ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Vaginal Swab ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Gram Stain ◽  
Healthy Control ◽  
History Of ◽  
Abnormal Vaginal Discharge ◽  
And Control

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age. A total 200 women aged 15- 45 years with history of abnormal vaginal discharge were included as study population. Fifty women without such history of discharge were taken as healthy control. Two vaginal swab samples were taken from each case and control. These swab samples were subjected to test by Gram stain (Nugent method) and culture. 21.5 % of the cases were diagnosed as bacterial vaginosis by Gram stain (Nugent method) and 21 % by culture. Clindamycin was susceptible to G. vaginalis in (90.5%) followed by metronidazol (76.1 %), chloramphenicol (71.4 %) and erythromycin (66.7 %). Out of 50 cases of recurrent bacterial vaginosis, G. vaginalis was isolated from 15 (30 %) cases, of which 5 (33.3 %) were sensitive and 10 (66.7 %) were resistant to metronidazol, while all 15 cases were sensitive to clindamycin.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15814 Bangladesh J Med Microbiol 2011; 05 (01): 8-11

scholarly journals Comparative study of pap smear and microbiological pattern in bacterial vaginosis

2018 ◽  
Vol 7 (3) ◽  
pp. 1039
Author(s):  
Girishma J. ◽  
Rupakala B. M. ◽  
Sunil Chavan
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Pap Smear ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Gram Stain ◽  
Medical College ◽  
Gram Staining ◽  
Gynecology And Obstetrics

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.

scholarly journals Microbiological, behavioral and anamnestic predictor factors of bacterial vaginosis in women with vaginal discharge

2016 ◽  
Vol 65 (3) ◽  
pp. 32-42
Author(s):  
Elena V Shipitsyna ◽  
Tatyana A Khusnutdinova ◽  
Olga S Ryzhkova ◽  
Anna A Krysanova ◽  
Olga V Budilovskaya ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Modes Of Transmission ◽  
Vaginal Microflora ◽  
Normal Microflora ◽  
Clinically Significant ◽  
Predictor Factors

Introduction. Bacterial vaginosis (BV) is the primary cause of pathological vaginal discharge in women of reproductive age. Gardnerella vaginalis and Atopobium vaginae are considered key components of the vaginal microflora in BV. Etiology, pathogenesis and modes of transmission of BV are actively studied, however these questions still remain unanswered. Objective: investigate predictor factors of BV in women with vaginal discharge. Material and methods. In total, 318 women were included. As clinical material, vaginal samples were used. BV was diagnosed using the Nugent method. For quantitative determination of G. vaginalis and A. vaginae DNA, real-time PCR was used. Behavioral and anamnestic data were obtained from questionnaire filled out by the patients. Results. BV was diagnosed in 27 % of women. G. vaginalis and A. vaginae DNA was detected, respectively, in 93 % and 83 % of patients with BV, 73 % and 59 % - with intermediate microflora, 52 % and 38 % - with normal microflora. Difference between the three types of microflora in the frequency and concentrations of these microorganisms were statistically significant. Detection of G. vaginalis and A. vaginae were significant predictor factors of BV (OR 12.2; 95 % CI 5.1-29.4 and OR 7.9; 95 % CI 4.2-14.9, respectively), with chances to diagnose BV being manifold increased when clinically significant concentrations of these bacteria were detected (≥3×106 and ≥8×105 DNA copies/ml for G. vaginalis and A. vaginae, respectively). Detection of clue cells in Gram stained preparations was shown to be the strongest BV predictor (OR 765.6; 95 % CI 99.6-5883.2). Conclusions. BV is diagnosed in more than one fourth of women with vaginal discharge. Detection of G. vaginalis and A. vaginae, especially in clinically significant concentrations, and clue cells in Gram stained preparations are significant predictor factors of BV.

scholarly journals Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 191
Author(s):  
Giuseppina Campisciano ◽  
Nunzia Zanotta ◽  
Vincenzo Petix ◽  
Manuela Giangreco ◽  
Giuseppe Ricci ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Reproductive Age ◽  
P Value ◽  
Gram Stain ◽  
Aerobic Vaginitis ◽  
Nugent Score ◽  
Sexually Transmitted ◽  
Gram Staining ◽  
Reproductive Age Women

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 (Mycoplasmas spp., Chlamydia t., Trichomonas v., and Neisseria g.). 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 (p 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 (p < 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.

scholarly journals Importance of Isolation and Biotypization of Gardnerella Vaginalis in Diagnosis of Bacterial Vaginosis

2008 ◽  
Vol 8 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Fatima Numanović ◽  
Mirsada Hukić ◽  
Mahmud Nurkić ◽  
Merima Gegić ◽  
Zineta Delibegović ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Natural Habitat ◽  
Anaerobic Bacteria ◽  
Clinical Signs ◽  
Gardnerella Vaginalis ◽  
Subjective Symptoms ◽  
Vaginal Infection ◽  
Vaginal Secretion ◽  
Aerobic And Anaerobic ◽  
Amsel Criteria

The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13,5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20,5% of women with subjective problems of vaginal infection, and in 48,80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2,58% of cases it was solitary, while in 1,28% it was found in combination with other aerobic and anaerobic bacteria and, in 1,28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0,05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2,58% cases. Following Benit biotype scheme, biotypes IVa, IVc and Ilc were identified in 12,90% cases, while biotypes Illa, IIa, Ia, IVb, IIb were found in 6,45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.

An update on the role of Atopobium vaginae in bacterial vaginosis: what to consider when choosing a treatment?

2020 ◽  
Vol 19 (4) ◽  
pp. 138-144
Author(s):  
Werner Mendling ◽  
◽  
Ana Palmeira‑de‑Oliveira ◽  
Stephan Biber ◽  
Valdas Prasauskas ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Treatment Options ◽  
Anaerobic Bacteria ◽  
Scientific Data ◽  
Bacterial Biofilm ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Dequalinium Chloride ◽  
Facultative Anaerobic Bacteria ◽  
Atopobium Vaginae

Introduction. Bacterial vaginosis (BV) is the most common vaginal disorder in reproductive-age women. The condition is characterised by the replacement of a healthy, lactobacilli-dominated vaginal microbiota by anaerobic and facultative anaerobic bacteria. BV increases the risk of acquisition of STIs and is associated with pregnancy complications. Although the composition of the bacteria in BV varies between individuals, there are some species such as Gardnerella, Atopobium, Mycoplasma, Snethia, Megasphera, Dialister, etc., that are found most frequently. Material and methods. Literature research to the importance of Atopobium vaginae in BV and treatment options. Results. Atopobium (A.) vaginae is an important component of the complex abnormal vaginal flora in BV; even though A. vaginae, like Gardnerella vaginalis, has also been detected in the normal flora, it is much more common in BV patients. A. vaginae has been shown to play an important role in the pathophysiology of BV and is thought to be at least a partial cause of the known negative sequelae. The presence of A. vaginae in the BV-associated biofilms and its resistance to some antimicrobial substances has been described – this seems to have a major impact on treatment outcome. Conclusion. Current scientific data demonstrate that dequalinium chloride (Fluomycin®) is one of the valid therapeutic options for BV treatment, since it displays a broad antimicrobial spectrum against relevant vaginal pathogens, especially against G. vaginalis and A. vaginae, without having safety concerns. Key words: Bacterial vaginosis, Bacterial biofilm, Atopobium vaginae, Metronidazole, Clindamycin, Dequalinium chloride, Microbial resistance

scholarly journals Study on bacterial vaginosis in pregnant women and associated factors on maternal and fetal outcome

2019 ◽  
Vol 8 (9) ◽  
pp. 3459
Author(s):  
Chitti Sudha A. ◽  
G. Kanthi Teja
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Adverse Pregnancy Outcome ◽  
Anaerobic Bacteria ◽  
Fetal Outcome ◽  
Routine Screening ◽  
Gardnerella Vaginalis ◽  
Multiple Sexual Partners ◽  
Clinical Criteria ◽  
Adverse Pregnancy

Background: Bacterial vaginosis (BV) is a condition in which the normal, lactobacillus-predominant vaginal flora is replaced with anaerobic bacteria, gardnerella vaginalis and mycoplasma hominis1. It is one cause of vaginitis among pregnant and non-pregnant women and an extremely prevalent vaginal condition.Methods: The present study was conducted on all antenatal women attending OPD satisfying the inclusion criteria was taken during the study period 1st October 2012 to 30th June 2014 in GSL General Hospital, Rajahmundry was examined for bacterial vaginosis using Nugent score. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth was collected. BV was detected by both Gramstain (Nugent criteria) and gold standard clinical criteria (Amsel’s composite criteria).Results: In this study bacterial vaginosis is seen in 313 cases of educated women (62.6%) as most of them have got primary education and 187 (37.4%) cases are uneducated. In this study, symptomatic bacterial vaginosis is more common in multigravida (Bladder -23; Discharge -50) 73 (22%) when compared with primigravida 11 (6.5%) probably because of longer period of marital life. In this study antenatal risk factors like previous IUCD (4.2%) use, H/O STD’s (1.4%), husband having h/o of multiple sexual partners (1.8%) are 7.4%.No cases of smoking, alcohol, drug abuse, douching were reported.Conclusions: Both primigravida and multigravida asymptomatic cases are more when compared to symptomatic cases leading to the need for routine screening. Routine screening of antenatal women resulted in the decrease of adverse pregnancy outcome.

scholarly journals Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania

2021 ◽  
Vol 21 (2) ◽  
pp. 531-537
Author(s):  
Mtebe V Majigo ◽  
Paschal Kashindye ◽  
Zachariah Mtulo ◽  
Agricola Joachim
Keyword(s):  
Bacterial Vaginosis ◽  
Low Income ◽  
Vaginal Discharge ◽  
Dar Es Salaam ◽  
Referral Hospital ◽  
Reproductive Age ◽  
Low Income Countries ◽  
Vaginal Infection ◽  
Vaginal Infections ◽  
Regional Referral Hospital

Background: Pathological vaginal discharge is a common complaint of women in reproductive age worldwide caused by various agents. The prevalence and etiologic agents vary depending on the population studied. Management of vaginal discharge in low-income countries, typically depend on the syndromic approach, which limits understanding the specific causative agents. We determined the proportion of bacterial vaginosis, candidiasis, and trichomoniasis among women with vaginal discharge at a regional referral hospital in Dar es Salaam, Tanzania. Methods: We conducted a cross-sectional study between June and August of 2017 among nonpregnant women at Amana Regional Referral Hospital. Experienced staff performed physical examination to establish a clinical diagnosis, and collection of the high vaginal swab for microscopic examination. Descriptive statistics were performed to assess the characteristics of study participants and the proportion of vaginal infections. Results: A total of 196 samples were collected, of all, 128 (65.3%) had either bacterial vaginosis, candidiasis, or trichomo- niasis. Bacterial vaginosis was the leading infection at 33.2%, followed by candidiasis (19.4%) and trichomoniasis (13.3%). Laboratory confirmed vaginal infection were generally found more in age below 25, unmarried, and those employed or petty business. Conclusion: The proportion of bacterial vaginosis in women with vaginal discharge was relatively higher than others, and the presence of vaginal infection relate to socio-demographic characteristics. Further advanced studies are needed to understand the potential role of aetiologic agents in causing vaginal infections. Keywords: Bacterial vaginosis; vaginal discharge; genital infection.

Sign in / Sign up

Export Citation Format

Share Document