Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method

Background/Aim. Bacterial vaginosis (BV) is a common cause of vaginal discomfort in women. The aim of this study was to compare Nugent’s scoring system and novel microscopy method, introduced in our laboratory and used in BV diagnosis. Methods. This study included 705 pregnant and asymptomatic women...

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Main Authors: Nenadić Dane, Ribis Snežana, Pavlović Miloš, Baskić Dejan
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2022-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000105N.pdf
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author Nenadić Dane
Ribis Snežana
Pavlović Miloš
Baskić Dejan
author_facet Nenadić Dane
Ribis Snežana
Pavlović Miloš
Baskić Dejan
author_sort Nenadić Dane
collection DOAJ
description Background/Aim. Bacterial vaginosis (BV) is a common cause of vaginal discomfort in women. The aim of this study was to compare Nugent’s scoring system and novel microscopy method, introduced in our laboratory and used in BV diagnosis. Methods. This study included 705 pregnant and asymptomatic women between 24 and 28 weeks of pregnancy. The degree of agreement between methods was determined by the kappa (κ) index. The sensitivity, specificity, positive and negative predictive value of the novel microscopy method was compared to Nugent’s score as standard. Results. Based on the scoring system of both methods, Nugent’s and novel microscopy method, BV was diagnosed in 21% and 25% of women, respectively. Despite the disparities among diagnostic criteria, which mainly concerned classification of intermediary samples, the degree of agreement between categories, determined by κ index, was satisfactory: Nugent’s vs. novel microscopy method (κ = 0.68; good agreement), and Nugent’s vs. novel microscopy method without intermediary results (κ = 0.83; very good agreement). We also demonstrated that compared to Nugent’s method, as the golden standard, the novel microscopy method had high sensitivity and specificity (ranging from 75%–99.3%) and positive and negative predictive values (ranging from 88.8%–99.5%). Our method is based on a relative number of bacterial morphotypes, either rod forms (˃ 1.5 μm, lactobacilli) or non-rod forms (< 1.5 μm, bacterial vaginosis associated bacteria) under 200× magnification, which extends the surface of examined preparation, but without prolongation of observer’s working time. Conclusion. The novel microscopy method in diagnosing BV corresponded well with Nugent’s scoring system which allows it to be an alternative method in diagnosing BV. Further-more, the novel microscopy method is based on a relative number of bacterial morphotypes that appeared to be flexible and can be reorganized in the way to categorize findings into only two groups: normal and BV, which makes it comparable to dichotomous Amsel’s clinical criterion.
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publishDate 2022-01-01
publisher Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
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series Vojnosanitetski Pregled
spelling doaj-art-81aafec6544a453682bd3b86c8e8704a2025-08-20T02:08:27ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202022-01-0179326427110.2298/VSP200405105N0042-84502000105NDiagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic methodNenadić Dane0Ribis Snežana1Pavlović Miloš2Baskić Dejan3https://orcid.org/0000-0002-6152-0742Military Medical Academy, Department of Gynecology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity Clinical Center of Kragujevac, Department of Microbiology, Kragujevac, SerbiaInfinity Family Medicine Clinic, Dubai, UAEUniversity of Kragujevac, Faculty of Medical Sciences, Center for Molecular Medicine and Stem Cell Research, Kragujevac, Serbia Background/Aim. Bacterial vaginosis (BV) is a common cause of vaginal discomfort in women. The aim of this study was to compare Nugent’s scoring system and novel microscopy method, introduced in our laboratory and used in BV diagnosis. Methods. This study included 705 pregnant and asymptomatic women between 24 and 28 weeks of pregnancy. The degree of agreement between methods was determined by the kappa (κ) index. The sensitivity, specificity, positive and negative predictive value of the novel microscopy method was compared to Nugent’s score as standard. Results. Based on the scoring system of both methods, Nugent’s and novel microscopy method, BV was diagnosed in 21% and 25% of women, respectively. Despite the disparities among diagnostic criteria, which mainly concerned classification of intermediary samples, the degree of agreement between categories, determined by κ index, was satisfactory: Nugent’s vs. novel microscopy method (κ = 0.68; good agreement), and Nugent’s vs. novel microscopy method without intermediary results (κ = 0.83; very good agreement). We also demonstrated that compared to Nugent’s method, as the golden standard, the novel microscopy method had high sensitivity and specificity (ranging from 75%–99.3%) and positive and negative predictive values (ranging from 88.8%–99.5%). Our method is based on a relative number of bacterial morphotypes, either rod forms (˃ 1.5 μm, lactobacilli) or non-rod forms (< 1.5 μm, bacterial vaginosis associated bacteria) under 200× magnification, which extends the surface of examined preparation, but without prolongation of observer’s working time. Conclusion. The novel microscopy method in diagnosing BV corresponded well with Nugent’s scoring system which allows it to be an alternative method in diagnosing BV. Further-more, the novel microscopy method is based on a relative number of bacterial morphotypes that appeared to be flexible and can be reorganized in the way to categorize findings into only two groups: normal and BV, which makes it comparable to dichotomous Amsel’s clinical criterion.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000105N.pdfdiagnosismicroscopyvaginal smearsvaginosis, bacterial
spellingShingle Nenadić Dane
Ribis Snežana
Pavlović Miloš
Baskić Dejan
Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
Vojnosanitetski Pregled
diagnosis
microscopy
vaginal smears
vaginosis, bacterial
title Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
title_full Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
title_fullStr Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
title_full_unstemmed Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
title_short Diagnosis of bacterial vaginosis: Comparison of Nugent´s and novel microscopic method
title_sort diagnosis of bacterial vaginosis comparison of nugent´s and novel microscopic method
topic diagnosis
microscopy
vaginal smears
vaginosis, bacterial
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000105N.pdf
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AT baskicdejan diagnosisofbacterialvaginosiscomparisonofnugentsandnovelmicroscopicmethod