Comparative study of pap smear and microbiological pattern in bacterial vaginosis

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.

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

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v5i1.15814 ◽

2013 ◽

Vol 5 (1) ◽

pp. 8-11 ◽

Cited By ~ 1

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

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Study of Trichomonas Vaginalis and Bacterial Vaginosis in Pap smear at a Tertiary Health Care Centre of Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v22i1-2.29926 ◽

2020 ◽

Vol 22 (1-2) ◽

pp. 8-12

Author(s):

Rakesh Pathak ◽

P Pradhan ◽

S Pudasaini ◽

S Maharjan ◽

AS Basnyat

Keyword(s):

Bacterial Vaginosis ◽

Trichomonas Vaginalis ◽

Pap Smear ◽

Disease Diagnosis ◽

Reproductive Age ◽

Gardnerella Vaginalis ◽

Pap Smears ◽

Vaginal Infections ◽

Health Care Centre ◽

Pap Screening

Cervical-vaginal infections are common problems in women of reproductive age presented with clinical features like white vaginal discharge, foul smelling odor and pruritis. Trichomonas vaginalis, Candidia and Gardnerella vaginalis are responsible for infectious vaginitis in creating anaerobic environment favoring Bacterial vaginosis caused by organisms like Gardnerella vaginalis, Chlamydia Trachomatis. Papanicolaou (Pap) smear examination is the simple, quick, painless routine screening test used for identification and detection of precancerous changes of uterine cervix as well as the cervico-vaginal infections resulting from bacterial, fungal and candida infections. The prime objective of the study was to identify the age wise distribution of cervical-vaginal infections and determine the frequency of Trichomonas vaginalis (TV) and Bacterial vaginosis (BV). A descriptive cross-sectional study was carried out in the Department of Pathology, Nepal Medical College and Teaching Hospital, Kathmandu. A total of 163 cases of TV and BV diagnosed on Pap smear were taken for the study. However, 564 Pap smears were received in the Department of Pathology for cytological evaluation during the study period. Once the smears were stained, the presence of clue cells, cannon balls and Trichomonas were observed. Out of 564 Pap smears received during the study period, 163 cases were of BV, TV and combined BV and TV. These 163 cases were included in our study. The age ranged from 20 to 65 years with majority (19.1%) of the women belonging to 35-39 years and the mean age was 38.18 ± 10.18 years. There were 97 cases (17.2%) of BV, 50 cases (8.9%) of TV and 16 cases (2.8%) of TV and BV co-infection. Bacterial vaginosis was the most predominant type of cervicovaginal infection followed by TV infection and TV and BV co-infections. Trichomonas vaginalis may create an environment favoring the development of BV. Pap screening could be the beneficial tool in early disease diagnosis and helps in preventing further complications by starting appropriate treatment.

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Significance of Reporting Cannon Balls in Diagnosing Bacterial Vaginosis Infection in PAP Smear

Nepal Medical College Journal ◽

10.3126/nmcj.v23i2.38507 ◽

2021 ◽

Vol 23 (2) ◽

pp. 109-113

Author(s):

Kricha Pande ◽

Shraddha Koirala ◽

Astha Shrestha

Keyword(s):

Bacterial Vaginosis ◽

Pap Smear ◽

College Teaching ◽

Cross Sectional Study ◽

Gardnerella Vaginalis ◽

Pap Smears ◽

Cross Sectional ◽

Medical College ◽

The Mean ◽

One Year

Bacterial vaginosis is the most common cause of vaginitis. It is caused by depopulation of lactobacilli from the normal vaginal flora and overgrowth of Gardnerella vaginalis and other anaerobic species. Pap smear being a screening and diagnostic tool for malignancy, is equally important to diagnose infective pathology as well. This study tried to establish the significance of reporting the presence of cannon balls in Pap smears and whether their presence suggested bacterial vaginosis or not. This was a cross sectional study conducted at Nepal Medical College, Teaching Hospital (NMCTH), Kathmandu for duration of one year (January 2020 to December 2020). Pap smears were sent from gynaecology department and standard routine Pap stain was done in Pathology Department. Presence of bacterial vaginosis and cannon balls were noted. Total of 799 Pap smears were received. The mean age of bacterial vaginosis was 38.2 ± 9.6 years. The age group of 31-40 years (n=32, 39%) was most commonly affected. Bacterial vaginosis was seen in 81 pap smears out of 799 pap smears. The prevalence of bacterial vaginosis was 10.1%. Of the total of 799 cases of Pap smears, cannon balls were seen in 9.1% cases and among the bacterial vaginosis, cannon balls were seen in 48% cases. There was significant association between cannonballs and bacterial vaginosis (p < 0.0001). Thus, the present study re-enforces the fact that Pap smear is also very effective tool to diagnose bacterial vaginosis.

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

Diagnostics ◽

10.3390/diagnostics11020191 ◽

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.

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Bacterial Vaginosis and its Relation with Sociodemographic Determinants in married reproductive age females

10.53350/pjmhs211561249 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1249-1252

Author(s):

R. Mukhtar ◽

A. U.- Rehman ◽

A. Ilyas ◽

M. J. Khan ◽

R. Liaqat ◽

...

Keyword(s):

Nutritional Status ◽

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Pap Smear ◽

Reproductive Age ◽

Age Group ◽

Women Of Reproductive Age ◽

Sociodemographic Determinants ◽

Reproductive Age Group ◽

Nonspecific Inflammation

Aim: To determine the frequency of Bacterial vaginosis by pap smear cytology and find its association with its sociodemographic determinants. Study design: Cross sectional analytical study Place and duration of study: Department of Histopathology, Shaikh Zayed Hospital, Lahore from 1st January 2016 to 31st October 2016. Methodology: Two hundred and sixty pap smears of married women of reproductive age group with vaginal discharge who attended Gynecology OPD were included. Proper history regarding age, socioeconomic status, age of marriage, literacy level, smoking, and nutritional status was taken. Results: Disease prevalence was found to be 19.2%(50)in this sample of 260 while 9.1% had Candidiasis, 47%, 17.2% ,3.7%, 4.1% had Mild nonspecific inflammation, Moderate nonspecific inflammation, Moderate to severe nonspecific inflammation, and negative smears respectively. Bacterial vaginosis was associated with age, monthly income, illiteracy, early age at marriage, history of abortion and nutritional status with significant p-value ≤ 0.05. However no association was found between the disease and marital status, smoking and pallor. Conclusion: Low socioeconomic status, literacy, age >35, nutritional status is strongly related to occurrence of bacterial vaginosis in women of reproductive age group with vaginal discharge. Key Words: Bacterial vaginosis, Pap smear, Sociodemographic determinants

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

Journal of obstetrics and women s diseases ◽

10.17816/jowd66457-67 ◽

2017 ◽

Vol 66 (4) ◽

pp. 57-67 ◽

Cited By ~ 2

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.

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TO EVALUATE THE ASSOCIATION BETWEEN BACTERIAL VAGINOSIS AND HISTORY OF SPONTANEOUS ABORTION FOR PERIOD OF GESTATION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i7.1282 ◽

2020 ◽

Vol 4 (7) ◽

Author(s):

B S Meena ◽

Anita Simlot ◽

Ramesh Chandra ◽

Pratibha Sharma

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Reproductive Age ◽

Prior History ◽

Reproductive Outcome ◽

Women Of Reproductive Age ◽

Medical College ◽

Obstetrics And Gynaecology ◽

History Of ◽

Period Of Gestation

Background: Bacterial Vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of reproductive age, accounting for 40 to 50 per cent of all cases of vaginal discharge. BV is a polymicrobial disorder. Methods: Hospital based observational study. The Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur, Rajasthan. Results: In the present study 75.30% women had history of previous one abortion. Among them 25% women had BV. Women who had prior history of two or three and more than three abortions had BV in 40% and 40% proportion subsequently. Conclusion: In the present study, the author also studied the association between previous reproductive outcome and BV. No statistically significant association between history of previous one abortion and the presence of BV was found. Keywords: BV, Abortion, Reproductive outcome

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Rapid Detection of Bacterial Vaginosis (BV) by BVBlue test

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v4i1.8465 ◽

1970 ◽

Vol 4 (1) ◽

pp. 24-27

Author(s):

Shameem Akhter ◽

Humayun Satter ◽

Shirin Tarafder ◽

Ruhul Amin Miah ◽

Sohely Sharmin ◽

...

Keyword(s):

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Vaginal Swab ◽

Reproductive Age ◽

Gram Stain ◽

Clinical Criteria ◽

Healthy Control ◽

History Of ◽

Study Population ◽

Abnormal Vaginal Discharge

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and require laboratory test for diagnosis . 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. Three vaginal swab samples were taken from each case and control. These swab samples were subjected to test by conventional methods such as Amsel clinical criteria, Gram stain Nugent method, culture and by newly developed BV Blue test. The results of the BVBlue test were compared with these methods to find out the efficacy of BVBlue test. Rate of detection of bacterial vaginosis (BV) cases was 21.5% by Amsel clinical criteria, 21.0% by Gram stain Nugent method, 21.0% by culture and 22% by BVBlue test among the study population. When comparing with the conventional test and culture, BVBlue test was 100% sensitive and 98% specific. It is rapid, technically simple and is suitable for screening large number of patient in short time where laboratory facilities are not developed. Key words: Bacterial Vaginosis, BVBlue test, Nugent method, Abnormal vaginal discharge. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8465 BJMM 2011; 4(1): 24-27

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PREVALENCE OF MICROBIOTA ASSOCIATED TO VAGINAL DISCHARGE AMONG REPRODUCTIVE AGE GROUP BASED ON SOCIOECONOMIC STATUS AND DEMOGRAPHIC BACKGROUND

10.36106/ijar/6011705 ◽

2021 ◽

pp. 49-50

Author(s):

Neha Yadav ◽

Sonu Panwar

Keyword(s):

Socioeconomic Status ◽

Bacterial Vaginosis ◽

Vaginal Discharge ◽

Demographic History ◽

Tertiary Care ◽

Reproductive Age ◽

Care Hospital ◽

Women Of Reproductive Age ◽

Biochemical Tests ◽

Gram Staining

In women of reproductive age, vaginal discharge is one of the most frequent signs. Vaginal discharge may be physiological or pathological; thus, this study was conducted to ascertain the microbial diversity of vaginal discharge cases in relation to socioeconomic status and demographic history among women of reproductive age attending a tertiary care hospital. To diagnose the organism, simple wet laboratory preparation, 10% KOH, Gram staining, and pH paper were used, while to classify and categorise the pathogens, various differential agar media such as CHROM agar, Blood agar, and Sabouraud Dextrose agar were used, followed by some biochemical tests and the use of the Nugent Score. The majority of the patients were between the ages of 22 and 28. The patients were all from the lower middle class 41. (37.61 percent ). Microbial diagnosis revealed that 45 percent of patients had Bacterial Vaginosis, 41 percent had Candidiasis, 5% had Trichomoniasis, and 9% had both Bacterial Vaginosis and Candidiasis..

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Pap smear in women with leucorrhea : Experience in a tertiary medical college hospital of Bangladesh

Northern International Medical College Journal ◽

10.3329/nimcj.v9i1.35921 ◽

2018 ◽

Vol 9 (1) ◽

pp. 252-254

Author(s):

Mohammed Mustafizur Rahman ◽

Shabnam Imam ◽

Mst Sayedatun Nessa ◽

Joyosree Saha ◽

Farhana Islam ◽

...

Keyword(s):

Candida Albicans ◽

Vaginal Discharge ◽

Pap Smear ◽

Pap Smears ◽

Low Grade ◽

College Hospital ◽

Medical College ◽

Epithelial Lesions ◽

Genital Hygiene ◽

Epithelial Lesion

Background : Poor genital hygiene has been responsible for high prevalence of excessive vaginal discharge. Leucorrhoea is the clinical evidence of infection and can be treated satisfactorily whenever diagnosed. Occurrence of various cervical epithelial lesion associated with discharge can be easily prevented if detected early. Majority of the patients with various cervical epithelial lesion attending in the hospital present with varying degree of vaginal discharge and cytological cellular aberrations in the cervical epithelium.Objective : The aim of the present study is to observe the various patterns of cervical epithelial lesions in cytopathology and associated infections in patients with Leucorrhoea.Methodology : This observational study was done over a period of ten months in Popular Medical college hospitals of Bangladesh. A total of 230 cases were included in the study with women of age range 15-45 years, complaining of leucorrhoea. After a thorough vaginal examination Pap smears were taken and immediately fixed in absolute alcohol and stained according to the papanicolaous technique. The cytopathological changes observed in the cervical smears were graded according to the Bethesda system for reporting cervical cytology.Results : Out of 230 cases the cytological patterns were found Normal in 4 (1.7%), Inflammatory 204 (88.3%), Low grade squamous intraepithelial (LSIL)10 (4.8%), High grade squamous intraepithelial (HSIL) 6(2.6%), Atypical squamous cells of undetermined significance (ASCUS) 6 (2.6%) and the distribution of different types of pathogens detected were Trichomonas 33 (70.62%), Candida albicans 19 (40.66%).Conclusion : In this study significant numbers of Leucorrhoea patients were detected with cervical squamous intraepithelial lesions (SIL) in which LSIL (Low grade squamous intraepithelial) was higher. Associated infections were Trichomonas and Candida albicans. Therefore cytological screening for early detection of cervical squamous intraepithelial lesion is essential routine medical examination for Leucorrhoea patients in gynaecological practice.Northern International Medical College Journal Vol.9(1) July 2017: 252-254

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