HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gutman, R. E. Articles by Blume, J. Search for Related Content PubMed PubMed Citation Articles by Gutman, R. E. Articles by Blume, J. Related Collections General gynecology Infectious disease

Evaluation of Clinical Methods for Diagnosing Bacterial Vaginosis

Robert E. Gutman, MD^*, Jeffrey F. Peipert, MD, MPH^*, Sherry Weitzen, PhD^* and Jeffrey Blume, PhD^*

From the *Division of Research, Department of Obstetrics and Gynecology, Women & Infants Hospital, and the Center for Statistical Sciences, Brown University, Medical School, Providence, Rhode Island.

Address reprint requests to: Address correspondence to: Robert E. Gutman, MD, 4940 Eastern Avenue, Room 125, Baltimore, MD 21224-2780; e-mail: rgutman1{at}jhmi.edu.

OBJECTIVE: To determine whether the current clinical criteria for diagnosing bacterial vaginosis can be simplified by using 2 clinical criteria rather than the standard 3 of 4 criteria (Amsel's criteria).

METHODS: This was a prospective observational study of 269 women undergoing a vaginal examination in the Women's Primary Care Center, Division of Research, or Colposcopy Clinic at Women & Infants Hospital. All 4 clinical criteria for diagnosing bacterial vaginosis were collected, and Gram stain was used as the gold standard. Sensitivity and specificity were calculated for each individual criterion, combinations of criteria, and a colorimetric pH and amine card. Receiver operating characteristic curve was generated to estimate the preferred pH and percentage of clue cells for diagnosing bacterial vaginosis.

RESULTS: The prevalence of bacterial vaginosis in our study population was 38.7%. Vaginal pH was the most sensitive of all the criteria, at 89%, and a positive amine odor was the individual criteria with the highest specificity, at 93%. Similar specificity was seen with combinations of 2 criteria and Amsel's criteria. Receiver operating characteristic curve analysis yielded a preferred pH and percentage of clue cells of 5.0 and 20%, respectively. However, a pH of 4.5 or greater improves sensitivity with minimal loss of specificity.

CONCLUSION: The clinical criteria for diagnosing bacterial vaginosis can be simplified to 2 clinical criteria without loss of sensitivity and specificity.

LEVEL OF EVIDENCE: II-2

This article has been cited by other articles:

				A. Swidsinski, W. Mendling, V. Loening-Baucke, A. Ladhoff, S. Swidsinski, L. P. Hale, and H. Lochs Adherent Biofilms in Bacterial Vaginosis Obstet. Gynecol., November 1, 2005; 106(5): 1013 - 1023. [Abstract] [Full Text] [PDF]