Materiały źródłowe

• #1 The laboratory diagnosis of bacterial vaginosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095014/

  Bacterial vaginosis (BV) is an extremely common health problem for women. […] Diagnostic tests include real-time clinical/microbiological diagnosis, and the current gold standard, the standardized evaluation of morphotypes on Gram stain analysis. […] The diagnosis of BV has been problematic due to its complex polymicrobial nature. […] The most widely accepted clinical criteria are 'Amsel’s criteria’. […] For the laboratory testing method, the preferred specimen is an unfixed vaginal smear sent to the laboratory to be Gram stained by standard methods. […] A score of zero to three is considered to be normal, four to six is considered intermediate, and seven to ten is defined as BV. […] The decision to recheck or treat is based on the clinical risk of proceeding to BV. […] There have been alternative diagnostic methods suggested, but none are currently better than the standardized Gram stain methodology. […] In summary, the most useful current diagnostic method is the vaginal Gram stain.

• #2 Bacterial Vaginosis (BV) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/vaginitis-cervicitis-and-pelvic-inflammatory-disease/bacterial-vaginosis-bv

  Bacterial vaginosis is a dysbiosis, a complex alteration of vaginal flora, in which lactobacilli decrease and anaerobic pathogens overgrow. […] Diagnosis is confirmed by evaluation of vaginal secretions. […] For bacterial vaginosis to be diagnosed, 3 of 4 criteria (Amsel criteria) must be present: […] Diagnose by evaluation of vaginal discharge with microscopy for Amsel criteria (at least 3 of 4): yellow-green or gray discharge, pH 4.5, fishy odor on potassium hydroxide whiff test, and clue cells on saline wet mount. […] If the diagnosis is inconclusive or symptoms persist after treatment, test with a nucleic acid amplification test (NAAT).

• #3 Bacterial vaginosis: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management

  Pharmacists can identify bacterial vaginosis and recommend appropriate treatment options to patients. […] Understand how BV is diagnosed. […] BV is often misdiagnosed or left untreated, which can lead to complications, such as pelvic inflammatory disease (PID), increased risk of STIs and adverse pregnancy outcomes, including preterm labour and low birth weight. […] Patients with symptoms suggestive of BV present to a broad number of healthcare settings, including community pharmacies, general practice and integrated sexual health clinics. […] History taking is a vital aspect of BV diagnosis, but it can be difficult to differentiate between BV, candida and STIs, including trichomonas vaginalis. […] In GUM or integrated sexual health clinics, the diagnosis of BV follows British Association for Sexual Health and HIV (BASHH) guidelines.

• #4 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #5 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  BV can be diagnosed by using clinical criteria (i.e., Amsels diagnostic criteria) or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 03 is consistent with a Lactobacillus-predominant vaginal microbiota, 46 with intermediate microbiota (emergence of G. vaginalis), and 710 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs: […] Detection of at least three Amsel criteria has been correlated with results by Gram stain. The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score.

• #6 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  BV can be diagnosed by using clinical criteria (i.e., Amsels diagnostic criteria) or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 03 is consistent with a Lactobacillus-predominant vaginal microbiota, 46 with intermediate microbiota (emergence of G. vaginalis), and 710 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs: […] Detection of at least three Amsel criteria has been correlated with results by Gram stain. The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score.

• #7 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #8 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  BV can be diagnosed by using clinical criteria (i.e., Amsels diagnostic criteria) or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 03 is consistent with a Lactobacillus-predominant vaginal microbiota, 46 with intermediate microbiota (emergence of G. vaginalis), and 710 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs: […] Detection of at least three Amsel criteria has been correlated with results by Gram stain. The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score.

• #9 New guidelines for bacterial vaginosis diagnosis and treatment

  https://www.contemporaryobgyn.net/view/cdc-updates-guidelines-for-diagnosis-and-treatment-of-bacterial-vaginosis

  According to the CDC, BV can be diagnosed via Amsels diagnostic criteria or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain is the reference standard method for BV diagnosis. It is used to determine the relative concentration of lactobacilli, small gram-negative and gram-variable rods (i.e., G. vaginalis or Bateroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. […] Point-of-care tests and nucleic acid amplification tests (NAATs) may also be used for BV diagnosis. […] A Nugent score of 0-3 is consistent with a Lactobacillus-predominant vaginal microbiota, 4-6 with intermediate microbiota (emergence of G. vaginalis), and 7-10 with BV. […] To diagnose BV via Amsel criteria, at least four of the following symptoms or signs must be present: Homogeneous, thin discharge of a milky consistency that smoothly coats the vaginal walls; Clue cells (e.g., vaginal epithelial cells studded with adherent bacteria) on microscopic examination; pH of vaginal fluid 4.5; and/or Fishy odor of vaginal discharge before or after addition of 10% KOH (i.e., the whiff test).

• #10 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #11 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #12 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #13 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #14 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  BV can be diagnosed by using clinical criteria (i.e., Amsels diagnostic criteria) or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 03 is consistent with a Lactobacillus-predominant vaginal microbiota, 46 with intermediate microbiota (emergence of G. vaginalis), and 710 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs: […] Detection of at least three Amsel criteria has been correlated with results by Gram stain. The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score.

• #15 Diagnosis of bacterial vaginosis • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/diagnosis-of-bacterial-vaginosis.html

  Diagnosis of bacterial vaginosis is a common infectious disorder that affects millions of women worldwide. […] BV is the most common cause of infectious vaginitis. […] Diagnostic testing for BV should be accurate, timely, and cost efficient. Available testing approaches each have advantages and limitations. Current methods differ mainly in their sensitivity, turnaround time to results, ease of use, cost, and their ability to be performed in a variety of treatment settings, including a physician’s office, clinic, or other point-of-care setting. The four main methods for diagnosing BV are Amsel Criteria, Gram Stain with Nugent Score, Molecular testing, and OSOM BVBlue. […] A disadvantage of this method would be the need for a microscope and trained technologist. […] This method is an accurate method that involves quantifying the bacteria in a stained vaginal smear and scoring the sample, with a score 7 considered to be positive for BV.

• #16 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  BV can be diagnosed by using clinical criteria (i.e., Amsels diagnostic criteria) or by determining the Nugent score from a vaginal Gram stain. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. A Nugent score of 03 is consistent with a Lactobacillus-predominant vaginal microbiota, 46 with intermediate microbiota (emergence of G. vaginalis), and 710 with BV. Clinical diagnosis of BV by Amsel criteria requires at least three of the following four symptoms or signs: […] Detection of at least three Amsel criteria has been correlated with results by Gram stain. The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score.

• #17 The laboratory diagnosis of bacterial vaginosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095014/

  Bacterial vaginosis (BV) is an extremely common health problem for women. […] Diagnostic tests include real-time clinical/microbiological diagnosis, and the current gold standard, the standardized evaluation of morphotypes on Gram stain analysis. […] The diagnosis of BV has been problematic due to its complex polymicrobial nature. […] The most widely accepted clinical criteria are 'Amsel’s criteria’. […] For the laboratory testing method, the preferred specimen is an unfixed vaginal smear sent to the laboratory to be Gram stained by standard methods. […] A score of zero to three is considered to be normal, four to six is considered intermediate, and seven to ten is defined as BV. […] The decision to recheck or treat is based on the clinical risk of proceeding to BV. […] There have been alternative diagnostic methods suggested, but none are currently better than the standardized Gram stain methodology. […] In summary, the most useful current diagnostic method is the vaginal Gram stain.

• #18 CG-LAB-22 Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Vaginitis

  https://www.anthem.com/dam/medpolicies/abcbs/active/guidelines/gl_pw_e001870.html

  Gram stain with Nugent scoring is conducted in the laboratory setting and is considered the gold-standard for the diagnosis of BV. […] The identification of clue cells on microscopy compares well with Gram stain findings and are the most reliable indicator of BV (ACOG, 2020; Powell, 2014; Workowski, 2021). […] Although Gram staining using Nugent scoring is considered the diagnostic standard and demonstrated higher interobserver and intraobserver reproducibility than Amsels criteria, it is impractical (time consuming to perform), and its use is generally limited to the laboratory or research settings. […] The clinical value of nucleic acid amplification tests (NAATs) using algorithmic analysis to detect BV over standard diagnostic testing (for example, Amsel criteria, Nugent score, and the Affirm VP III assay) has not been established.

• #19 How do healthcare providers diagnose bacterial vaginosis (BV)? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/diagnosis

  Diagnosis of BV requires a vaginal exam by a qualified healthcare provider and the laboratory testing of fluid collected from the vagina. […] An examination to diagnose BV is similar to a regular gynecological checkup. […] Your healthcare provider will also collect a small amount of your vaginal fluid with a wooden spatula or cotton-tipped applicator. The sample will be tested in a laboratory for the diagnosis of BV. […] An accurate diagnosis of BV is important because it will help the provider determine whether you have BV or some other infection, such as a sexually transmitted disease like chlamydia.

• #20 Bacterial vaginosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/diagnosis-treatment/drc-20352285

  During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs. […] To diagnose bacterial vaginosis, your doctor may: […] Take a sample of vaginal discharge. This sample will be tested for „clue cells.” Clue cells are vaginal cells covered in bacteria. These are a sign of BV. […] Test your vaginal pH. The acidity of your vagina can be tested with a pH strip. You place the test strip in your vagina. A vaginal pH of 4.5 or higher is a sign of bacterial vaginosis. […] If your symptoms return soon after treatment, talk with your care team. It might be possible for you to take extended-use metronidazole therapy. […] In a random trial, probiotics were no better than a treatment that didn’t contain medicine, called a placebo, in stopping recurrent BV. So probiotics are not recommended as a treatment option for bacterial vaginosis.

• #21 Bacterial vaginosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/diagnosis-treatment/drc-20352285

  During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs. […] To diagnose bacterial vaginosis, your doctor may: […] Take a sample of vaginal discharge. This sample will be tested for „clue cells.” Clue cells are vaginal cells covered in bacteria. These are a sign of BV. […] Test your vaginal pH. The acidity of your vagina can be tested with a pH strip. You place the test strip in your vagina. A vaginal pH of 4.5 or higher is a sign of bacterial vaginosis. […] If your symptoms return soon after treatment, talk with your care team. It might be possible for you to take extended-use metronidazole therapy. […] In a random trial, probiotics were no better than a treatment that didn’t contain medicine, called a placebo, in stopping recurrent BV. So probiotics are not recommended as a treatment option for bacterial vaginosis.

• #22 Bacterial Vaginosis (BV) Test: How It’s Done & Results

  https://my.clevelandclinic.org/health/diagnostics/22123-bacterial-vaginosis-test

  The first step of this test is to get a sample of fluid from your vagina. […] For a wet mount, a pathologist puts the sample of vaginal discharge on a glass slide mixed with a solution, then examines it under a microscope. […] For a whiff test, your provider checks the sample of vaginal discharge for an odor. […] A vaginal pH test measures the level of acidity versus alkalinity of the sample of vaginal discharge. Bacterial vaginosis makes pH higher than normal. […] Results of a wet mount or whiff test come back as normal or abnormal. A normal result means theres no bacterial infection. An abnormal result means you have a bacterial infection. […] If the results of a bacterial vaginosis test are positive, your healthcare provider may recommend treatment with antibiotics. […] A bacterial vaginosis test is a quick, painless and risk-free way to diagnose an infection in your vagina. Your provider takes a sample of your vaginal discharge and sends it to a lab for testing. If you have bacterial vaginosis, your healthcare provider may prescribe antibiotics to clear the infection.

• #23 The laboratory diagnosis of bacterial vaginosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095014/

  Bacterial vaginosis (BV) is an extremely common health problem for women. […] Diagnostic tests include real-time clinical/microbiological diagnosis, and the current gold standard, the standardized evaluation of morphotypes on Gram stain analysis. […] The diagnosis of BV has been problematic due to its complex polymicrobial nature. […] The most widely accepted clinical criteria are 'Amsel’s criteria’. […] For the laboratory testing method, the preferred specimen is an unfixed vaginal smear sent to the laboratory to be Gram stained by standard methods. […] A score of zero to three is considered to be normal, four to six is considered intermediate, and seven to ten is defined as BV. […] The decision to recheck or treat is based on the clinical risk of proceeding to BV. […] There have been alternative diagnostic methods suggested, but none are currently better than the standardized Gram stain methodology. […] In summary, the most useful current diagnostic method is the vaginal Gram stain.

• #24 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #25 The ABCDs of bacterial vaginosis: Abnormal flora, Bothersome symptoms, Chronicity, and Differential diagnosis – Women’s Healthcare

  https://www.npwomenshealthcare.com/bacterial-vaginosis-abnormal-flora/

  At least three of these four criteria must be met to make the diagnosis. […] Several commercial products such as the BD Affirm VPIII Microbial Identification System and the OSOM BVBlue point-of-care testing can identify the microbes present in a patients vaginal fluid. […] BV diagnosis should not be made solely on the basis of a positive G. vaginalis culture because this bacterium is present in ~50%- 80% of healthy, asymptomatic women. […] According to the CDC, the benefits of BV therapy in nonpregnant women are symptom relief and infection cure. […] For a single episode of BV, the CDC recommends these regimens: metronidazole 500 mg orally twice daily for 7 days OR metronidazole gel 0.75%, 1 full applicator (5 g) intravaginally, once daily for 5 days OR clindamycin cream 2%, 1 full applicator (5 g) intravaginally at bedtime for 7 days.

• #26 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p807.html

  Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Diagnosis is commonly made using the Amsel criteria, which include vaginal pH greater than 4.5, positive whiff test, milky discharge, and the presence of clue cells on microscopic examination of vaginal fluid. […] In clinical practice, bacterial vaginosis is diagnosed by the presence of three out of four Amsel criteria: Thin, homogenous vaginal discharge, Vaginal pH greater than 4.5, Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added), At least 20 percent clue cells (vaginal epithelial cells with borders obscured by adherent coccobacilli on wet-mount preparation or Gram stain). […] In a prospective observational study of 269 women, a vaginal pH of more than 4.5 was found to be the most sensitive (89 percent) and a positive whiff test was the most specific (93 percent) method of detecting bacterial vaginosis. […] Culture of Gardnerella vaginalis is not recommended because of low specificity. Cervical cytology has no clinical value for diagnosing bacterial vaginosis, especially in asymptomatic women, because it has low sensitivity.

• #27 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  Multiple BV NAATs are available for BV diagnosis among symptomatic women. These tests are based on detection of specific bacterial nucleic acids and have high sensitivity and specificity for BV (i.e., G. vaginalis, A. vaginae, BVAB2, or Megasphaera type 1) and certain lactobacilli (i.e., Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus gasseri). […] Despite the availability of BV NAATs, traditional methods of BV diagnosis, including the Amsel criteria, Nugent score, and the Affirm VP III assay, remain useful for diagnosing symptomatic BV because of their lower cost and ability to provide a rapid diagnosis.

• #28 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  Multiple BV NAATs are available for BV diagnosis among symptomatic women. These tests are based on detection of specific bacterial nucleic acids and have high sensitivity and specificity for BV (i.e., G. vaginalis, A. vaginae, BVAB2, or Megasphaera type 1) and certain lactobacilli (i.e., Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus gasseri). […] Despite the availability of BV NAATs, traditional methods of BV diagnosis, including the Amsel criteria, Nugent score, and the Affirm VP III assay, remain useful for diagnosing symptomatic BV because of their lower cost and ability to provide a rapid diagnosis.

• #29 New guidelines for bacterial vaginosis diagnosis and treatment

  https://www.contemporaryobgyn.net/view/cdc-updates-guidelines-for-diagnosis-and-treatment-of-bacterial-vaginosis

  Detection of at least three Amsel criteria has been correlated with results by Gram stain (1001). The sensitivity and specificity of the Amsel criteria are 37%70% and 94%99%, respectively, compared with the Nugent score (1002). […] NAATs are tests that detect specific bacterial nucleic acids and have high sensitivity and specificity for BV (G. vaginalis, A. vaginae, BVAB2, or Megasphaera type 1), and for certain lactobacilli (Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus gasseri). They should only be used only among symptomatic women, the recommendations note, because their accuracy is not well-defined for asymptomatic women. […] NAATs can be performed on clinician- or self-collected vaginal specimens with results available in less than 24 hours, depending on the availability of the molecular diagnostic platform.

• #30 Molecular Testing for the Diagnosis of Bacterial Vaginosis | Encyclopedia MDPI

  https://encyclopedia.pub/entry/54933

  A number of commercial molecular diagnostic tests for BV diagnosis are available, including NuSwab R multiplex PCR, the SureSwab BV real-time DNA quantitative PCR assay, the BD Max vaginal panel, and the multiplex BV assay. Thus, these methods establish the diagnosis of BV with a sensitivity of 90.5% to 96.7% and a specificity of 85.8% to 95% when compared to Amsel’s criteria and Nugent’s system. […] The presence of a structured polymicrobial biofilm on the surface of the vaginal epithelium represents an important diagnostic marker of BV. […] The above-mentioned studies provided a new perspective on the term “clue” cell as a part of the biofilm. […] Thus, currently, approaches for BV diagnosis are undergoing significant changes. More attention is being paid to molecular techniques due to the importance of not only confirming the condition at the time when the patient presents with complaints. An emphasis should be made on treatment and future prognosis: whether the chances for recurrence are high or if it was a single episode of BV.

• #31 Bacterial Vaginosis – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/bv.htm

  Multiple BV NAATs are available for BV diagnosis among symptomatic women. These tests are based on detection of specific bacterial nucleic acids and have high sensitivity and specificity for BV (i.e., G. vaginalis, A. vaginae, BVAB2, or Megasphaera type 1) and certain lactobacilli (i.e., Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus gasseri). […] Despite the availability of BV NAATs, traditional methods of BV diagnosis, including the Amsel criteria, Nugent score, and the Affirm VP III assay, remain useful for diagnosing symptomatic BV because of their lower cost and ability to provide a rapid diagnosis.

• #32 Bacterial Vaginosis – CDC Diagnosis and Treatment Recommendations – The ObG Project

  https://www.obgproject.com/2016/10/16/bv-cdc-diagnosis-treatment-recommendations/

  Bacterial Vaginosis (BV) occurs when normal hydrogen peroxide producing Lactobacillus sp. is replaced by an overgrowth of facultative anaerobic bacteria. If a woman presents with symptoms, including vaginal discharge, irritation and malodor […] Diagnose BV if 3 of the following (Amsel) clinical criteria are present […] Gram stain with Nugent scoring is considered the gold standard to diagnose […] Affirm VP III (Becton Dickinson, Sparks, MD), a DNA hybridization probe test for high concentrations of G. vaginalis […] OSOM BV Blue test (Sekisui Diagnostics, Framingham, MA), which detects vaginal fluid sialidase activity, have acceptable performance characteristics compared with Gram stain […] Nucleic Acid Amplification Tests (NAAT) are also available and “can be used as an alternative to clinical testing in settings where pH paper, KOH, and microscopy are not available”

• #33 OSOM® BVBLUE® Test – Sekisui Diagnostics

  https://sekisuidiagnostics.com/product/osom-bvblue-test/

  Detects elevated vaginal fluid sialidase activity, an enzyme produced by bacterial pathogens associated with bacterial vaginosis including Gardnerella, Bacteroides, Prevotella and Mobiluncus. […] 92.8% sensitive, 98% specific versus Gram Stain.

• #34 Bacterial Vaginosis – CDC Diagnosis and Treatment Recommendations – The ObG Project

  https://www.obgproject.com/2016/10/16/bv-cdc-diagnosis-treatment-recommendations/

  Bacterial Vaginosis (BV) occurs when normal hydrogen peroxide producing Lactobacillus sp. is replaced by an overgrowth of facultative anaerobic bacteria. If a woman presents with symptoms, including vaginal discharge, irritation and malodor […] Diagnose BV if 3 of the following (Amsel) clinical criteria are present […] Gram stain with Nugent scoring is considered the gold standard to diagnose […] Affirm VP III (Becton Dickinson, Sparks, MD), a DNA hybridization probe test for high concentrations of G. vaginalis […] OSOM BV Blue test (Sekisui Diagnostics, Framingham, MA), which detects vaginal fluid sialidase activity, have acceptable performance characteristics compared with Gram stain […] Nucleic Acid Amplification Tests (NAAT) are also available and “can be used as an alternative to clinical testing in settings where pH paper, KOH, and microscopy are not available”

• #35 Bacterial Vaginosis Workup: Laboratory Studies, Other Tests

  https://emedicine.medscape.com/article/254342-workup

  Clinical diagnosis of bacterial vaginosis (BV) relies on history, vaginal examination, and microscopic examination (see the Table under „Diagnostic tools” for a summary of the differential diagnoses). […] Demonstrating three of the following four Amsel’s criteria is considered necessary to diagnose BV most accurately: […] Obtaining routine vaginal cultures in patients with BV has no utility, because this is a polymicrobial infection and some women may have asymptomatic carriage of G vaginalis organisms. […] FemExam has been shown to have variable sensitivity (38-90%) and specificity (12.5-97%) depending on the study and study population (pre- vs postmenopausal). […] Research indicates that genital cytokine profiles may be used as a biomarker of sexually transmitted infections (STIs) and BV to identify women with asymptomatic, treatable infections, which may allow improvement in treatment of these conditions and possibly reduce the risk of HIV infection in high-risk women.

• #36 Diagnosis of bacterial vaginosis • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/diagnosis-of-bacterial-vaginosis.html

  Molecular methods detect DNA sequences from microorganisms associated with BV. These methods are very accurate. […] OSOM BVBlue is a rapid test that detects sialidase activity in a vaginal fluid sample. […] The goal of a BV diagnostic test is to accurately and rapidly detect infection by the organisms causing BV, and thereby enable initiation of appropriate treatment as soon as possible. OSOM BVBlue is an easy-to-use, cost-efficient, point-of-care diagnostic test that provides rapid results, allowing a test-and-treat approach to the management of patients with BV.

• #37 Bacterial Vaginosis (BV): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis

  Bacterial vaginosis (BV) is a common vaginal infection that happens when some normal bacteria that live in your vagina overgrow, causing a bacterial imbalance. […] Only a healthcare provider can diagnose bacterial vaginosis. Contact a provider for an appointment if you have signs of BV. At your appointment, your provider will ask you about your medical history, including vaginal infections or sexually transmitted infections (STIs). […] Tests for bacterial vaginosis use samples of fluid from your vagina. That sample can undergo several types of tests for bacterial vaginosis. The most common are: […] Your healthcare provider will prescribe antibiotics, typically metronidazole or clindamycin. […] If you have bacterial vaginosis (BV), your provider can prescribe medication that’s safe to use during pregnancy. You should get treated for the infection whether or not you have symptoms. BV can cause pregnancy complications, such as premature birth or having a baby that weighs less than average (low birth weight).

• #38 Bacterial Vaginosis Workup: Laboratory Studies, Other Tests

  https://emedicine.medscape.com/article/254342-workup

  Although metronidazole is a first-line agent for treatment of BV, it is not unusual for treatment failure and recurrent disease to occur. […] Abramovici et al suggest that quantitative polymerase chain reaction (qPCR) bacterial load measurement is useful in the evaluation of BV treatment response and the risk of preterm birth in pregnant women. […] In 2025, the US Food and Drug Administration approved marketing authorization for a single-use, at-home diagnostic test for chlamydia, gonorrhea, and trichomoniasis.

• #39 The ABCDs of bacterial vaginosis: Abnormal flora, Bothersome symptoms, Chronicity, and Differential diagnosis – Women’s Healthcare

  https://www.npwomenshealthcare.com/bacterial-vaginosis-abnormal-flora/

  Chronic or recurrent BV is defined as three or more episodes per year. […] The recurrence rate may be as high as 80% in some populations. […] Bacterial vaginosis is distinctive in terms of the characteristics of the vaginal discharge, the fi shy odor, the elevated vaginal pH, and the presence of clue cells on wet prep. […] Many woman are unfamiliar with the condition of BV, which is far more common than women or their HCPs may realize. BV involves a disruption in healthy vaginal microflora and is not always symptomatic, but it can have major adverse sequelae.

• #40 Bacterial Vaginosis

  https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/genital/bacterial-vaginosis/

  Bacterial Vaginosis (BV) is a common cause of abnormal vaginal discharge in women of reproductive age. It is not considered to be sexually transmitted. […] The diagnosis can be made clinically on the basis of the description and appearance of the discharge. Typically the normal pH of the vagina is increased from normal (4.5) to above 4.5 and up to 6.0 reflecting the replacement of normal lactobacilli with anaerobic organisms. Treatment can be started without doing a high vaginal swab (HVS). […] A HVS is indicated when assessing abnormal vaginal discharge but is not part of an asymptomatic STI screen. Gram staining from a HVS in people with BV will demonstrate changes in the normal vaginal flora. A diagnosis of BV should not be made solely on demonstration of changes in the vaginal flora consistent with BV and / or the presence of organisms associated with BV (e.g. Gardnerella species) on a HVS. […] For women experiencing repeated episodes of bacterial vaginosis: Reconsider diagnosis, including further examination as appropriate. […] Women may benefit from using lactic acid vaginal gels to facilitate restoration of the normal vaginal flora.

• #41 Bacterial vaginosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bacterial-vaginosis/diagnosis-treatment/drc-20352285

  During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs. […] To diagnose bacterial vaginosis, your doctor may: […] Take a sample of vaginal discharge. This sample will be tested for „clue cells.” Clue cells are vaginal cells covered in bacteria. These are a sign of BV. […] Test your vaginal pH. The acidity of your vagina can be tested with a pH strip. You place the test strip in your vagina. A vaginal pH of 4.5 or higher is a sign of bacterial vaginosis. […] If your symptoms return soon after treatment, talk with your care team. It might be possible for you to take extended-use metronidazole therapy. […] In a random trial, probiotics were no better than a treatment that didn’t contain medicine, called a placebo, in stopping recurrent BV. So probiotics are not recommended as a treatment option for bacterial vaginosis.

• #42 Bacterial Vaginosis – CDC Diagnosis and Treatment Recommendations – The ObG Project

  https://www.obgproject.com/2016/10/16/bv-cdc-diagnosis-treatment-recommendations/

  Do NOT use Pap tests […] Do NOT culture for G. vaginalis given normal vaginal flora is heterogenous […] Test all women with BV for HIV and other sexually transmitted diseases (STDs) […] Follow-up visits are unnecessary if symptoms resolve […] Routine treatment of sex partners in not recommended […] Using a different recommended treatment regimen can be considered in women who have a recurrence […] Retreatment with the same recommended regimen is an acceptable approach for treating persistent or recurrent BV after the first occurrence […] Recurrent BV: At least 3 documented, separate episodes of BV in one year […] The USPSTF recommends against screening for bacterial vaginosis in pregnant persons not at increased risk for preterm delivery. (D recommendation) […] The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in pregnant persons at increased risk for preterm delivery. (I statement)

• #43 Bacterial vaginosis

  https://www.nhs.uk/conditions/bacterial-vaginosis/

  Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge. […] If you have symptoms of bacterial vaginosis, a GP or sexual health clinic will want to confirm it is bacterial vaginosis and rule out an STI. […] A cotton bud may be wiped over the discharge inside your vagina to test for bacterial vaginosis and other infections. […] Bacterial vaginosis is usually treated with antibiotic tablets or gels or creams. […] A GP or sexual health clinic will recommend how long you need to treat it. […] Bacterial vaginosis is caused by a change in the natural balance of bacteria in your vagina. […] Bacterial vaginosis is not an STI, even though it can be triggered by sex. […] You’re more likely to get an STI if you have bacterial vaginosis. This may be because it makes your vagina less acidic and reduces your natural defences against infection. […] If you develop bacterial vaginosis in pregnancy, there’s a small chance of complications, such as premature birth or miscarriage.

• #44 Bacterial Vaginosis Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/bacterial-vaginosis-test/

  If your results show you don’t have BV, your provider may do more tests to find the cause of your symptoms. […] BV is not spread through sex between female and male partners. So, if you’re diagnosed with BV and have a male sex partner, he will not need to be tested. But the infection can be spread between female sex partners.

• #45 BV Treatment | Bacterial Vaginosis | MinuteClinic®

  https://www.cvs.com/minuteclinic/services/vaginosis

  Bacterial vaginosis (BV) is a vaginal infection. Symptoms most often occur when the natural balance of helpful bacteria in the vagina is disrupted. Treatment for bacterial vaginosis reduces your risk of developing future complications or infecting others. […] If an examination confirms bacterial vaginosis, your health care provider will prescribe an oral or topical antibiotic. It’s usually unnecessary to treat a woman’s male partners. However, female partners can be infected and should also be tested. Testing both female partners enables both partners to be effectively treated. […] If left untreated, BV can linger without symptoms and cause future health complications.

• #46 Diagnosis of Vaginitis

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/diagnosis-of-vaginitis/

  The use of established molecular diagnostic tests as an alternative to traditional methods is an opportunity to improve the diagnosis and management of vaginitis; NAAT tests have already improved detection of trichomoniasis (Sobel, 2023b). […] A diagnosis of vaginitis can be given based on a combination of symptoms, physical examination, and office or laboratory-based testing methods. […] Laboratory documentation of the etiology of vaginitis is important before initiating therapy, given the nonspecific nature and considerable overlap of the symptoms (Anderson et al., 2004; Ellis et al., 2001; Landers et al., 2004). […] Diagnostic testing enables targeted treatment, increases therapeutic compliance, and increases the likelihood of partner notification (Sobel, 2023b; Workowski Bolan, 2015).

• #47 Vaginitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0301/p321.html

  Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Bacterial vaginosis is implicated in 40% to 50% of cases when a cause is identified, with vulvovaginal candidiasis accounting for 20% to 25% and trichomoniasis for 15% to 20% of cases. […] Diagnosis is made using a combination of symptoms, physical examination findings, and office-based or laboratory testing. Bacterial vaginosis is traditionally diagnosed with Amsel criteria, although Gram stain is the diagnostic standard. Newer laboratory tests that detect Gardnerella vaginalis DNA or vaginal fluid sialidase activity have similar sensitivity and specificity to Gram stain.

• #48 Vaginitis – Bacterial Vaginosis, Vulvovaginal Candidiasis, and Trichomoniasis | Choose the Right Test

  https://arupconsult.com/content/vaginitis-bacterial-vaginosis-vulvovaginal-candidiasis-and-trichomoniasis

  Accurate diagnosis is important to determine appropriate treatment and medical management of vaginitis. Recent increasing evidence shows that nucleic acid amplification testing (NAAT) better facilitates accurate detection of vaginitis compared with traditional methods (eg, culture or DNA probes) because it is highly sensitive and can be used to detect multiple targets simultaneously on a single patient specimen. NAAT can be used for the diagnosis of vaginitis due to BV, vulvovaginal candidiasis, and trichomoniasis.

• #49 Bacterial vaginosis: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management

  Vaginal smears are Gram stained and viewed under light microscopy. […] Women undergoing testing for BV, who are sexually active, should undergo testing for STIs, including chlamydia, gonorrhoea and trichomonas, to rule out additional causes for their symptoms. […] While over-the-counter testing strips are available, most of these tests are based on pH litmus strips, with little clinical evaluation to support their use.

• #50 Bacterial Vaginosis (BV): Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

  https://www.webmd.com/women/what-is-bacterial-vaginosis

  Bacterial Vaginosis Diagnosis […] To confirm a BV diagnosis, your doctor will: […] – Ask about your medical history […] – Do an overall physical exam […] – Do a pelvic exam […] – Check your vagina’s pH or acidity level […] – Take a sample of discharge from your vagina to look for cells covered with bacteria […] Tests for BV […] Your doctor can check your vaginal discharge for BV. These tests include: […] – Wet mount or vaginal smear. This test looks at a sample under a microscope to check for infection. […] – Whiff test. Vaginal fluid is mixed with a chemical that produces a strong, fishy smell if you have BV. […] – Vaginal pH. The acidity of your discharge is checked. A high reading is a sign of BV. […] – PCR test. This test looks for DNA from harmful bacteria and costs more, so it is not used very often. […] Home test kits […] There are many BV home test kits on the market. They are not always accurate. Your best bet is to get checked by your doctor. But when used correctly, some tests are close to 90% reliable.

• #51 Bacterial Vaginosis Test | BV Swab Test | Quest®

  https://www.questhealth.com/product/bacterial-vaginosis-test-10016M.html?srsltid=AfmBOooKSc4YCfDPOr3WQwIh0KU_IaULlFPwopcdyCDj-VOqi15tjXxr

  These symptoms can be associated with other conditions. Regardless of your results, please discuss your symptoms with your healthcare provider. […] This test is for females only. You must be 18 years of age or older to purchase a test on questhealth.com. […] After you provide your specimen, it generally takes a few business days to process and release your test results. However, processing times may vary. Your test results will be available in a clear and easy-to-read report. If your results differ from expected ranges, you may receive an alert call from an independent healthcare coordinator. Independent physicians are available to discuss questions or concerns you may have regarding your results. This physician may be able to prescribe medication, if appropriate. […] According to the CDC, by following step-by-step collection instructions, patients can collect their own samples correctly, and the results of the tests are as accurate as when they are collected by a doctor.

• #52 Diagnosis of Vaginitis – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/600_699/0643.html

  Diagnosis of vaginitis is based on clinical symptoms, pH of the vaginal fluid and microscopic examination of the discharge. […] Symptoms are not present in approximately 50 % of women with bacterial vaginosis infection. […] Bacterial vaginosis is not associated with soreness, itching or irritation. […] Ideally, a diagnosis of BV is made if 3 out of 4 of „Amsel’s criteria” are met: A strong, fishy odor on adding alkali to vaginal fluid (positive amine test); Clue cells (vaginal epithelial cells heavily coated with bacilli) on microscopy; Thin, white, homogenous discharge; Vaginal pH greater than 4.5. […] The presence of Gardnerella vaginalis on culture can not be used to diagnose BV, since it is present in approximately 50 % of healthy women. […] DNA probes have been developed to directly detect the presence of candida, trichomonas and Gardnerella, thus providing a more objective diagnosis.

• #53 Diagnosis of Vaginitis

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/diagnosis-of-vaginitis/

  The use of established molecular diagnostic tests as an alternative to traditional methods is an opportunity to improve the diagnosis and management of vaginitis; NAAT tests have already improved detection of trichomoniasis (Sobel, 2023b). […] A diagnosis of vaginitis can be given based on a combination of symptoms, physical examination, and office or laboratory-based testing methods. […] Laboratory documentation of the etiology of vaginitis is important before initiating therapy, given the nonspecific nature and considerable overlap of the symptoms (Anderson et al., 2004; Ellis et al., 2001; Landers et al., 2004). […] Diagnostic testing enables targeted treatment, increases therapeutic compliance, and increases the likelihood of partner notification (Sobel, 2023b; Workowski Bolan, 2015).

• #54 Molecular Testing for the Diagnosis of Bacterial Vaginosis | Encyclopedia MDPI

  https://encyclopedia.pub/entry/54933

  A number of commercial molecular diagnostic tests for BV diagnosis are available, including NuSwab R multiplex PCR, the SureSwab BV real-time DNA quantitative PCR assay, the BD Max vaginal panel, and the multiplex BV assay. Thus, these methods establish the diagnosis of BV with a sensitivity of 90.5% to 96.7% and a specificity of 85.8% to 95% when compared to Amsel’s criteria and Nugent’s system. […] The presence of a structured polymicrobial biofilm on the surface of the vaginal epithelium represents an important diagnostic marker of BV. […] The above-mentioned studies provided a new perspective on the term “clue” cell as a part of the biofilm. […] Thus, currently, approaches for BV diagnosis are undergoing significant changes. More attention is being paid to molecular techniques due to the importance of not only confirming the condition at the time when the patient presents with complaints. An emphasis should be made on treatment and future prognosis: whether the chances for recurrence are high or if it was a single episode of BV.

• #55 The laboratory diagnosis of bacterial vaginosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095014/

  Bacterial vaginosis (BV) is an extremely common health problem for women. […] Diagnostic tests include real-time clinical/microbiological diagnosis, and the current gold standard, the standardized evaluation of morphotypes on Gram stain analysis. […] The diagnosis of BV has been problematic due to its complex polymicrobial nature. […] The most widely accepted clinical criteria are 'Amsel’s criteria’. […] For the laboratory testing method, the preferred specimen is an unfixed vaginal smear sent to the laboratory to be Gram stained by standard methods. […] A score of zero to three is considered to be normal, four to six is considered intermediate, and seven to ten is defined as BV. […] The decision to recheck or treat is based on the clinical risk of proceeding to BV. […] There have been alternative diagnostic methods suggested, but none are currently better than the standardized Gram stain methodology. […] In summary, the most useful current diagnostic method is the vaginal Gram stain.

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