Comparison of the Methods of Diagnosis of Bacterial Vaginosis

Background and Objective: Although Nugent's criterion is considered as the gold standard, routinely a combination of various methods is used for the diagnosis of bacterial vaginosis. In the present study we compared culture, Spiegel's criteria and Amsel's criteria with Nugent's method for the diagnosis of bacterial vaginosis. Materials and Methods: Five hundred and twenty seven women who attended the Government Maternity Hospital and a tertiary care centre in south India for antenatal care or forany other complaint formed the study population. Diagnosis of bacterial vaginosis was done by culture, Amsel's, Nugent's and Spiegel's criteria. The positive predictive value, the negative predictive value and the sensitivity and specificity of these methods, in comparison with Nugent's criteria, by considering it as the gold standard, were calculated. Statistical analysis was done by using the Chi Square test or the Fisher's exact test as was appropriate. Results: In comparison with Nugent's criteria, the positive predictive value, negative predictive value and the sensitivity and specificity of Amsel's criteria were 80.4%, 94.8%, 78% and 95.6% and that of Spiegel's criteria were 77.5%, 100%, 100% and 93.2%. The culture was 51% sensitive and 88.7% specific, the positive predictive value was 85.5% and the negative predictive value was 58%. We diagnosed 100 (19%) casesof bacterial vaginosisby Nugent's method, 129 (24%) casesby Spiegel's method, 97 (18%) cases by Amsel's criteria and 88 (16.7%) cases by culturing. Conclusion: Amsel's and Spiegel's criteria were comparable with Nugent's criteria for the diagnosis of bacterial vaginosis. Diagnosis of bacterial vaginosis by culture was least sensitive method.