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Academic literature on the topic 'Nugent scoring'
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Journal articles on the topic "Nugent scoring"
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Chawla, Rohit, Preena Bhalla, Sanjim Chadha, Sujatha Grover, and Suneela Garg. "Comparison of Hay’s Criteria with Nugent’s Scoring System for Diagnosis of Bacterial Vaginosis." BioMed Research International 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/365194.
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Although Nugent’s criterion is considered as the gold standard for the diagnosis of bacterial vaginosis (BV), the method requires an experienced slide reader and considerable time and skill. In this study, we compared the method of Hay and Ison with Nugent’s scoring criteria. Vaginal specimens were collected from a total of 213 women, presenting with or without the symptoms of vaginitis. Diagnosis of BV was done using Nugent’ and Hay’s method. Sensitivity, specificity, and predictive values for positive and negative test were calculated for Hay’s method using Nugent’s method as the gold standard. We diagnosed 70 cases (32.86%) of BV by Nugent’s method and 87 (40.85%) cases by the Hay’s method. Sensitivity, specificity, predictive value of positive result, predictive value of negative result, and Kappa value when evaluating Hay’s criteria using Nugent’s criteria as the gold standard were ≥97.2%, ≥88.1%, ≥80.4%, ≥97.1%, and ≥0.830, respectively, when Hay’s grade II and/or Nugent’s intermediate score were considered either as negative or positive or excluded. Using Nugent score for the intermediate group is the most difficult. Hay’s method shows good agreement with the gold standard method of Nugent et al. and can be used as an alternative to Nugent’s criteria in busy tertiary care hospitals.
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Nenadic, Dane, Snezana Ribis, Milos Pavlovic, and Dejan Baskic. "Diagnosis of bacterial vaginosis: Comparison of Nugent and novel microscopic method." Vojnosanitetski pregled, no. 00 (2020): 105. http://dx.doi.org/10.2298/vsp200405105n.
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Background/Aim: Bacterial vaginosis (BV) is common cause of vaginal discomfort in women. The aim of this study was comparison of Nugent's scoring system and novel microscopy method, introduced in our laboratory and used in BV diagnosis. Methods: 705 pregnant and asymptomatic women between 24 and 28 weeks of pregnancy participated in this prospective study. Degree of agreement between methods was determined by kappa index. Sensitivity, specificity, positive and negative predictive value of novel microscopy method was compared to Nugent's score as standard. Results: Based on scoring system of both methods, Nugent 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 kappa index, was satisfactory: Nugent vs novel microscopy method (?=0,68; good agreement), and Nugent vs novel microscopy method without intermediary results (?=0,83; very good agreement). We also demonstrated that compared to Nugent, as golden standard, 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%). Conclusion: novel microscopy method in diagnosis of BV, corresponded well with Nugent's scoring system which allows it to be an alternative method in diagnosing of BV. Our method is based on relative number of bacterial morphotypes, either rod forms (? 1.5?m, lactobacilli) or non-rod forms (< 1.5?m, bacterial vaginosis associated bacteria) under 200x magnification, which extends the surface of examined preparation, but without prolongation of observer's working time. Furthermore, novel microscopy method 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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Hilbert, David W., William L. Smith, Sean G. Chadwick, et al. "Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis." Journal of Clinical Microbiology 54, no. 4 (2016): 1017–24. http://dx.doi.org/10.1128/jcm.03104-15.
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Bacterial vaginosis (BV) is the most common gynecological infection in the United States. Diagnosis based on Amsel's criteria can be challenging and can be aided by laboratory-based testing. A standard method for diagnosis in research studies is enumeration of bacterial morphotypes of a Gram-stained vaginal smear (i.e., Nugent scoring). However, this technique is subjective, requires specialized training, and is not widely available. Therefore, a highly accurate molecular assay for the diagnosis of BV would be of great utility. We analyzed 385 vaginal specimens collected prospectively from subjects who were evaluated for BV by clinical signs and Nugent scoring. We analyzed quantitative real-time PCR (qPCR) assays on DNA extracted from these specimens to quantify nine organisms associated with vaginal health or disease:Gardnerella vaginalis,Atopobium vaginae, BV-associated bacteria 2 (BVAB2, an uncultured member of the orderClostridiales),Megasphaeraphylotype 1 or 2,Lactobacillus iners,Lactobacillus crispatus,Lactobacillus gasseri, andLactobacillus jensenii. We generated a logistic regression model that identifiedG. vaginalis,A. vaginae, andMegasphaeraphylotypes 1 and 2 as the organisms for which quantification provided the most accurate diagnosis of symptomatic BV, as defined by Amsel's criteria and Nugent scoring, with 92% sensitivity, 95% specificity, 94% positive predictive value, and 94% negative predictive value. The inclusion ofLactobacillusspp. did not contribute sufficiently to the quantitative model for symptomatic BV detection. This molecular assay is a highly accurate laboratory tool to assist in the diagnosis of symptomatic BV.
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Mittal, Vineeta, Amita Jain, and Yashodhara Pradeep. "Development of modified diagnostic criteria for bacterial vaginosis at peripheral health centres in developing countries." Journal of Infection in Developing Countries 6, no. 05 (2011): 373–77. http://dx.doi.org/10.3855/jidc.1625.
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Introduction: Bacterial vaginosis (BV) is the commonest cause of abnormal vaginal discharge in women of child-bearing age and is associated with increased susceptibility to HIV-AIDS and sexually transmitted diseases. In obstetrics, BV has been implicated in causing various complications. In clinical practice, BV is diagnosed using Amsel criteria and Nugent scoring. Using modified Amsel criteria, we determined that the fulfilling of any two instead of three criteria can be diagnostic of BV. Methodology: This prospective cross-sectional study involved pregnant females complaining of excessive vaginal discharge admitted in a tertiary health centre in central India. Four vaginal swabs were collected for the diagnosis of BV by Amsel criteria, modified Amsel criteria, and Nugent scoring on Gram stain. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of each individual criterion and combinations of criteria were calculated by using Nugent scoring as the gold standard and by chi square test. Results: In the present study overall prevalence of BV was 12%. The sensitivity of individual or a combination of two criteria was almost same or higher than that of Amsel criteria. Specificity of each combination of criteria was comparable to that of Amsel criteria. However, a combination of high pH and amine odor test had the highest sensitivity (88%) and highest PPV (62%). Diagnostic accuracy of all combinations in our study was equal to or slightly higher than that of Amsel criteria. Conclusion: Diagnostic accuracy of new modified Amsel criteria is as reliable as that of Amsel criteria.
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Bansal, Romi, Priyanka Garg, and Aastha Garg. "Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 2 (2019): 637. http://dx.doi.org/10.18203/2320-1770.ijrcog20190297.
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Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.
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El Sayed Zaki, Maysaa, Douaa Raafat, Wafaa El Emshaty, Manar Sobh Azab, and Hossam Goda. "Correlation of Trichomonas vaginalis to bacterial vaginosis: a laboratory-based study." Journal of Infection in Developing Countries 4, no. 03 (2010): 156–63. http://dx.doi.org/10.3855/jidc.434.
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Background: This study aimed to define the occurrence of different organisms causing vulvovaginitis; to evaluate different laboratory methods used for diagnosis of Trichomonas vaginalis (T. vaginalis); and to evaluate the direct score system and clue cell method compared with culture for diagnosis of bacterial and T. vaginalis vaginosis. Methodology: Clinical and laboratory evaluations were performed for 110 patients. Laboratory methods used for bacteriological diagnosis were direct Gram staining for clue cells and scoring by Nugent score system and bacterial culture. T. vaginalis was identified by wet mount microscopic examination, culture, direct Gram, Giemsa staining and acridine orange (AO). Results: The Nugent score method revealed that the sensitivity and specificity for diagnosis of vaginal discharge by direct rapid microscopic methods were 30% and 80% and for clue cells sensitivity and specificity were 37% and 75% respectively for diagnosis of bacterial vaginosis compared to culture. For diagnosis of T. vaginalis, the Nugent score method revealed that the sensitivity and specificity were 60% and 90% respectively, and for clue cells 75% and 80% respectively. For microcopic methods used for T. vaginalis only, the Gram stain and Giemsa stain sensitivities were poor (15.2% and 48.5%, respectively). Wet mount showed reasonable sensitivity of 75.8%. Acridine orange sensitivity was 93.9% and specificity was 97.5%, Conclusion: Prevalent pathogens associated with vaginitis were (Gardnerella vaginalis) G. vaginalis, T. vaginalis and Mycoplasma hominis (M. hominis). Wet mount microscopic examination, acridine orange, and high Nugent score were found as rapid and sensitive methods for diagnosis of T. vaginalis.
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Sule-Odu, Adewale O., Adedayo A. Oluwole, Adebayo A. Akadri, et al. "Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome." Ghana Medical Journal 54, no. 1 (2020): 10–16. http://dx.doi.org/10.4314/gmj.v54i1.3.
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Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome.
 Design: A prospective longitudinal study.
 Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018.
 Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour.
 Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission.
 Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant reduction in abnormal vaginal flora in labour compared to the proportion of abnormal flora in antenatal period(P<0.001). There were no significant differences in the fetal outcomes of mothers with bacterial vaginosis when compared with those with normal vaginal flora (P-value >0.05).
 Conclusions: Persistence of abnormal vaginal microflora from pregnancy till early labour did not seem to be associated with poorer foetal outcomes when compared with women with normal vaginal microflora in labour. The possibility of persistent infection or re-infection before labour may justify the need for re-evaluation of vaginal smears in the late third trimester to allow for prompt treatment before the onset of labour.
 Keywords: Bacterial vaginosis, foetal outcome, Lactobacillus, pregnancy, vaginal microflora.
 Funding: This research work was sponsored by the Tertiary Education Trust Fund, Nigeria (TETFund) with referencenumber OOU/IBR/010.
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Nenadic, Dane, Milos Pavlovic, and Tatjana Motrenko. "A novel microscopic method for analyzing gram-stained vaginal smears in the diagnosis of disorders of vaginal microflora." Vojnosanitetski pregled 72, no. 8 (2015): 670–76. http://dx.doi.org/10.2298/vsp140612065n.
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Background/Aim. The Nugent?s score is still the gold standard in the great majority of studies dealing with the assessment of vaginal flora and the diagnosis of bacterial vaginosis (BV). The aim of this study was to show that the analysis of Gram-stained vaginal samples under microscope at the magnification of ?200 (a novel microscopic method - NMM), as a fast and simple tool, easily applicable in everyday practice, better reflects complexity of vaginal microflora than the Nugent?s methodology (?1000). Methods. Gramstained vaginal smears from 394 asymptomatic pregnant women (24-28 week of pregnancy) were classified according to the Nugent?s microscopic criteria (immersion, magnification ?1000). The smears were then reexamined under immersion but at magnification ?200. All samples were classified into 6 groups according to semiquanititative assessment of numbers (cellularity) and the ratio of rod (length < 1.5 ?m) and small bacterial (< 1.5 ?m) forms: hypercellular (normal full - NF), moderately cellular (normal mid - NM), hypocellular (normal empty - NE), bacterial vaginosis full (BVF), bacterial vaginosis mid (BVM), and bacterial vaginosis empty (BVE). Also yeasts, coccae, bifido and lepto bacterial forms as well polymorphonuclear (PMN) leukocytes were identified. Results. According to the Nugent?s scoring, BV was found in 78, intermediate findings in 63, and yeasts in 48 patients. By our criteria BV was confirmed in 88 patients (37 BVF, 24 BVM, and 27 BVN). Generally, both tools proved to be highly concordant for the diagnosis of BV (Lin?s concordance correlation coefficient = 0.9852). In 40% of the women mixed flora was found: yeasts in 126 (32%), coccae in 145 (37%), bifido forms in 32 (8%) and lepto forms in 20 (5%). Almost a half of BV patients had also yeasts (39/88). Elevated PMN numbers were found in 102 (33%) patients with normal and in 36 (41%) women with BV. Conclusion. The newly described methodology is simpler to apply and much better reflects diversity of vaginal microflora. In this way it may be more valuable to molecular biologists and their attempts based on quantitative polymerase chain reaction (PCR) to define formulas for molecular diagnosis of bacterial vaginosis.
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Barnabas, Shaun L., Smritee Dabee, Jo-Ann S. Passmore, et al. "Converging epidemics of sexually transmitted infections and bacterial vaginosis in southern African female adolescents at risk of HIV." International Journal of STD & AIDS 29, no. 6 (2017): 531–39. http://dx.doi.org/10.1177/0956462417740487.
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Adolescents in Africa are at high risk for HIV infection, other sexually transmitted infections (STIs) and bacterial vaginosis (BV). Since behavior and burden of STIs/BV may influence HIV risk, behavioral risk factors and prevalence of STIs/BV were compared in HIV-seronegative adolescent females (n = 298; 16–22 years) from two South African communities (Soweto and Cape Town). STIs ( Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, herpes simplex virus (HSV)-1, HSV-2, Treponema pallidum, and Haemophilus ducreyi) were detected by multiplex polymerase chain reaction, human papillomavirus (HPV) by Roche Linear Array, and BV by Nugent scoring. Rates of BV (Nugent ≥7; 46.6%) and HPV (66.8%) were high in both communities. Prevalence of C. trachomatis and N. gonorrhoeae were >2-fold higher in Cape Town than Soweto (Chlamydia: 42% [62/149] versus 18% [26/148], p < 0.0001; gonorrhoea 11% [17/149] versus 5% [7/148], p = 0.05). Only 24% of adolescents with vaginal discharge-causing STIs or BV were symptomatic. In South African adolescents, clinical symptoms compatible with vaginal discharge syndrome had a sensitivity of 23% and specificity of 85% for the diagnosis of discharge-causing STI or BV. In a region with high HIV prevalence and incidence, >70% of young women with treatable conditions that could enhance HIV risk would have been missed because they lacked symptoms associated with syndromic management.
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Masson, Lindi, Shaun Barnabas, Jennifer Deese, et al. "Inflammatory cytokine biomarkers of asymptomatic sexually transmitted infections and vaginal dysbiosis: a multicentre validation study." Sexually Transmitted Infections 95, no. 1 (2018): 5–12. http://dx.doi.org/10.1136/sextrans-2017-053506.
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ObjectivesVaginal dysbiosis and STIs are important drivers of the HIV epidemic and reproductive complications. These conditions remain prevalent, partly because most cases are asymptomatic. We have shown that inflammatory cytokines interleukin (IL)-1α, IL-1β and interferon-γ-induced protein (IP)-10 are biomarkers for detecting asymptomatic STIs and vaginal dysbiosis (bacterial vaginosis (BV) or intermediate microbiota). This study aimed to validate the performance of these biomarkers in African women recruited regardless of symptoms.MethodsIL-1α, IL-1β and IP-10 were measured in menstrual cup secretions, endocervical, lateral vaginal wall and vulvovaginal swabs from 550 women from Pretoria, Soweto and Cape Town, South Africa and Bondo, Kenya using Luminex and ELISA. STIs were assessed by PCR, BV by Nugent scoring and vaginal microbiota by 16S rRNA sequencing.ResultsAcross four study populations and four types of genital specimens, the performance of IL-1α, IL-1β and IP-10 for identification of women with STIs, BV or intermediate microbiota was consistent. Of the genital samples assessed, biomarkers measured in lateral vaginal wall swabs performed best, correctly classifying 76%(95% CI 70% to 81%) of women according to STI, BV or intermediate microbiota status (sensitivity 77%, specificity 71%) and were more accurate than clinical symptoms (sensitivity 41%, specificity 57%) (p=0.0003). Women incorrectly classified as STI/BV positive using the biomarkers had more abundant dysbiosis-associated bacteria, including Prevotella bivia and Gardnerella sp, detected by 16S rRNA sequencing, but not Nugent scoring. Including vaginal pH with the cytokine biomarkers improved the accuracy of the test (82% (95% CI 75% to 88%) correctly classified), although pH alone had poor specificity (61%).ConclusionsAn inexpensive, point-of-care screening test including IL-1α, IL-1β and IP-10 (and potentially pH) could be used in resource-limited settings to identify women with asymptomatic STIs and dysbiosis. These women could then be referred for aetiological testing, followed by specific treatment.
Dissertations / Theses on the topic "Nugent scoring"
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Stemmet, Megan. "Prevalence and characterization of Gardnerella vaginalis in pregnant mothers with a history of preterm delivery." Thesis, University of the Western Cape, 2012. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4430_1373278573.
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<p>Risk factors such as intrauterine and vaginal infection put pregnant women at risk for delivering preterm. Bacterial vaginosis (BV) is a polymicrobial clinical syndrome commonly diagnosed in women of reproductive age, with women of African descent with low socioeconomic status and previous preterm delivery at high risk. Although frequently isolated from healthy women, <br>Gardnerella vaginalis has been most frequently associated with BV. There is limited data available on the prevalence of BV in Southern Africa<br>therefore, we embarked on a study to determine the <br>prevalence of BV and G. vaginalis in predominantly black communities in the Western Cape, in order to establish the role of G. vaginalis in BV. Women attending various Maternity and Obstetrics <br>units (MOU) in the Cape Peninsula with and without a history of pre-term delivery (PTD) were invited to participate in the study. Several factors were statistically associated with pregnancy history, <br>including location of study population, parity, smoking and presence of clinical symptoms. The presence of G. vaginalis was determined by culture in 51.7% of the preterm delivery group (PTDG) <br>and 44% of the full-term delivery group (FTDG) women. BV was detected in 31.13% of PTDG and 23.67% of FTDG by Gram stained analysis according to Nugent scoring criteria, with age and HIV <br>status posing as risk factors. When comparing PTDG and FTDG for an association between the presence of G. vaginalis and BV, a stronger association was observed in the PTDG but it was not statistically significant. In both PTDG and FTDG, G. vaginalis was isolated significantly more often in women diagnosed with BV at 24.5% (p <<br>0.05). Antibiogram studies revealed both Metronidazole and Clindamycin resistant strains of G. vaginalis. G. vaginalis Biotype 7 is specifically associated with BV, while Biotype 2 appears to be associated with BV in women with a history <br>of PTD. Accuracy of diagnostic tools were tested and it was determined that Nugent scoring is more sensitive in diagnosing BV (76.04%), but culture for G. vaginalis is more specific (83.21%). Although this study was limited in that we were unable to follow-up pregnancy outcomes, we were able to confirm the perceived role of G. vaginalis in BV. <br></p>