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Utility of Microscopic Techniques and Quantitative Real-time Polymerase Chain Reaction for the Diagnosis of Vaginal Microflora Alterations

Rumyantseva, Tatiana A. MD1; Bellen, Gert MD2; Romanuk, Tatiana N. MD1; Shipulina, Olga Iu MD1; Guschin, Alexander E. PhD1; Shipulin, German A. PhD1; Donders, Gilbert G.G. MD, PhD2,3

Journal of Lower Genital Tract Disease: April 2015 - Volume 19 - Issue 2 - p 124–128
doi: 10.1097/LGT.0000000000000060
Original Articles: Vulva and Vagina

Objective: The aim of the study was to evaluate the diagnostic value of Nugent score, wet mount microscopy, and polymerase chain reaction (PCR) test developed in Russia for bacterial vaginosis (BV) diagnosis.

Materials and Methods: One hundred Caucasian women were enrolled in this study. Three vaginal samples were taken from each participant: 1 for PCR analysis, 1 for Nugent score evaluation, and 1 for wet mount microscopy. The smears for microscopy were air-dried and sent to Femicare, Tienen, Belgium, for blinded analysis by microscopy. Multiplex real-time PCR was performed using primers and probes targeting Gardnerella vaginalis, Atopobium vaginae, Lactobacillus species, and total quantity of bacterial DNA (16SrRNA gene).

Results: Agreement among the 3 methods was 72 (73.5%) of 98 samples. Agreement between Nugent score and PCR results was 77 (78.6%) of 98 samples; between wet mount microscopy and PCR, 81 (82.65%) of 98 samples; between wet mount microscopy and Nugent score, 84 (85.7%) of 98 samples. The sensitivity and specificity of the methods studied were as follows: 75% (21/28) and 97.1% (68/70) for Nugent score, 96.4% (27/28) and 94.3% (66/70) for wet mount microscopy, 92.8% (26/28) and 85.7% (60/70) for PCR, respectively.

Conclusions: This study demonstrated that wet mount microscopy is a superior method for BV diagnosis. The PCR test under study showed a high sensitivity and can be used for discrimination between normal flora and BV.

1Central Research Institute for Epidemiology, Moscow, Russia; 2Femicare Clinical Research for Women, Tienen, Belgium; and 3Department of Obstetrics and Gynecology, Antwerp University, Antwerp, Belgium

Reprint requests to: Tatiana A. Rumyantseva, MD, Central Research Institute for Epidemiology, Novogireevskaya st., 3a, 111123 Moscow, Russia. E-mail: ivanovatatiana86@yandex.ru

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

To access any underlying research materials, please contact Tatiana Rumyantseva (ivanovatatiana86@yandex.ru).

T. A. Rumyantseva, T. N. Romanuk, O. I. Shipulina, A. E. Guschin, and G. A. Shipulin work in the Central Research Institute for Epidemiology, Moscow, Russia, where the polymerase chain reaction–based test described in this study was developed. For the remaining authors, no conflicts of interest were declared.

Copyright © 2015 by the American Society for Colposcopy and Cervical Pathology