DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180888

Comparative study of pap smear and microbiological pattern in bacterial vaginosis

Girishma J., Rupakala B. M., Sunil Chavan

Abstract


Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.

Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.

Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.

Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.


Keywords


Bacterial vaginosis, Culture, Gram stain, Pap smear

Full Text:

PDF

References


Lentz: Comprehensive Gynecology, 6th ed. Copyright Mosby, An Imprint of Elsevier; 2012:23.

Marx J, Hockberger R, Walls R. Marx: Rosen’s Emergency Medicine: Concepts and clinical practice, 8th ed. Elsevier; 2014;98.

Sherman ME. Cytopathology. In: K Urman RJ (ed). Blaustein’s pathology of the female genital tract, 4th edn. Springer-Verlag: USA; 1994:1097-130.

Gardner HL, Dukes CD. Haemophilus vaginalis vaginitis. A newly defined specific infection previously classified “nonspecific” vaginitis. Am J Obstet Gynecol. 1995;69:962-76.

Hoffman B,‎ Schorge J,‎ Schaffer J,‎ Halvorson J,‎ Bradshaw K,‎ Corton MM, Williams gynecology 2nd ed. Texas: McGraw Hill; 2012.

Morris MC, Rogers PA, Kinghorn GR. Is bacterial vaginosis a sexually transmitted infection? Sex Transm Infect. 2001;77:63-8.

Holmes KK. Sexually transmitted diseases. 3th ed. New York: Mc Graw Hill; 1999.

Wolrath H, Forsum U, Larsson PG, Boren H. Analysis of bacterial vaginosis-related amines in vaginal fluid by gas chromatography and mass spectroscopy. J Clin Microbiol. 2001;39:4026-31.

Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol. 1991;29:297-301.

Smith JHF. Bethesda 2001. Cytopathol 2002;13:4-10.

Batra N, Kumar RV, Alva S, Kariappa TM. Diversity of vaginal microbial communities and role of PAP smear in its detection. Int J Curr Microbiol App Sci. 2014;3(11):596-605.

Platz-Christensen JJ, Larson PG, Sundstrom E, Wiqvist N. Detection of bacterial vaginosis in wet mount, Papanicolaou stained vaginal smears and in Gram-stained smears. Acta Obstet Gynecol Scand. 1995;74:67-70.

Filho DSC, Diniz CG, da Silva VL. Bacterial vaginosis: clinical, epidemiologic and microbiological features. HU Magazine, Juiz de Fora. 2010;36(3):223-30.

Spiegel CA, Amsel R, Holmes KK. Diagnosis of bacterial vaginosis by direct gram stain of vaginal fluid. J Clin Microbiol. 1983:170-7.

Schnadig VJ, Davie KD, Shaferc SK. The cytologist and bacteriosis of the vaginal ectocervical area: clues, commas and confusion. Acta Cytol. 1989;33:287-97.

Amsel R, Totten PA, Spiegal CA. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74:14-22.

Eschenbach DA, Hiller SL, Critchlow C. Diagnosis and clinical manifestations of bacterial vaginosis. Am J Obstet Gynecol. 1988;158(4):819-28.