Comparison of Amsel Clinical Criteria with Standard Method of Gram Stain for Diagnosis of Bacterial Vaginosis

Document Type : Original Article


1 M.Sc. in Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Assistant professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistant professor, Department of Biosttistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 PhD in Parasitology, Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Lorestan, Iran.

5 M.Sc. in Microbiology, School of Paramedical, Jundishapur University of Medical Sciences, Ahvaz, Iran.

6 BC in Laboratory Sciences, School of Paramedical, Islamic Azazd University Borojerrd Branch, Borojerrd, Iran.


Introduction: Bacterial Vaginosis is the most common type of vaginitis in women of reproductive age which is diagnosed by Amsel’s clinical criteria and the Nugent microscopic scoring system (Gram stain). This study was performed with aim to compare Amsel clinical criteria with standard method of Gram stain for diagnosis of bacterial vaginosis.
Methods: The experimental study was conducted to compare Amsel's clinical criteria with standard gram stain method for diagnosis of bacterial vaginosis on 100 married women referred to women clinics of Khorramabad in 2015-2016. Nugent scoring system was considered as the gold standard method for diagnosis of bacterial vaginosis. Sensitivity, specificity, positive predictive value, and negative predictive value of Amsel's criteria was compared with those of the Nugent scoring system. Data was analyzed by SPSS software (version 20). P<0.05 was considered statistically significant.
Results: The mean of age, duration of marriage, age of the first menstruation and first pregnancy were 31.96 ± 8.93, 18.96 ± 3.50, 12.99± 0.85, and 20.03 ± 3.84 years. In the evaluation of diagnostic value of the Nugent scoring system in comparison with the Amsel's criteria, Amsel's criteria had sensitivity 100%, specificity 46%, positive predictive value 92.5%, and negative predictive value of 100%.
Conclusion: Amsel's criteria are not as accurate as the Nugent scoring system in the diagnosis of this infection and Gram staining is needed to correctly diagnose bacterial vaginosis.


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