Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice
Bacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermedia...
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| Format: | Article |
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MDPI AG
2021-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/2/191 |
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| author | Giuseppina Campisciano Nunzia Zanotta Vincenzo Petix Manuela Giangreco Giuseppe Ricci Gianpaolo Maso Manola Comar Francesco De Seta |
| author_facet | Giuseppina Campisciano Nunzia Zanotta Vincenzo Petix Manuela Giangreco Giuseppe Ricci Gianpaolo Maso Manola Comar Francesco De Seta |
| author_sort | Giuseppina Campisciano |
| collection | DOAJ |
| description | Bacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermediate microbiota, raising the problem of how to clinically handle it. We retrospectively analyzed cervicovaginal swabs from 985 immunocompetent non-pregnant symptomaticspp. women (vaginal discharge, burning, itching) by Nugent score and qPCR for BV, aerobic or fungal vaginitis, and STIs (<i>Mycoplasmas</i> spp., <i>Chlamydia t.</i>, <i>Trichomonas v.</i>, and <i>Neisseria g.</i>). Nugent scores 0–3 and 7–10 were confirmed in 99.3% and 89.7% cases, respectively, by qPCR. Among Nugent scores 4–6 (partial BV), qPCR identified 46.1% of BV cases, with 37.3% of cases negative for BV, and only 16.7% of partial BV. Gram staining and qPCR were discordant (<i>p</i> value = 0.0001) mainly in the partial BV. Among the qPCR BV cases, the presence of aerobic vaginitis and STIs was identified, with a significant association (<i>p</i> < 0.0001) between the STIs and partial BV/overt BV. qPCR is more informative and accurate, and its use as an alternative or in combination with Gram staining could help clinicians in having an overview of the complex vaginal microbiota and in the interpretation of partial BV that can correspond to vaginitis and/or STIs. |
| first_indexed | 2024-03-09T03:21:40Z |
| format | Article |
| id | doaj.art-8ed85c9e5fb24bc39805112a61cffa0e |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T03:21:40Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-8ed85c9e5fb24bc39805112a61cffa0e2023-12-03T15:08:06ZengMDPI AGDiagnostics2075-44182021-01-0111219110.3390/diagnostics11020191Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical PracticeGiuseppina Campisciano0Nunzia Zanotta1Vincenzo Petix2Manuela Giangreco3Giuseppe Ricci4Gianpaolo Maso5Manola Comar6Francesco De Seta7Advanced Laboratory of Translational Microbiology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyAdvanced Laboratory of Translational Microbiology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyAdvanced Laboratory of Translational Microbiology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyInstitute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65/1, 34137 Trieste, ItalyObstetrics and Gynecology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyObstetrics and Gynecology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyAdvanced Laboratory of Translational Microbiology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyObstetrics and Gynecology, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”—Via dell’Istria 65, 34137 Trieste, ItalyBacterial vaginosis (BV) affects one-third of reproductive age women, increasing the risk of acquiring sexually transmitted infections (STIs) and posing a risk for reproductive health. The current diagnosis with Gram stain (Nugent Score) identifies a transitional stage named partial BV or intermediate microbiota, raising the problem of how to clinically handle it. We retrospectively analyzed cervicovaginal swabs from 985 immunocompetent non-pregnant symptomaticspp. women (vaginal discharge, burning, itching) by Nugent score and qPCR for BV, aerobic or fungal vaginitis, and STIs (<i>Mycoplasmas</i> spp., <i>Chlamydia t.</i>, <i>Trichomonas v.</i>, and <i>Neisseria g.</i>). Nugent scores 0–3 and 7–10 were confirmed in 99.3% and 89.7% cases, respectively, by qPCR. Among Nugent scores 4–6 (partial BV), qPCR identified 46.1% of BV cases, with 37.3% of cases negative for BV, and only 16.7% of partial BV. Gram staining and qPCR were discordant (<i>p</i> value = 0.0001) mainly in the partial BV. Among the qPCR BV cases, the presence of aerobic vaginitis and STIs was identified, with a significant association (<i>p</i> < 0.0001) between the STIs and partial BV/overt BV. qPCR is more informative and accurate, and its use as an alternative or in combination with Gram staining could help clinicians in having an overview of the complex vaginal microbiota and in the interpretation of partial BV that can correspond to vaginitis and/or STIs.https://www.mdpi.com/2075-4418/11/2/191bacterial vaginosisaerobic vaginitisSTIsNugent scoreintermediate vaginal microbiota |
| spellingShingle | Giuseppina Campisciano Nunzia Zanotta Vincenzo Petix Manuela Giangreco Giuseppe Ricci Gianpaolo Maso Manola Comar Francesco De Seta Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice Diagnostics bacterial vaginosis aerobic vaginitis STIs Nugent score intermediate vaginal microbiota |
| title | Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice |
| title_full | Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice |
| title_fullStr | Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice |
| title_full_unstemmed | Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice |
| title_short | Vaginal Dysbiosis and Partial Bacterial Vaginosis: The Interpretation of the “Grey Zones” of Clinical Practice |
| title_sort | vaginal dysbiosis and partial bacterial vaginosis the interpretation of the grey zones of clinical practice |
| topic | bacterial vaginosis aerobic vaginitis STIs Nugent score intermediate vaginal microbiota |
| url | https://www.mdpi.com/2075-4418/11/2/191 |
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