Analysis of Nugent and Amsel Criteria for the Detection of Female Genital Tract Infections in a Tertiary Care Hospital, Coastal Karnataka

Abstract

BACKGROUND Female genital tract infections are polymicrobial in nature. Among the genital infections, bacterial vaginosis is the most common infection caused by anaerobic and microaerophilic organisms such as Bacteroides fragilis group, Mobiluncus species, Porphyromonas species, Prevotella group and Gardnerella vaginalis. Objective-Comparative evaluation of Nugent and Amsel criteria in diagnosis of various types of female genital tract infections. MATERIALS AND METHODS The present descriptive study was conducted in a tertiary care hospital in coastal Karnataka, South India during the period from July 2013 to June 2016. Of the 1217 women under study, 1054 cases were taken with complaints of vaginal discharge and 163 were included as control, which belongs to normal vaginal flora, confirmed by microscopy in the Dept. of Microbiology, Father Muller Medical College, Mangalore. High vaginal swabs from women of reproductive age group (15-45 years) and 163 age matched control group were examined by preliminary examination. RESULTS By employing Amsel and Nugent criteria, out of 1054 vaginal samples 415 (39.4%) were Normal vaginal flora, Vaginal Lactobacillosis 117 (9.3%), Bacterial vaginosis 315 (29.9%), Intermediate Bacterial vaginosis 11 (1.0%), Vulvovaginitis 6 (0.6%), Cervicitis 4 (0.4%), HIV 2 (0.2%), Candidiasis 106 (10.1%), Group B Streptococcus with Antenatal cases 73 (6.9%) and Trichomoniasis 5 (0.5%). No vaginal infections were detected from the control group. CONCLUSION BV, Candidiasis, Trichomoniasis and Vulvovaginitis are the most common conditions present among female genital tract infections. Nugent and Amsel criteria are the most cost effective and less time-consuming tests for the diagnosis of vaginal infections.

A study on vaginitis among pregnant and non-pregnant females in Alexandria, Egypt: An unexpected high rate of mixed vaginal infection

“…A weak agreement was identified between these indices for BV. Several studies have reported that Amsel's criteria are as good as Nugent's scores for diagnosing BV; both are simple, easy, cost effective and reliable methods [27] . However, by applying molecular techniques, we also diagnosed a further 13 additional BV cases.…”

“…In terms of Candida distribution, our data agreed with Hassan et al . (2017) [27] . We identified six Candida species: C. albicans was the predominant strain (62.9%), followed by Candida lusitaniae (13.7%), C. krusei (10.7%), C. glabrata (6.3%), C. tropicalis , and Candida parapsilosis [34] .…”