Comparison of the Diagnostic Method of Cultivation with Amsel Standard in the Diagnosis of Gardnerella vaginalis in Patients with Genital Infection

Abstract

Background & objectives: Vaginal microbial infections are common, and involvement of bacterial agents in genital infection is equal to that of fungal and protozoal agents. Gardnerella vaginalis is an organism that is often thought to play the most important role in bacterial vaginosis. The aim of this study was to compare the value of the diagnostic method of cultivation with Amsel standard in the diagnosis of Gardnerella Vaginalis infection in patients with genital tract infection. Methods: A cross-sectional study was performed on 150 women aged 15-55 years who complained of vaginal discharge during the period of the study, Jan 2017 to July 2017, in Alawi Hospital in Ardabil and were examined by a clinical examination. For each of the patients, three of the four diagnostic criteria of Amsel, including homogeneous discharge, PH measurements and whiff test were performed, and if two of them were positive, a questionnaire containing general and clinical information was completed. Using three sterile swabs, samples were taken from vaginal discharge. The first swab was used for culture, the second swab for the whiff testing and the third swab for Papanicolaou staining and verifying the presence of clue cell in the vaginal smear sample as a fourth grade of Amsel to diagnose bacterial vaginosis. In general, if three of the four Amsel criteria were positive in one person, it was considered to be positive in terms of Amsel's standard. Results: Of 150 participants, 21 were diagnosed with Gardnerella vaginalis infection, of which 14 cases (%66.6) had positive Gardnerella culture. All of 21 patients (%100) with Gardnerella vaginalis had clue cells in Pap smear. The pH of vaginal discharge of 20 samples was 4.5 (%95.23), 18 samples had positive Amine tests (%85.71) and 16 samples had homogeneous secretion (%76.19). Conclusion: The results of this study showed that culture method in comparison with Amsel diagnostic criteria did not have sufficient accuracy to detect Gardnerella vaginalis infection. In addition, the culture method is costly and time consuming.