| Summary: | Bacground/Aim. Vaginal and cervical swab culture is still very common
procedure in our country’s everyday practice whereas simple and rapid
diagnostic methods have been very rarely used. The aim of this study was to
show that the employment of simple and rapid diagnostic tools [vaginal fluid
wet mount microscopy (VFWMM), vaginal pH and potassium hydroxide (KOH) test]
offers better assessment of vaginal environment than standard microbiologic
culture commonly used in Serbia. Methods. This prospective study included 505
asymptomatic pregnant women undergoing VFWMM, test with 10% KOH,
determination of vaginal pH and standard culture of cervicovaginal swabs.
Combining findings from the procedures was used to make diagnoses of
bacterial vaginosis (BV) and vaginitis. In addition, the number of
polymorphonuclear leukocytes (PMN) was determined in each sample and analyzed
along with other findings. Infections with Candida albicans and Trichomonas
vaginalis were confirmed or excluded by microscopic examination. Results. In
36 (6%) patients cervicovaginal swab cultures retrieved several aerobes and
facultative anaerobes, whereas in 52 (11%) women Candida albicans was
isolated. Based on VFWMM findings and clinical criteria 96 (19%) women had
BV, 19 (4%) vaginitis, and 72 (14%) candidiasis. Of 115 women with BV and
vaginitis, pH 4.5 was found in 5, and of 390 with normal findings 83 (21%)
had vaginal pH 4.5. Elevated numbers of PMN were found in 154 (30%) women -
in 83 (54%) of them VFWMM was normal. Specificity and sensitivity of KOH test
and vaginal pH determination in defining pathological vaginal flora were 95%
and 81%, and 79% and 91%, respectively. Conclusion. Cervicovaginal swab
culture is expensive but almost non-informative test in clinical practice.
The use of simpler and rapid methods as vaginal fluid wet mount microscopy,
KOH test and vaginal pH offers better results in diagnosis, and probably in
the treatment and prevention of sequels of vaginal infections.
|
|---|
