IMR Press / CEOG / Volume 32 / Issue 3 / pii/2005049

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Comparison of clinical diagnosis and microbiological test results in vaginal infections

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1 Department of Obstetrics and Gynaecology, Bolu (Turkey)
2 Department of Microbiology and Clinical Microbiology, School of Medicine, Gaziantep University, Bolu (Turkey)
3 Department of Microbiology and Clinical Microbiology, Izzet Baysal Medical Faculty, Abant Izzet Baysal University, Bolu (Turkey)
4 Department of Obstetrics and Gynaecology, Bolu (Turkey)
5 Department of Microbiology and Clinical Microbiology, School of Medicine, Gaziantep University, Bolu (Turkey)
Clin. Exp. Obstet. Gynecol. 2005, 32(3), 172–174;
Published: 10 September 2005
Abstract

Lower genital tract infections continue to be a problem due to the fact that the clinical diagnosis is usually inadequate, and sub­sequent care is suboptimal. This study aimed at evaluating the accuracy of clinical diagnosis by comparing it with microbiologic test results, and to determine the causative agents of vaginal infections. Sixty-seven nonpregnant women (18-45 years of age) with the clinical diagnosis of lower genital tract infection were enrolled in the study. Patients were not included if they had a history of vaginal infection during the previous three-month period or intrauter­ine device. The clinical diagnosis was based on the combinations of symptoms, direct observation of wet mount, homogeneous dis­charge, vaginal pH >4.5, and detection of the amine odor after exposure of vaginal secretions to 10% KOH. Vaginal samples were taken with two cotton swabs, one was used for pH determination, and the second was utilized for microbiological tests. Gram stain­ing and cultures with Sabouraud agar and chocolate agar were performed for microbiological diagnosis, and the results were com­pared. The clinical diagnoses included 26 (38.8%) candidiasis, 18 (26.8 %) bacterial vaginosis, three (4.5%) trichomoniasis, and 20 (29.9%) mixed vaginal infections. Of the 26 patients with clinical diagnoses of candidiasis, 12 (46.1 %) revealed Candiada albicans, nine (34.6) patients revealed microorganisms other than candida species, and five (19.2%) patients had no growth. Five (27.8%) bac­terial vaginosis patients revealed Gardnarella vagina/is and 12 patients (66.6%) did not grow any microorganism. The overall rate of accurate clinical diagnoses confirmed by microbiological test results was 43.2%. Seventeen (43.6) of the 39 microbiological test results correlated with clinical diagnosis, and no growth was observed in 28 (41.8%) cultures. We conclude that the clinical diagnosis of vaginal infection is inadequate and should be confirmed with microbiological testing if the resources are avaliable.

Keywords
Vaginal infection
Clinical diagnosis
Microbiological diagnosis
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