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Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study

Wet-mount microscopy aerobic vaginitis (AV) diagnostic criteria need phase-contrast microscopy and keen microscopists, and the preservation of saline smears is less common in clinical practice. This research work developed new AV diagnostic criteria that combine Gram stain with clinical features. We...

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Autores principales: Dong, Mengting, Wang, Chen, Li, Huiyang, Yan, Ye, Ma, Xiaotong, Li, Huanrong, Li, Xingshuo, Wang, Huihui, Zhang, Yixuan, Qi, Wenhui, Meng, Ke, Tian, Wenyan, Wang, Yingmei, Fan, Aiping, Han, Cha, Donders, Gilbert G. G., Xue, Fengxia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775230/
https://www.ncbi.nlm.nih.gov/pubmed/35054351
http://dx.doi.org/10.3390/diagnostics12010185
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author Dong, Mengting
Wang, Chen
Li, Huiyang
Yan, Ye
Ma, Xiaotong
Li, Huanrong
Li, Xingshuo
Wang, Huihui
Zhang, Yixuan
Qi, Wenhui
Meng, Ke
Tian, Wenyan
Wang, Yingmei
Fan, Aiping
Han, Cha
Donders, Gilbert G. G.
Xue, Fengxia
author_facet Dong, Mengting
Wang, Chen
Li, Huiyang
Yan, Ye
Ma, Xiaotong
Li, Huanrong
Li, Xingshuo
Wang, Huihui
Zhang, Yixuan
Qi, Wenhui
Meng, Ke
Tian, Wenyan
Wang, Yingmei
Fan, Aiping
Han, Cha
Donders, Gilbert G. G.
Xue, Fengxia
author_sort Dong, Mengting
collection PubMed
description Wet-mount microscopy aerobic vaginitis (AV) diagnostic criteria need phase-contrast microscopy and keen microscopists, and the preservation of saline smears is less common in clinical practice. This research work developed new AV diagnostic criteria that combine Gram stain with clinical features. We enrolled 325 AV patients and 325 controls as a study population to develop new AV diagnostic criteria. Then, an independent group, which included 500 women, was used as a validation population. AV-related microscopic findings on Gram-stained and wet-mount smears from the same participants were compared. The accuracy of bacterial indicators from the two methods was verified by bacterial 16S rRNA V4 sequencing (n = 240). Logistic regression was used to analyse AV-related clinical features. The screened clinical features were combined with Gram-stain microscopic indicators to establish new AV diagnostic criteria. There were no significant differences in the leukocyte counts or the parabasal epitheliocytes (PBC) proportion between the Gram-stain and wet-mount methods (400×). Gram stain (1000×) satisfied the ability to identify bacteria as verified by 16S rRNA sequencing but failed to identify toxic leukocytes. The new criteria included: Lactobacillary grades (LBG) and background flora (Gram stain, 1000×), leukocytes count and PBC proportion (Gram stain, 400×), and clinical features (vaginal pH > 4.5, vagina hyperemia, and yellow discharge). These criteria satisfied the accuracy and reliability for AV diagnosis (Se = 86.79%, Sp = 95.97%, and Kendall’s W value = 0.899) in perspective validation. In summary, we proposed an alternative and valuable AV diagnostic criteria based on the Gram stain, which can make it possible to diagnose common vaginitis like AV, BV, VVC, and mixed infections on the same smear and can be available for artificial intelligence diagnosis in the future.
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spelling pubmed-87752302022-01-21 Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study Dong, Mengting Wang, Chen Li, Huiyang Yan, Ye Ma, Xiaotong Li, Huanrong Li, Xingshuo Wang, Huihui Zhang, Yixuan Qi, Wenhui Meng, Ke Tian, Wenyan Wang, Yingmei Fan, Aiping Han, Cha Donders, Gilbert G. G. Xue, Fengxia Diagnostics (Basel) Article Wet-mount microscopy aerobic vaginitis (AV) diagnostic criteria need phase-contrast microscopy and keen microscopists, and the preservation of saline smears is less common in clinical practice. This research work developed new AV diagnostic criteria that combine Gram stain with clinical features. We enrolled 325 AV patients and 325 controls as a study population to develop new AV diagnostic criteria. Then, an independent group, which included 500 women, was used as a validation population. AV-related microscopic findings on Gram-stained and wet-mount smears from the same participants were compared. The accuracy of bacterial indicators from the two methods was verified by bacterial 16S rRNA V4 sequencing (n = 240). Logistic regression was used to analyse AV-related clinical features. The screened clinical features were combined with Gram-stain microscopic indicators to establish new AV diagnostic criteria. There were no significant differences in the leukocyte counts or the parabasal epitheliocytes (PBC) proportion between the Gram-stain and wet-mount methods (400×). Gram stain (1000×) satisfied the ability to identify bacteria as verified by 16S rRNA sequencing but failed to identify toxic leukocytes. The new criteria included: Lactobacillary grades (LBG) and background flora (Gram stain, 1000×), leukocytes count and PBC proportion (Gram stain, 400×), and clinical features (vaginal pH > 4.5, vagina hyperemia, and yellow discharge). These criteria satisfied the accuracy and reliability for AV diagnosis (Se = 86.79%, Sp = 95.97%, and Kendall’s W value = 0.899) in perspective validation. In summary, we proposed an alternative and valuable AV diagnostic criteria based on the Gram stain, which can make it possible to diagnose common vaginitis like AV, BV, VVC, and mixed infections on the same smear and can be available for artificial intelligence diagnosis in the future. MDPI 2022-01-13 /pmc/articles/PMC8775230/ /pubmed/35054351 http://dx.doi.org/10.3390/diagnostics12010185 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dong, Mengting
Wang, Chen
Li, Huiyang
Yan, Ye
Ma, Xiaotong
Li, Huanrong
Li, Xingshuo
Wang, Huihui
Zhang, Yixuan
Qi, Wenhui
Meng, Ke
Tian, Wenyan
Wang, Yingmei
Fan, Aiping
Han, Cha
Donders, Gilbert G. G.
Xue, Fengxia
Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title_full Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title_fullStr Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title_full_unstemmed Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title_short Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study
title_sort aerobic vaginitis diagnosis criteria combining gram stain with clinical features: an establishment and prospective validation study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775230/
https://www.ncbi.nlm.nih.gov/pubmed/35054351
http://dx.doi.org/10.3390/diagnostics12010185
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