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Infectious Diseases in Obstetrics and Gynecology
Volume 6, Issue 5, Pages 204-208
Clinical Study

Gram Stain Method Shows Better Sensitivity Than Clinical Criteria for Detection of Bacterial Vaginosis in Surveillance of Pregnant, Low-Income Women in a Clinical Setting

1Department of Obstetrics and Gynecology, St. Joseph Hospital, Chicago, IL, USA
2Department of Pathology, St. Joseph Hospital Chicago, Chicago, IL, USA
3Maternal-Fetal Medicine, St. Joseph Hospital Chicago, IL, USA

Received 7 April 1998; Accepted 19 October 1998

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: The purpose of the study is to determine whether the Gram stain method is superior to the clinical criteria for the diagnosis of bacterial vaginosis in low-income pregnant women seen in a resident clinic setting. The clinical criteria is the current diagnostic method employed to diagnose bacterial vaginosis.

Study Design: In this study, 51 pregnant women with vaginal discharge were prospectively evaluated. All were screened using the clinical criteria, Gram stain method, and culture of the discharge. The modified scoring system instituted by Nugent et al. (J Clin Microbiol 29:297–301, 1991) was employed in reading the Gram stain smears. The clinical criteria were then compared with the Gram stain method. Isolation of moderate to many Gardnerella vaginalis growth by culture was used as the confirmatory finding.

Results: Sensitivity of the Gram stain method (91%) was significantly higher than that of the clinical criteria (46%), (sign test P = 0.0023, <0.01). The Gram stain method also has both a low false-negative (4%) and high negative predictive value (96%), making it an ideal diagnostic test.

Conclusion: The Gram stain method is a rapid and cost-effective test that is also highly reproducible and readily available in many laboratories. These features make the Gram stain method a more desirable screening procedure for bacterial vaginosis in a clinic population.