In addition to the Amsel criteria, multiple POC tests are available for BV diagnosis. The sensitivity and specificity of the Amsel criteria are 37%–70% and 94%–99%, respectively, compared with the Nugent score ( 1002).
![std on vag std on vag](https://d3i71xaburhd42.cloudfront.net/6e0a772cf78d939873ba1ffea501902342dbce95/3-Figure1-1.png)
A Nugent score of 0–3 is consistent with a Lactobacillus-predominant vaginal microbiota, 4–6 with intermediate microbiota (emergence of G. vaginalis or Bacteroides), and curved gram-negative rods (i.e., Mobiluncus) characteristic of BV. Vaginal Gram stain, considered the reference standard laboratory method for diagnosing BV, is used to determine the relative concentration of lactobacilli (i.e., long gram-positive rods), small gram-negative and gram-variable rods (i.e., G. Diagnostic ConsiderationsīV can be diagnosed by using clinical criteria (i.e., Amsel’s diagnostic criteria) ( 999) or by determining the Nugent score from a vaginal Gram stain ( 1000). Among WSW, a high level of BV concordance occurs between sex partners ( 292) however, no studies have evaluated treatment of female sex partners of WSW to prevent BV recurrence. Evaluation of short-term valacyclovir suppression among women with HSV-2 did not decrease the risk for BV, despite effective suppression of HSV-2 ( 995).Īlthough BV-associated bacteria can be identified on male genitalia ( 996, 997), treatment of male sex partners has not been beneficial in preventing the recurrence of BV ( 998). BV also increases HIV infection acquisition ( 992) because specific BV-associated bacteria can increase susceptibility to HIV ( 993, 994) and the risk for HIV transmission to male sex partners ( 187). genitalium ( 986), HPV ( 987), and HSV-2 ( 988) complications after gynecologic surgery complications of pregnancy and recurrence of BV ( 971, 989– 991). Women with BV are at increased risk for STI acquisition, such as HIV, N. Vitamin D deficiency has not been reported to be a risk factor for BV ( 985). Hormonal contraception does not increase risk for BV ( 983) and might protect against BV development ( 983, 984). BV prevalence has been reported to increase among women with copper-containing IUDs ( 972, 982).
![std on vag std on vag](https://cdn.citl.illinois.edu/courses/CHLH206/ch15_lecture/images/slides/slide23.jpg)
The cause of the microbial alteration that precipitates BV is not fully understood, and whether BV results from acquisition of a single sexually transmitted pathogen is unknown. Women who have never been sexually active are rarely affected ( 981). In addition, BV prevalence increases during menses ( 979, 980). Male circumcision reduces the risk for BV among women ( 978). However, in a nationally representative survey, the majority of women with BV were asymptomatic ( 310).īV is associated with having multiple male sex partners, female partners, sexual relationships with more than one person ( 973), a new sex partner, lack of condom use ( 974), douching ( 975, 976), and HSV-2 seropositivity ( 977).
![std on vag std on vag](https://cdcssl.ibsrv.net/cimg/www.officiteaadeducationlibrary.smb/450x243_85/621/59-5-481621.jpg)
BV is a highly prevalent condition and the most common cause of vaginal discharge worldwide ( 972). Certain women experience transient vaginal microbial changes, whereas others experience them for longer intervals ( 971). A notable feature is the appearance of a polymicrobial biofilm on vaginal epithelial cells ( 970).
![std on vag std on vag](https://images.onhealth.com/images/slideshow/stds-s8-photo-of-herpes-simplex-virus-type-2.jpg)
vaginae, and other BV-associated bacteria. vaginalis, Prevotella species, Mobiluncus species, A. BV is a vaginal dysbiosis resulting from replacement of normal hydrogen peroxide and lactic-acid–producing Lactobacillus species in the vagina with high concentrations of anaerobic bacteria, including G.