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Srpski arhiv za celokupno lekarstvo
2013, vol. 141, iss. 7-8, pp. 560-564
article language: Serbian
document type: Professional Practice
published on: 13/11/2013
doi: 10.2298/SARH1308560D
Diagnosis of bacterial vaginosis
aUniversity of Belgrade, Faculty of Medicine, Institute of Microbiology and Immunology
bUniversity of Belgrade, Faculty of Medicine, Gynecology Obstetrics Clinic 'Narodni front'
cUniversity of Belgrade, Faculty of Medicine, Gynecology Obstetrics Clinic 'Narodni front' + University of Belgrade, Faculty of Medicine



Bacterial vaginosis is a common, complex clinical syndrome characterized by alterations in the normal vaginal flora. When symptomatic, it is associated with a malodorous vaginal discharge and on occasion vaginal burning or itching. Under normal conditions, lactobacilli constitute 95% of the bacteria in the vagina. Bacterial vaginosis is associated with severe reduction or absence of the normal H2O2­producing lactobacilli and overgrowth of anaerobic bacteria and Gardnerella vaginalis, Atopobium vaginae, Mycoplasma hominis and Mobiluncus species. Most types of infectious disease are diagnosed by culture, by isolating an antigen or RNA/DNA from the microbe, or by serodiagnosis to determine the presence of antibodies to the microbe. Therefore, demonstration of the presence of an infectious agent is often a necessary criterion for the diagnosis of the disease. This is not the case for bacterial vaginosis, since the ultimate cause of the disease is not yet known. There are a variety of methods for the diagnosis of bacterial vaginosis but no method can at present be regarded as the best. Diagnosing bacterial vaginosis has long been based on the clinical criteria of Amsel, whereby three of four defined criteria must be satisfied. Nugent's scoring system has been further developed and includes validation of the categories of observable bacteria structures. Up­to­date molecular tests are introduced, and better understanding of vaginal microbiome, a clear definition for bacterial vaginosis, and short­term and long­term fluctuations in vaginal microflora will help to better define molecular tests within the broader clinical context.



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