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Sex Transm Infect 2005;81:155-157 doi:10.1136/sti.2004.009902
  • In practice

Methods employed by genitourinary medicine clinics in the United Kingdom to diagnose bacterial vaginosis

  1. F E A Keane1,
  2. R Maw2,
  3. C Pritchard3,
  4. C A Ison4
  1. 1Department of Genito-urinary Medicine, Royal Cornwall Hospital, Truro, UK
  2. 2Department of Genito-urinary Medicine, Royal Victoria Hospital, Belfast, UK
  3. 3Research and Development Support Unit, Royal Cornwall Hospital, Truro, UK
  4. 4Department of Infectious Diseases and Microbiology, Imperial College London, St Mary’s Campus, London, UK
  1. Correspondence to:
 Dr Frances Keane
 Department of Genitourinary Medicine, Royal Cornwall Hospital, Treliske, Truro TR1 3LJ, UK; keanefrrcht.cornwall.nhs,uk
  • Accepted 3 June 2004

Abstract

Objective: To determine the methods used by genitourinary medicine (GUM) clinics in the United Kingdom for the diagnosis of bacterial vaginosis (BV).

Methods: A questionnaire survey of UK GUM clinics was conducted.

Results: 148/221 (67%) clinics returned a questionnaire. 96/148 (64.9%) clinics reported using Amsel’s criteria to diagnose BV but only 29 (30.5%) of these used all four of the composite criteria. 139/148 (93.9%) clinics used the appearance of a Gram stained vaginal smear as an aid in BV diagnosis, although a variety of scoring methods was employed. In the majority of clinics, 92/148 (62.2%), one staff discipline provided the microscopy service, in 50 (33.8%) clinics two staff disciplines provided microscopy services. The bulk of microscopy services within UK GUM clinics is provided by nurses.

Conclusions: Most UK GUM clinics utilise the appearance of a Gram stained vaginal smear for the diagnosis of BV although there is little consensus at present about the type of scoring method employed. Adaptation of a uniform scoring method would have enormous benefits, including consistency and reproducibility of results and the development of quality assurance schemes for BV diagnosis on a national basis. There are important issues to be addressed regarding the initial training and ongoing support for nurses providing microscopy services within UK GUM clinics.

Footnotes

  • Conflict of interest: None.

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