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P248 Sensitivity of the amsel’s criteria compared to the nugent score in absence and in presence of trichomonas vaginalis (TV) and/or candida SPP among women with symptomatic vaginitis/vaginosis
  1. Lucile Belley-Montfort1,
  2. Joel Lebed2,
  3. Bonnie Smith3,
  4. Melissa Farrell3,
  5. Jane Schwebke4,
  6. Paul Nyirjesy5,
  7. Thomas Davis6,
  8. DeAnna Fuller6,
  9. Kenneth Fife7,
  10. Safedin Sajo Beqaj8
  1. 1BD Diagnostics, Québec, QC, Canada
  2. 2Planned Parenthood Southeastern Pennsylvania, Philadelphia, PA, USA
  3. 3Planned Parenthood Gulf Coast, Houston, TX, USA
  4. 4The University of Alabama at Birmingham, Birmingham, AL, USA
  5. 5Drexel University, Philadelphia, PA, USA
  6. 8Pathology Inc, Torrance, CA, USA
  7. 6Wishard Health Services, Indianapolis, IN, USA
  8. 7Indiana University, Indianapolis, IN, USA

Abstract

Background/introduction In a multicenter clinical trial funded by BD, we observed less accurate clinician diagnosis of bacterial vaginosis (BV) based on clinical observations when Trichomonas vaginalis (TV) and/or Candida spp. were also detected by the trial Reference Methods than when only BV was detected.

Aim(s)/objectives To determine the sensitivity of each criterion and of the overall Amsel’s criteria (3/4 criteria met), the results of the Amsel’s corresponding to the sub-population of specimens that gave a Nugent score of 7–10 were analysed.

Methods Following informed consent, women with symptoms of vaginitis/vaginosis were included in the trial. The four Amsel’s criteria and the Nugent score were performed. Evaluation for trichomoniasis by wet mount and culture (InPouch™ TV, Biomed) were performed. Candida colonies were isolated (BBL™ Sabouraud Dextrose Agar, Emmons and BBL™ CHROMAgar™ Candida plate, BD) and identified by ITS-2 bi-directional sequencing (Accugenix®).

Results In total, 269/497 (54.1%) specimens gave a Nugent score of 7–10. Amongst them, TV and/or Candida spp. were found in 100 specimens (37.2%). The sensitivity of clue cells, amine test, vaginal pH, BV vaginal discharge, and overall Amsel’s criteria in absence of TV and/or Candida spp. was 86.3%, 82.7%, 91.1%, 71.0%, and 84.6% respectively. In presence of TV and/or Candida spp., the sensitivity was 63.6%, 64.0%, 75.0%, 42.0%, and 60.0% respectively (p values ≤ 0.0009 for all comparisons).

Discussion/conclusion The sensitivity of the Amsel’s criteria in women with BV decreases when TV and/or Candida spp. are present. The BV vaginal discharge is the least sensitive criterion.

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