Correlation of H2O2 Production of Lactobacillus species with Nugent Scores of Young Nigerian Women.

Aim: To correlate H2O2 production of Lactobacillus species with the Nugent scores of young Nigerian women in order to assess their vaginal health. Study Design: Cross-sectional study. Place and Duration of Study: Departments of Medical Microbiology & Parasitology, Biochemistry and Obstetrics and Gynaecology, College of Medicine of the University of Lagos, between May and august 2009. Methodology: Ninety- seven isolates of Lactobacillus from eighty-two women without Bacterial vaginosis (BV) and fifteen women with BV were used for the study. BV was diagnosed using Nugent scoring method. Lactobacilli were isolated using MRS agar and categorized into facultative anaerobes and strict anaerobes. Hydrogen peroxide was detected and measured by titration using dilute sulphuric acid and reaction stopped with potassium permanganate. Results: Out of 97 isolates studied, 76 (78%) were facultative anaerobes, while 21 (22%) were strict anaerobes. The facultative anaerobes were obtained from 11 of 15 women with BV and 65 of 82 women without BV. Forty- nine (50.51%) of the 97 isolates produced H2O2. Forty- four of the H2O2 producers were from women without BV while five were from women with BV. Majority (67%) of the strains obtained from women with BV were non-hydrogen peroxide producing. Proportion of H2O2 producing Lactobacillus by Nugent score were 70%, 43% and 33% in negative, intermediate and BV Nugent scores respectively. There was no significant difference between the mean concentrations of H2O2 production in the various Nugent scores. Conclusion: The overall rate of hydrogen peroxide production was low. While the rates of hydrogen peroxide production correlated with Nugent scores, being highest in negative Nugent scores and lowest with BV scores, the concentration of hydrogen peroxide produced had no association with Nugent scores. The Nigerian women studied might have a relatively high susceptibility rate to vaginal infections.

Estudo comparativo entre o teste do pH e do KOH versus escore de Nugent para diagnóstico da vaginose bacteriana em gestantes / Comparative study between the pH test and of the KOH versus Nugent score for diagnosis of bacterial vaginosis in pregnant women

OBJETIVO: Aquilatar a prevalência da vaginose bacteriana e comparar a acurácia dos testes do pH e do KOH com o gradiente de Nugent, método padrão-ouro, no diagnóstico da vaginose bacteriana (VB) em gestantes assintomáticas e sintomáticas de baixo risco. MÉTODOS: Foi realizado um estudo de corte transversal em 321 grávidas, com idade gestacional entre 14ª e 26ª semanas, 218 assintomáticas e 103 com queixa de secreção vaginal sugestiva de vaginose bacteriana. Todas as gestantes foram avaliadas pelos critérios de Nugent e submetidas à pHmetria vaginal e ao teste do KOH a 10%. O coeficiente de Kappa foi utilizado para avaliar os métodos quanto à concordância diagnóstica. RESULTADO: A maioria das gestantes era adolescente (média etária 21,0±5,6 anos), nulípara e parda. A prevalência da vaginose bacteriana foi de 33,3% pelo método de pH e KOH e de 35,5% pelo Nugent. Entre as grávidas assintomáticas, foi observada ótima concordância dos métodos, com 72,5% delas apresentando resultados negativos para ambos os métodos, o que resultou em um elevado coeficiente de Kappa (k=0,82). No grupo de gestantes sintomáticas, houve 49,5% de positividade para ambos os métodos diagnósticos, demonstrando ótima concordância (k=0,74). CONCLUSÃO: A prevalência da vaginose bacteriana foi elevada tanto pelo método de pH e KOH quanto pelo Nugent. O método do pH e KOH é tão capaz em diagnosticar a vaginose bacteriana quanto os critérios de Nugent.

PURPOSE: To assess the prevalence of bacterial vaginosis and to compare the accuracy of testing pH and KOH with the Nugent gradient, the gold standard for the diagnosis of bacterial vaginosis (BV) in asymptomatic and symptomatic pregnant women at low risk. METHODS: We conducted a cross-sectional study on 321 pregnant women with gestational age between 14 and 26 weeks, 218 of them asymptomatic and 103 with vaginal complaints suggestive of bacterial vaginosis. All women were assessed by the criteria of Nugent and subjected to the measurement of vaginal pH and to the 10% KOH test. The Kappa coefficient was used to evaluate the methods in terms of diagnostic agreement. RESULTS: Most patients were adolescents (mean age 21.0±5.6 years), nulliparous and mulattos. The prevalence of bacterial vaginosis was 33.3% as estimated by the pH and KOH method and 35.5% by the Nugent method. Excellent agreement of the methods was found among asymptomatic pregnant women, with 72.5% of them showing negative results to both tests, which resulted in a high Kappa coefficient (k=0.82). The group of symptomatic women showed 49.5% positivity to both diagnostic methods, with excellent agreement (k=0.74). CONCLUSION: The prevalence of bacterial vaginosis determined by both the pH and KOH method and the Nugent score was high. The pH and KOH method can diagnose bacterial vaginosis as accurately as the Nugent criterion.