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Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.
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Objective To identify Mobiluncus species with matrix-assisted laser desorption/ioniza-tion time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing and to analyze anti-biotic resistance genes and phylogenetic relationships among Mobiluncus species with whole genome sequen-cing. Methods Twenty-five Mobiluncus strains were isolated after anaerobic culture of 65 vaginal secretion samples of patients with bacterial vaginosis (BV) and identified to species level by MALDI-TOF MS and 16S rRNA gene sequencing. The whole genome DNA of each strain was extracted for next-generation sequencing. SPAdes was used to assembly genomes. Resistance genes were searched in ARGD database. The core ge-nome of all isolates was analyzed by Harvest to construct phylogenetic tree. Results MALDI-TOF MS could only identify Mobiluncus curtisii, while 16S rRNA gene sequencing could identify both Mobiluncus mulieris and Mobiluncus curtisii. Results of the whole genome sequencing showed that tetracycline resistance gene tet ( o) and macrolides resistance gene erm(x) were the two predominant acquired resistance genes of Mobilun-cus with a positive rate of 84. 7% and 61. 5% respectively. Intra-species relationships of the two Mobiluncus species were close, but a distant phylogenetic relationship was found between the two species. Conclusion This study shows that MALDI-TOF MS can't be used to identify Mobiluncus mulieris at present. Mobiluncus strains have potential resistance to tetracycline and macrolides. Intra-species evolution of Mobiluncus is slow, which indicates that there is no growing trend towards new species for the time being.