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Assessing a diagnosis tool for bacterial vaginosis
Ravesh Singh1,2,3, Veron Ramsuran4,5,6, Nireshni Mitchev7,4
1Department of Microbiology, National Health Laboratory Services, KwaZulu-Natal Academic Complex, Inkosi Albert Luthuli Central Hospital, Durban, South Africa. singhra@ukzn.ac.za.
Summary
A new quantitative PCR assay accurately detects bacterial vaginosis (BV) by quantifying specific bacteria. This cost-effective tool shows potential for diagnosing BV in resource-limited settings, improving upon traditional microscopy methods.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Bacterial vaginosis (BV) diagnosis often relies on the Nugent score (NS), a semiquantitative microscopy method.
- Resource-poor settings face challenges in accurate and accessible BV diagnostics.
Purpose of the Study:
- To evaluate a quantitative real-time PCR (qPCR) assay for detecting and quantifying individual BV-associated bacteria.
- To assess the assay's accuracy and potential for use in resource-limited settings.
Main Methods:
- Vaginal swabs from 247 South African women were analyzed using NS and a custom qPCR assay for eight key bacteria.
- Receiver Operating Characteristic (ROC) analysis determined cutoffs for bacterial species.
- Logistic regression identified the strongest predictors of BV status.
Main Results:
- The qPCR assay demonstrated high accuracy, with Atopobium vaginae (AV), Gardnerella vaginalis (GV), a combination of GV, AV, M-1, BVAB2 (GAMB), and Lactobacillus crispatus/jensenii (LC+LJ) showing significant AUC, sensitivity, and specificity.
- Increased GAMB copies and decreased LC+LJ copies were strongly associated with higher BV scores.
- BV scoring by the developed qPCR assay did not differ significantly from commercial assays or the Nugent score.
Conclusions:
- A novel qPCR assay accurately detects and quantifies BV-associated bacteria.
- This assay is a promising, cost-effective tool for BV diagnosis in resource-limited settings.
- The assay's performance is comparable to established diagnostic methods.
