Functional testing is a complementary tool for the diagnosis of vaginitis

Area of Science:

• Gynecology
• Microbiology
• Clinical Diagnostics

Background:

• Vaginal microbiota evaluation is crucial for diagnosing vaginal inflammatory diseases in China.
• Current morphological evaluation methods are time-consuming and require specialized expertise.
• A rapid six-index functional test offers a potential alternative diagnostic approach.

Purpose of the Study:

• To evaluate the diagnostic value of a six-index functional test (pH, H2O2, LEU, SNA, GUS, NAG) for vaginal inflammatory diseases.
• To compare the diagnostic performance of the functional test with traditional morphological evaluation.
• To determine the accuracy of specific functional markers in identifying common vaginal conditions.

Main Methods:

• Retrospective analysis of data from 4902 patients at Women and Children's Hospital.
• Collection of vaginal swab specimens for both functional and morphological testing.
• Statistical analysis using Fisher's exact test.

Main Results:

• Functional tests (pH, H2O2, LEU, SNA) demonstrated high sensitivity but low specificity for detecting vaginal inflammatory diseases.
• N-acetyl-β-D-glucosaminidase (NAG) and β-glucuronidase (GUS) exhibited high specificity but limited sensitivity.
• Sialidase (SNA) showed high sensitivity (80.72%) and specificity (96.78%) for bacterial vaginosis.

Conclusions:

• Functional tests alone are insufficient for accurate diagnosis of diverse vaginal inflammatory diseases due to variable specificity.
• While NAG and GUS offer high specificity, their low sensitivity limits their standalone diagnostic utility.
• Morphological evaluation remains the gold standard, particularly when functional and morphological test results are discordant.