The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation
Open accessAbstract
The purpose of the study was to examine intercenter variability in the interpretation of Gram-stained vaginal smears from pregnant women. The intercenter reliability of individual morphotypes identified on the vaginal smear was evaluated by comparing them with those obtained at a standard center. A new scoring system that uses the most reliable morphotypes from the vaginal smear was proposed for diagnosing bacterial vaginosis. This scoring system was compared with the Spiegel criteria for diagnosing bacterial vaginosis. The scoring system (0 to 10) was described as a weighted combination of the following morphotypes: lactobacilli, Gardnerella vaginalis or bacteroides (small gram-variable rods or gram-negative rods), and curved gram-variable rods. By using the Spearman rank correlation to determine intercenter variability, gram-positive cocci had poor agreement (0.23); lactobacilli (0.65), G. vaginalis (0.69), and bacteroides (0.57) had moderate agreement; and small (0.74) and curved (0.85) gram-variable rods had good agreement. The reliability of the 0 to 10 scoring system was maximized by not using gram-positive cocci, combining G. vaginalis and bacteroides morphotypes, and weighting more heavily curved gram-variable rods. For comparison with the Spiegel criteria, a score of 7 or higher was considered indicative of bacterial vaginosis. The standardized score had improved intercenter reliability (r = 0.82) compared with the Spiegel criteria (r = 0.61). The standardized score also facilitates future research concerning bacterial vaginosis because it provides gradations of the disturbance of vaginal flora which may be associated with different levels of risk for pregnancy complications.
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Cites
Amsel, R., Totten, P. A., Spiegel, C. A., Chen, K. C. S., Eschenbach, D., & Holmes, K. K. (1983) · The American Journal of Medicine · doi:10.1016/0002-9343(83)91112-9 · Cited by 2,349
A Case–Control Study of Chorioamnionic Infection and Histologic Chorioamnionitis in Prematurity
Hillier, S. L., Martius, J., Krohn, M., Kiviat, N., Holmes, K. K., & Eschenbach, D. A. (1988) · New England Journal of Medicine · doi:10.1056/nejm198810133191503 · Cited by 992
Self-citationHaemophilus vaginalis vaginitis
Gardner, H. L., & Dukes, C. D. (1955) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(55)90095-8 · Cited by 819
Misinterpretation and misuse of the kappa statistic
MACLURE, M., & WILLETT, W. C. (1987) · American Journal of Epidemiology · doi:10.1093/aje/126.2.161 · Cited by 808
Gravett, M. G. (1986) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1986.03380140069024 · Cited by 544
Anaerobic Bacteria in Nonspecific Vaginitis
Spiegel, C. A., Amsel, R., Eschenbach, D., Schoenknecht, F., & Holmes, K. K. (1980) · New England Journal of Medicine · doi:10.1056/nejm198009113031102 · Cited by 471
Preterm Labor Associated With Subclinical Amniotic Fluid Infection and With Bacterial Vaginosis
GRAVETT, M. G., HUMMEL, D., ESCHENBACH, D. A., & HOLMES, K. K. (1986) · Obstetrics & Gynecology · doi:10.1097/00006250-198602000-00013 · Cited by 455
Diagnosis of bacterial vaginosis by direct gram stain of vaginal fluid
Spiegel, C. A., Amsel, R., & Holmes, K. K. (1983) · Journal of Clinical Microbiology · doi:10.1128/jcm.18.1.170-177.1983 · Cited by 412
Martius, J., Krohn, M. A., Hillier, S. L., Stamm, W. E., Holmes, K. K., & Eschenbach, D. A. (1988) · PubMed · Cited by 302
Self-citationBacterial vaginosis as a risk factor for post-cesarean endometritis.
Watts, D. H., Krohn, M. A., Hillier, S. L., & Eschenbach, D. A. (1990) · PubMed · Cited by 274
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Epidemiology and causes of preterm birth
Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60074-4 · Cited by 7,801
“96 A score of 7-10 is used to diagnose bacterial vaginosis, and has been associated with a 1·5-fold to 3-fold increase in the rate of preterm birth.”
MethodVaginal microbiome of reproductive-age women
Ravel, J., Gajer, P., Abdo, Z., Schneider, G. M., Koenig, S. S. K., McCulle, S. L., Karlebach, S., Gorle, R., Russell, J., Tacket, C. O., et al. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1002611107 · Cited by 4,254
Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Intrauterine infection and preterm delivery
Goldenberg, R. L., Hauth, J. C., & Andrews, W. W. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005183422007 · Cited by 2,548
Association between Bacterial Vaginosis and Preterm Delivery of a Low-Birth-Weight Infant
Hillier, S. L., Nugent, R. P., Eschenbach, D. A., Krohn, M. A., Gibbs, R. S., Martin, D. H., Cotch, M. F., Edelman, R., Pastorek, J. G., Rao, A. V., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199512283332604 · Cited by 1,492
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Metadata
- Authors
- Nugent, R. P., Krohn, M. A., & Hillier, S. L.
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 1991-02
- Volume
- 29
- Issue
- 2
- Pages
- 297-301
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- OpenAlex
- W1868667984
- Cited by
- 3,331
- References
- 11
- FWCI
- 11.75
- Type
- journal article
- Language
- en
- Open access
- green
- Licence
- journals.asm.org/non-commercial-tdm-license (tdm)
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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