Detection of bacterial vaginosis, Trichomonas vaginalis infection, and vaginal Candida infection: a comparative study of methods of extracting exudates, with and without a speculum, during pregnancy.
OBJECTIVE
To compare the collection of vaginal exudates with and without the use of a speculum to diagnose vaginal infections.


METHODS
We examined 45 patients with vaginal discharge. Two vaginal swabs were taken, one with and the other without a speculum. Both were examined by wet mount microscopy to detect bacterial vaginosis (BV), Trichomonas vaginalis, and the presence of blastospores with or without pseudomycelium.


RESULTS
A total of 90.9% of patients whose vaginal exudates were negative for BV when extracted with a speculum were also negative in the swab taken without a speculum. In the case of BV-positive exudates using a speculum, the correspondence was 90.5% with the swabs taken without a speculum. Among those exudates obtained with a speculum that were negative for Candida, 92.6% of those obtained without a speculum tested negative. In patients with pseudomycelium, when a speculum was used, 100% also presented a diagnosis of pseudomycelium from the swabs taken without a speculum. A concordance test between the techniques involving the use or nonuse of a speculum was performed for each of the diagnoses showed a good agreement according to the observed Kappa statistics (0.8467 and 0.8396 for BV and Candida, respectively).


CONCLUSIONS
A very good agreement between the results obtained with and without the use of a speculum was observed. Swabbing without the use of a speculum is especially convenient for pregnant women who require frequent testing for these types of infections during their pregnancies.
Audisio
Teresita
T
Maternal and Newborn Hospital, Ministry of Health, Cordoba Province, Argentina. tere_audisio@arnet.com.ar
Penacino
Monica
M
Cannistraci
Roxana
R
Bertolotto
Patricia
P
D002181:Candidiasis, Vulvovaginal / Q000150:complications / Q000175:diagnosis*; D005122:Exudates and Transudates / Q000382:microbiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology*; D013525:Surgical Instruments; D014247:Trichomonas Vaginitis / Q000150:complications / Q000175:diagnosis*; D019522:Vaginal Discharge / Q000209:etiology; D014626:Vaginal Smears / Q000295:instrumentation; D016585:Vaginosis, Bacterial / Q000150:complications / Q000175:diagnosis*