Preliminary Study On The Diagnosis Criteria Of Aerobic Vaginitis By Gram Staining

Objective: To analyze the clinical manifestations of Aerobic vaginitis(Aerobic vaginitis,AV)patients and microscopic appearances of vaginal discharge,and to explore whether a new AV diagnostic criterion combining the clinical manifestations with Gram staining can be established on the basis of AV Donders score.Methods: Between October 2010 to December 2018,535 women who were diagnosed with AV at Tianjin university general hospital gynecologic outpatient were enrolled.The clinical manifestations and microscopic appearances of AV were analyzed retrospectively.Two hundred and six AV women from September 2017 to January 2019 were selected,and 240 non-vaginitis women were used as the control group.Using ROC curve analysis,the cut-off value of the newly diagnosed parameters was determined according to the primary standard.The new diagnostic criteria of AV were validated by ordinal ploytomous logistic regression analysis.Results: 1.Among the symptoms and signs of AV,increased vaginal discharge,Yellow vaginal discharge and redness of vaginal walls were the main symptoms,accounting for 79.6%,81.3%,and 77.8%,respectively.However,the Spearman correlation between vaginal mucosal congestion and AV score was 0.444,which was the best among the symptoms and signs of AV.2.Among the microscopic manifestations of AV,the Lactobacillus grade,the change of background bacteria and the increase of leukocytes were the main manifestations,accounting for 96.8%,96.8% and 89.0%,respectively.But the correlation between toxic leukocytes and PBC/epithelium with AV score was 0.747 and 0.602,which was the best among the microscopic manifestations of AV.3.LBG and leukocyte were different between 400-fold wet smear and 1000-fold Gram staining of vaginal secretion of the same patient.4.The ROC values of LBG,background bacteria,white blood cell count,PBC/epithelium,vaginal mucosal congestion for normal and AV,mild to moderate and severe AV were IIB and III,Bacterioid and coccoid bacteria,3/HPF and 6/HPF,2% and 8%,mild and moderate congestion,respectively.5.Ordinal ploytomous logistic regression analysis showed that the five parameters of new AV diagnosis were statistically significant;The sensitivity,specificity and accuracy rate of the new criteria for diagnosis of AV were 98.6%,94.2% and 96.4%,respectively,while the sensitivity of moderate and severe AV was 70.8% and 70.0%,respectively;the consistency of new diagnosis criteria and the wet microscopy diagnosis for AV was good,and that of moderate and severe AV was moderate.Conclusion Vaginal mucosal congestion is one of the main symptoms of AV,and has a good correlation with AV score.The accuracy and consistency of the new AV diagnostic criteria consist of LBG,background bacteria,white blood cell count,PBC/epithelium and vaginal mucosal congestion were good.