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  • Title: 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.
    Author: Audisio T, Penacino M, Cannistraci R, Bertolotto P.
    Journal: J Low Genit Tract Dis; 2005 Oct; 9(4):213-5. PubMed ID: 16205190.
    Abstract:
    PURPOSE: To compare the collection of vaginal exudates with and without the use of a speculum to diagnose vaginal infections. MATERIAL AND 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.
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