Year: 2023 | Month: October | Volume: 13 | Issue: 10 | Pages: 194-201
DOI: https://doi.org/10.52403/ijhsr.20231026
Comparative Evaluation of Gram Stain and Conventional Pap Stain in Diagnosing Bacterial Vaginosis and Candidiasis: A Cross-Sectional Study
Dr. Santosh Kumar Mondal1, Dr. Bibhas Saha Dalal2, Dr. Deepika Pandey3, Ashish Kumar Yadav4, Shifana T5, Dr. Subrat Panda6
1Professor & HOD, Department of Pathology, AIIMS, Kalyani, India
2Assistant Professor, Department of Pathology, AIIMS, Kalyani, India
3Assistant Professor, Department of Pathology, Dr. Sonelal Patel ASMC, Uttar Pradesh, India
4Assistant Professor, Centre of Biostatistics IMS, BHU, Uttar Pradesh, India
5MBBS student, AIIMS, Kalyani, India
6Professor & HOD, Department Obstetrics and Gynaecology, AIIMS, Kalyani, India
Corresponding Author: Dr. Bibhas Saha Dalal
ABSTRACT
Background: Genital tract infectionsbacterial vaginosis (BV) and vulvovaginal candidiasis are a significant global health concern, impacting reproductive and child health. The conventional Pap smear, though effective for cervical cancer screening, has conflicting evidence regarding its accuracy in diagnosing BV.
Methods and Materials: A comparative, cross-sectional study was conducted on 518 female patients aged 21 to 65 years attending a tertiary care hospital's Obstetrics & Gynaecology Outpatient Department. Cervicovaginal smears were collected from each patient and submitted for Gram staining and conventional Pap staining. The slides were independently evaluated by two blinded pathologists, and a third pathologist was consulted in cases of discordant results. The final diagnosis was always offered with 2 out of 3 majority. The presence of BV and candidiasis were assessed using established criteria.
Results: Out of the 518 cases, BV was diagnosed in 32.4% by Gram stain and 24.5% by Pap stain. The sensitivity and specificity of Gram stain were 81.08% and 94.59%, respectively, while for Pap stain, they were 57.30% and 93.69%, respectively. Positive predictive values were 89.29% for Gram stain and 83.46% for Pap stain in diagnosing BV. However, there was no significant difference between the two staining methods in diagnosing vulvovaginal candidiasis.
Conclusion: Gram stain demonstrated higher sensitivity and positive predictive value than Pap stain in diagnosing BV. While Pap smear is widely used for cervical cancer screening, it may not be as reliable in diagnosing BV due to its lower sensitivity and lack of a standardized scoring system. The Gram stain, on the other hand, is readily available, cost-effective, and easy to perform, making it a valuable tool in resource-limited settings to aid in the diagnosis and management of BV.
Key words: Gram stain, Pap stain, bacterial vaginosis, candidiasis