Bacteriological study of vaginal discharge of pregnant women using Gram stain smear and culture

Bacterial vaginosis is caused by an imbalance of the organisms that naturally exist in the vagina. The importance of bacterial vaginosis with respect to pregnant women’s health is emphasized by the association betweenbacterial vaginosis and adverse outcome of pregnancy. The aim of present study was to evaluate the direct smear microscopy and culture for determination of bacteria from vaginal discharge of pregnant women. In total, 240 vaginal swabs were collected from 120 pregnant women and were screened for bacterial population. For each patient one swab was used for smear preparation and Gram staining and the second swab was used for cultivation. The prepared Gram-stained smears were observed for various morphotypes. Each morphotype was quantified on a scale from 0 to 4 and weighed to yield a score of 0 to 10, as per Nugent’s system. The bacteria grown in preliminary culture media were identified using standard identification tests. The majority of isolated bacteria in culture were Diphtheroid, Lactobacillus spp., Coagulase-negative Staphylococci and yeast. In Gram-stained smears, 78 (65%) Gram positive rods and 54 (45%) Gram positive cocci were detected. According to Nugent’s criteria, 64 cases (53.33%) were classified as having normal vaginal flora, 45 (37.5%) intermediate flora and 11 cases (9.2%) having bacterial vaginosis. The prevalence of bacterial vaginosis is not very high. However we recommend the regular screening of women with Gram stain method using Nugent’s criteria which is reliable, easy to perform and well suited for the routine clinical laboratory.   Key words: Vaginal discharge, bacterial vaginosis, Nugent’s criteria, Gram stain, culture.