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Nugent's method in diagnosis of bacterial vaginosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Nugent et al. suggested a modification of Spiegel's method of scoring Gram-stained vaginal smears for the diagnosis of bacterial vaginosis

  • the score, calculated by assessing the presence of large Gram-positive rods (Lactobacillus morphotypes), small Gram-negative/Gram-variable rods (G. vaginalis morphotypes), and curved Gram-variable rods (Mobiluncus spp. morphotypes) can range from 0 to 10 with a score of 7 to 10 being consistent with bacterial vaginosis
  • compared to the Amsel criteria, the Nugent's score allows for assessment of alteration in vaginal flora as a continuum rather than a dichotomy

Amsel criteria, despite being less sensitive compared to the Nugent's set of criteria, had a high specificity (94.7%) which is in accordance with the report by Sha et al (1)

The chief drawback of Nugent's method seems to be that it turns out a higher number of false positive cases compared to the Amsel criteria method (2)

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