Accuracy of the BD MAX™ vaginal panel in the diagnosis of infectious vaginitis

  • Amaia Aguirre-QuiñoneroEmail author
  • I. Sáez de Castillo-Sedano
  • F. Calvo-Muro
  • A. Canut-Blasco
Original Article


The aim of this study was to evaluate the BD MAX™ vaginal panel in the diagnosis of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis by comparing it with conventional methods: (i) combination of Hay criteria and presence of clue cells with predominant growth of Gardnerella vaginalis, (ii) yeast culture, and (iii) combination of culture, wet mount microscopic examination, and an alternative molecular assay. One thousand vaginal samples of women ≥ 14 years were analyzed; 5% of the samples belonged to pregnant women. 19.3% were classified as BV, in 33.6% yeasts were recovered and in 1.5% TV was detected. For BV, sensitivity and specificity were of 89.8% and 96.5%, respectively; for VVC, sensitivity and specificity were of 97.4% and 96.8%, respectively, and for T. vaginalis, the sensitivity and specificity were of 100%. The BD MAX™ vaginal panel is highly sensitive and specific and simplifies the identification of infectious vaginitis.


Bacterial vaginosis Gardnerella vaginalis Vulvovaginal candidiasis Trichomonas vaginalis Vaginitis BD MAX vaginal panel 


Compliance with ethical standards

Conflict of interest

A. Canut-Blasco reports personal fees from Pfizer, Merck, Roche, and Werfen unrelated to the current study. All other authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.


  1. 1.
    Nyirjesy P (2008) Vulvovaginal candidiasis and bacterial vaginosis. Infect Dis Clin N Am 22:637–652CrossRefGoogle Scholar
  2. 2.
    Ranjit E, Raghubanshi BR, Maskey S, Parajuli P (2018) Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: a hospital-based study. Inter J Microbiol 8349601.
  3. 3.
    Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach DA, Holmes KK (1983) Nonspecific vaginitis. Am J Med 74:14–22CrossRefPubMedGoogle Scholar
  4. 4.
    Spiegel CA, Amsel R, Holmes KK (1983) Diagnosis of bacterial vaginosis by direct Gram stain of vaginal fluid. J Clin Microbiol 18:170–177PubMedPubMedCentralGoogle Scholar
  5. 5.
    Nugent RP, Krohn MA, Hillier SL (1991) Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol 29:297–301PubMedPubMedCentralGoogle Scholar
  6. 6.
    Ison CA, Hay PE (2002) Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinical. Sex Transm Infect 78:413–415CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Chawla R, Bhalla O, Chadha S, Grover S, Garg S (2013) Comparison of Hay’s criteria with Nugent’s scoring system for diagnosis of bacterial vaginosis. Biomed Res Int 365194.
  8. 8.
    Rodrigues FS, Peixote S, Adami F, Alves Bda C, Gehreke FS, Azzalis LA et al (2015) Proposal of a new cutoff for Nugent criteria in the diagnosis of bacterial vaginosis. J Microbiol Methods 115:144–146CrossRefPubMedGoogle Scholar
  9. 9.
    Bitew A, Abebaw Y (2018) Vulvovaginal candidiasis: species distribution of Candida and their antifungal susceptibility pattern. BMC Womens Health 18:94CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Watson CJ, Fairley CK, Grando D, Garland SM, Myers SP, Pirotta M (2013) Associations with asymptomatic colonization with candida in women reporting past vaginal candidiasis: an observational study. Eur J Obstet Gynecol Reprod Biol 169:376–379CrossRefPubMedGoogle Scholar
  11. 11.
    Sutton M, Sternberg M, Koumans EH, McQuillan G, Berman S, Markowitz L (2007) The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004. Clin Infect Dis 45:1319–1326CrossRefPubMedGoogle Scholar
  12. 12.
    Kissinger P (2015) Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues. BMC Infect Dis 15:307CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Hobbs MM, Seña AC (2013) Modern diagnosis of Trichomonas vaginalis infection. Sex Transm Infect 89:434–438CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Schwebke JR, Gaydos CA, Nyirjesy P, Paradis S, Kodsi S, Cooper CK (2018) Diagnostic performance of a molecular test versus clinical assessment of vaginitis. J Clin Microbiol 56:e00252–e00218CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Gaydos CA, Beqaj S, Schwebke JR, Lebed J, Smith B, Davis TE, Fife KH et al (2017) Clinical validation of a test for the diagnosis of vaginitis. Obstet Gynecol 130:181–189CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Coleman JS, Gaydos CA (2018) Molecular diagnosis of bacterial vaginosis: an update. J Clin Microbiol 56:e00342–e00318CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mengistie Z, Woldeamanuel Y, Asrat D, Adera A (2014) Prevalence of bacterial vaginosis among pregnant womrn attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC Res Notes 20(7):822CrossRefGoogle Scholar
  18. 18.
    Schwebke JR, Muzny CA, Josey WE (2014) Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis 210:338–343CrossRefPubMedGoogle Scholar
  19. 19.
    Machado A, Cerca N (2015) Influence of biofilm formation by Gardnerella vaginalis and other anaerobes on bacterial vaginosis. J Infect Dis 212:1856–1861CrossRefPubMedGoogle Scholar
  20. 20.
    Muzny CA, Blanchard E, Taylor CM, Aaron KJ, Talluri R, Griswold ME (2018) Identification of key bacteria involved in the induction of incident bacterial vaginosis: a prospective study. J Infect Dis 218:966–978PubMedPubMedCentralGoogle Scholar
  21. 21.
    Carrillo- Ávila JA, Serrano-García ML, Fernández-Parra J, Sorlózano-Puerto A, Navarro-Marí JM, Stensvold R (2017) Prevalence and genetic diversity of Trichomonas vaginalis in the general population of Granada and co-infections with Gardnerella vaginalis and Candida species. J Med Microbiol 66:1436–1442CrossRefPubMedGoogle Scholar
  22. 22.
    Li XD, Tong F, Zhang XJ, Pan WJ, Chen ML, Wang CC (2015) Incidence and risk factors of bacterial vaginosis among pregnant women: a prospective study in Maanshan city, Anhui Province, China. J Obstet Gynaecol Res 41:1214–1222CrossRefPubMedGoogle Scholar
  23. 23.
    Guzel AB, Ilkit M, Burgut R, Urunsak IF, Ozgunen FT (2011) An evaluation of risk factors in pregnant women with Candida vaginitis and the diagnosis value of simultaneous vaginal and rectal sampling. Mycopathologia 172:25–36CrossRefPubMedGoogle Scholar
  24. 24.
    Jacob L, John M, Kalder M, Kostev K (2018) Prevalence of vulvovaginal candidiasis in gynecological practices in Germany: a retrospective study of 954,186 patients. Curr Med Mycol 4:6–11CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Holzer I, Farr A, Kiss H, Hagmann M, Petricevic L (2017) The colonization with Candida species is more harmful in the second trimester of pregnancy. Arch Gynecol Obstet 295:891–895CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Servicio de Microbiología, Hospital Universitario de ÁlavaInstituto de Investigación Biosanitaria, BioArabaVitoria-GasteizSpain

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