{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:34:27Z","timestamp":1790742867641,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Russian state budget assignment for D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive medicine","award":["1022061900081-0-3.2.2"],"award-info":[{"award-number":["1022061900081-0-3.2.2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Previously established diagnostic approaches for the diagnosis of bacterial vaginosis (BV), such as the Amsel criteria or the Nugent scoring system, do not always correspond to modern trends in understanding the etiology and pathogenesis of polymicrobial conditions. Inter-examiner variability and interpretation of data complicate the wet mount microscopy method. Gram staining of smears does not always provide reliable information regarding bacterial taxa, biofilms, or vaginal dysbiosis. Therefore, the introduction of molecular techniques into clinical practice is extremely relevant. Molecular approaches allow not only the diagnosis of BV but also provide an assessment of microbial composition, which is especially important in the differential diagnosis of vaginal infections. The current review represents an expert opinion on BV diagnosis and is based on extensive experience in the field of vaginal infection diagnosis and treatment.<\/jats:p>","DOI":"10.3390\/ijms25010449","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T06:18:13Z","timestamp":1703830693000},"page":"449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Molecular Testing for the Diagnosis of Bacterial Vaginosis"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3870-5930","authenticated-orcid":false,"given":"Alevtina M.","family":"Savicheva","sequence":"first","affiliation":[{"name":"D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, St. Petersburg 199034, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"ref_1","unstructured":"Radzinsky, E.V., Savicheva, A.M., Vorobyev, S.V., Spasibova, E.V., Shalepo, K.V., Budilovskaya, O.V., Khusnutdinova, T.A., Krysanova, A.A., Gushin, A.E., and Raevskaya, O.A. (2023). Vaginal biocenosis, StatusPraesens."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1099\/jmm.0.000407","article-title":"Comparison of culture-dependent and culture-independent molecular methods for characterization of vaginal microflora","volume":"66","author":"Pandya","year":"2017","journal-title":"J. Med. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s10096-019-03538-7","article-title":"Comparison of Amsel criteria, Nugent score, culture and two CE-IVD marked quantitative real-time PCRs with microbiota analysis for the diagnosis of bacterial vaginosis","volume":"38","author":"Boers","year":"2019","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_4","first-page":"39","article-title":"Pathogenesis of bacterial vaginosis: Expanding knowledge and therapeutic possibilities","volume":"3","author":"Swidsinski","year":"2023","journal-title":"StatusPraesens Gynecol. Obstet. Infert. Marriage"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0002-9343(83)91112-9","article-title":"Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations","volume":"74","author":"Amsel","year":"1983","journal-title":"Am. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1136\/sti.78.6.413","article-title":"Validation of a simplified grading of gram stained vaginal smears for use in genitourinary medicine clinics","volume":"78","author":"Ison","year":"2002","journal-title":"Sex. Transm. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.17816\/JOWD65148-53","article-title":"Vaginal flora in bacterial vaginosis\u2014The criteria Amsel","volume":"65","author":"Nazarova","year":"2016","journal-title":"J. Obstet. Women Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e0231921","DOI":"10.1128\/aac.02319-21","article-title":"Preclinical Data on the Gardnerella-Specific Endolysin PM-477 Indicate Its Potential to Improve the Treatment of Bacterial Vaginosis through Enhanced Biofilm Removal and Avoidance of Resistance","volume":"66","author":"Landlinger","year":"2022","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4607","DOI":"10.1128\/JCM.43.9.4607-4612.2005","article-title":"Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women","volume":"43","author":"Sha","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1089\/aid.2018.0304","article-title":"The Evolving Facets of Bacterial Vaginosis: Implications for HIV Transmission","volume":"35","author":"McKinnon","year":"2019","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1111\/apm.12608","article-title":"Evaluation and subsequent optimizations of the quantitative AmpliSens Florocenosis\/Bacterial vaginosis-FRT multiplex real-time PCR assay for diagnosis of bacterial vaginosis","volume":"124","author":"Rumyantseva","year":"2016","journal-title":"APMIS"},{"key":"ref_13","first-page":"1","article-title":"Diagnosis of Bacterial Vaginosis Using a Novel Molecular Real-Time PCR Test","volume":"7","author":"Breding","year":"2020","journal-title":"J. Womens Health Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.diagmicrobio.2018.05.022","article-title":"Multicenter Study Establishing the Clinical Validity of a Nucleic-Acid Amplification\u2013Based Assay for the Diagnosis of Bacterial Vaginosis","volume":"92","author":"Cartwright","year":"2018","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1128\/JCM.03104-15","article-title":"Development and Validation of a Highly Accurate Quantitative Real-Time PCR Assay for Diagnosis of Bacterial Vaginosis","volume":"54","author":"Hilbert","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e00342-18","DOI":"10.1128\/JCM.00342-18","article-title":"Molecular Diagnosis of Bacterial Vaginosis: An Update","volume":"56","author":"Coleman","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"57","DOI":"10.17816\/JOWD66457-67","article-title":"Criteria for diagnosis of bacterial vaginosis using the test Femoflor-16","volume":"66","author":"Nazarova","year":"2017","journal-title":"J. Obstet. Women Dis."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Savicheva, A.M., Krysanova, A.A., Budilovskaya, O.V., Spasibova, E.V., Khusnutdinova, T.A., Shalepo, K.V., Beliaeva, N.R., Safarian, G.K., Sapozhnikov, K.V., and Tapilskaya, N.I. (2023). Vaginal Microbiota Molecular Profiling in Women with Bacterial Vaginosis: A Novel Diagnostic Tool. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242115880"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1093\/infdis\/jiz342","article-title":"An Updated Conceptual Model on the Pathogenesis of Bacterial Vaginosis","volume":"220","author":"Muzny","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1093\/infdis\/jiv338","article-title":"Influence of Biofilm Formation by Gardnerella vaginalis and Other Anaerobes on Bacterial Vaginosis","volume":"212","author":"Machado","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1007\/s00248-021-01917-2","article-title":"Gardnerella Vaginalis Dominates Multi-Species Biofilms in both Pre-Conditioned and Competitive In Vitro Biofilm Formation Models","volume":"84","author":"Rosca","year":"2022","journal-title":"Microb. Ecol."},{"key":"ref_22","first-page":"567","article-title":"Infection through structured polymicrobial Gardnerella biofilms (StPM-GB)","volume":"29","author":"Swidsinski","year":"2014","journal-title":"Histol. Histopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0167-7012(00)00152-4","article-title":"Fluorescence in situ hybridization (FISH) for direct visualization of microorganisms","volume":"41","author":"Moter","year":"2000","journal-title":"J. Microbiol. Methods"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/978-1-0716-1115-9_20","article-title":"Quality control in diagnostic fluorescence in situ hybridization (FISH) in microbiology","volume":"2246","author":"Kikhney","year":"2021","journal-title":"Methods Mol. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1097\/01.AOG.0000183594.45524.d2","article-title":"Adherent biofilms in bacterial vaginosis","volume":"106","author":"Swidsinski","year":"2005","journal-title":"Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Swidsinski, A., Loening-Baucke, V., Swidsinski, S., Sobel, J.D., D\u00f6rffel, Y., and Guschin, A. (2022). Clue cells and pseudo clue cells in different morphotypes of bacterial vaginosis. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.905739"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1099\/ijsem.0.003200","article-title":"Emended description of Gardnerella vaginalis and description of Gardnerella leopoldii sp. nov., Gardnerella piotii sp. nov. and Gardnerella swidsinskii sp. nov., with delineation of 13 genomic species within the genus Gardnerella","volume":"69","author":"Vaneechoutte","year":"2019","journal-title":"Int. J. Syst. Evol. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"48","DOI":"10.33667\/2078-5631-2021-30-48-52","article-title":"Significance of Gardnerella vaginalis genotyping in diagnosis of recurrent bacterial vaginosis","volume":"1","author":"Krysanova","year":"2021","journal-title":"Med. Alphabet."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1038\/s41396-018-0337-0","article-title":"Unveiling the role of Gardnerella vaginalis in polymicrobial Bacterial Vaginosis biofilms: The impact of other vaginal pathogens living as neighbors","volume":"13","author":"Castro","year":"2019","journal-title":"ISME J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/978-1-4939-7037-7_13","article-title":"Multiplex Peptide Nucleic Acid Fluorescence in Situ Hybridization (PNA-FISH) for Diagnosis of Bacterial Vaginosis","volume":"1616","author":"Machado","year":"2017","journal-title":"Methods Mol. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kim, H., Kim, T., Kang, J., Kim, Y., and Kim, H. (2020). Is Lactobacillus Gram-Positive? A Case Study of Lactobacillus iners. Microorganisms, 8.","DOI":"10.3390\/microorganisms8070969"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"France, M.T., Ma, B., Gajer, P., Brown, S., Humphrys, M.S., Holm, J.B., Waetjen, L.E., Brotman, R.M., and Ravel, J. (2020). VALENCIA: A nearest centroid classification method for vaginal microbial communities based on composition. Microbiome, 8.","DOI":"10.1186\/s40168-020-00934-6"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"De Seta, F., Campisciano, G., Zanotta, N., Ricci, G., and Comar, M. (2019). The Vaginal Community State Types Microbiome-Immune Network as Key Factor for Bacterial Vaginosis and Aerobic Vaginitis. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.02451"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1590\/S1517-83822011000100028","article-title":"Correlation between api 50 ch and multiplex polymerase chain reaction for the identification of vaginal lactobacilli in isolates","volume":"42","author":"Brolazo","year":"2011","journal-title":"Braz. J. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.diagmicrobio.2013.08.004","article-title":"Multiplex quantitative polymerase chain reaction assay for the identification and quantitation of major vaginal lactobacilli","volume":"78","author":"Balashov","year":"2014","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_37","first-page":"56","article-title":"Diagnosis of vaginal infections taking into account the profiles of lactobacillary microflora and the local immune response of the vaginal mucosa","volume":"3","author":"Budilovskaya","year":"2020","journal-title":"Mol. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.mycmed.2017.04.105","article-title":"Identification of Candida species in vaginal flora using conventional and molecular methods","volume":"27","author":"Ameen","year":"2017","journal-title":"J. Mycol. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1111\/myc.13280","article-title":"Molecular identification and antifungal susceptibility profiles of Candida dubliniensis and Candida africana isolated from vulvovaginal candidiasis: A single-centre experience in Iran","volume":"64","author":"Shokoohi","year":"2021","journal-title":"Mycoses"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"392","DOI":"10.17116\/klinderma202322041392","article-title":"Malassesia-associated infections in newborns: Prospects of molecular genetic diagnostic methods","volume":"22","author":"Strokova","year":"2023","journal-title":"Klin. Dermat.i Venerol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"471.e1","DOI":"10.1016\/j.ajog.2019.10.008","article-title":"Associations between the vaginal microbiome and Candida colonization in women of reproductive age","volume":"222","author":"Tortelli","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11908-020-00735-w","article-title":"Cytolytic vaginosis: A critical appraisal of a controversial condition","volume":"22","author":"Voytik","year":"2020","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kraut, R., Carvallo, F.D., Golonka, R., Campbell, S.M., Rehmani, A., Babenko, O., Lee, M.C., and Vieira-Baptista, P. (2023). Scoping review of cytolytic vaginosis literature. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0280954"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1055\/s-0040-1715139","article-title":"Laboratorial Aspects of Cytolytic Vaginosis and Vulvovaginal Candidiasis as a Key for Accurate Diagnosis: A Pilot Study","volume":"42","author":"Sanches","year":"2020","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"376","DOI":"10.3389\/fimmu.2018.00376","article-title":"Role of Lactobacilli and Lactoferrin in the Mucosal Cervicovaginal Defense","volume":"9","author":"Valenti","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1086\/499824","article-title":"Local and systemic cytokine levels in relation to changes in vaginal flora","volume":"193","author":"Hedges","year":"2006","journal-title":"J. Infect. Dis."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/1\/449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:43:49Z","timestamp":1760132629000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/1\/449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,28]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["ijms25010449"],"URL":"https:\/\/doi.org\/10.3390\/ijms25010449","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,28]]}}}