General Information

Microbiological Examination of Vaginal Secretions – Modern Diagnostics with MALDI‑TOF, BIOMIC, Vitek 2, Microscopy and PCR Testing

What is a microbiological examination of vaginal secretions?

Microbiological examination of vaginal secretions is a key diagnostic method for identifying infections of the vagina. It allows detection of bacterial, fungal, and other pathogens responsible for symptoms such as itching, burning, unpleasant odor, abnormal discharge, or discomfort.

For maximum accuracy, our laboratory combines microscopy, culture-based methods, MALDI‑TOF identification, automated antibiotic susceptibility testing, and molecular diagnostics.

Microscopic Examination – Rapid Assessment of Vaginal Flora

As part of the standard test, we prepare a microscopic slide that allows:

• assessment of vaginal cleanliness

• detection of bacterial vaginosis

• diagnosis of aerobic vaginitis

• visualization of clue cells, leukocytes, fungi, and other elements

If needed, we can also evaluate a slide provided by a gynecologist, which facilitates treatment follow‑up and rapid diagnosis.

Identification of Microorganisms with MALDI‑TOF

After isolating the causative agent, identification is performed using MALDI‑TOF mass spectrometry – the most advanced technology in microbiology, providing:

• exceptionally high accuracy

• results within minutes

• reliable identification of difficult‑to‑detect bacteria and fungi

Antibiotic Susceptibility Testing with BIOMIC or the Automated Vitek 2 System

When antibiotic susceptibility testing is required, we use two of the most precise methods:

BIOMIC – Digital Reading of Antibiograms

• automated measurement of inhibition zones

• elimination of subjective interpretation

• high reproducibility

Vitek 2 – Fully Automated System

• rapid determination of MIC values

• standardized testing conditions

• internationally recognized methodology

Included in the Panel: Gardnerella vaginalis Antigen Test – Fast and Reliable Diagnosis of Vaginal Secretions

Gardnerella vaginalis is a key microorganism associated with bacterial vaginosis (BV) – one of the most common disturbances of the vaginal microbiota. For accurate and timely diagnosis, our laboratory offers an antigen test for Gardnerella vaginalis as an additional examination to the standard vaginal secretion analysis.

The antigen test enables rapid detection of specific Gardnerella vaginalis proteins, making it a valuable method when BV or mixed vaginal infections are suspected.

What is Bacterial Vaginosis?

Bacterial vaginosis is a condition in which the normal vaginal flora, dominated by lactobacilli, is disrupted. Anaerobic bacteria overgrow, including:

• Gardnerella vaginalis

• Mobiluncus spp.

• Prevotella spp.

• Atopobium vaginae

Most common symptoms of bacterial vaginosis

• grey‑white discharge

• unpleasant “fishy” odor

• mild burning or discomfort

• absence of significant redness or itching

BV often presents without symptoms but may lead to complications, including increased risk of infections and pregnancy‑related issues. Accurate diagnosis is therefore essential.

Diagnostic Methods Offered by the Laboratory

To ensure maximum accuracy, we combine microscopic analysis, antigen testing, and MALDI‑TOF identification when necessary.

1. Microscopic Examination (Nugent / Amsel Criteria)

Microscopy is a primary method for evaluating vaginal flora. It assesses:

• presence of clue cells

• reduced lactobacilli

• increased anaerobic bacteria

• morphological changes characteristic of BV

This is a fast and informative method that provides a clear picture of the vaginal microbiome.

2. Gardnerella vaginalis Antigen Test

The antigen test is a rapid, sensitive, and specific method that detects proteins characteristic of Gardnerella vaginalis.

When is testing for Gardnerella vaginalis recommended?

• symptoms of bacterial vaginosis

• recurrent vaginal infections

• changes in odor or discharge

• discomfort after sexual intercourse

• routine gynecological screening

• during pregnancy (as recommended by a physician)

Advantages of Testing in Our Laboratory

• high‑sensitivity antigen test

• microscopic analysis using standardized criteria

• modern equipment: MALDI‑TOF

• culture media from certified manufacturers

• experienced team of microbiologists

• fast and accurate results

• discretion and professional care

Recommendations for Additional Testing – Based on Microbiologist Assessment

After evaluating the microscopic slide and culture results, the microbiologist may recommend additional tests, also performed at SMDL Laborexpres 2000. This is especially important in cases of:

• recurrent infections

• mixed infections

• unclear causative agent

• suspected sexually transmitted pathogens

Possible additional tests include:

PCR for Vaginal Microbiome

• assessment of balance between beneficial and pathogenic bacteria

• detection of hard‑to‑culture microorganisms

• precise diagnosis in chronic or recurrent symptoms

PCR for Sexually Transmitted Pathogens

Useful when suspecting:

• Chlamydia trachomatis

• Mycoplasma genitalium

• Ureaplasma spp.

• Trichomonas vaginalis

• other STI pathogens

HPV Testing

• detection of high‑risk HPV types

• assessment of cervical risk

• recommended for abnormal Pap smears or per gynecologist’s advice

These tests provide high diagnostic value and support the selection of the most appropriate treatment.

Sample Collection Instructions

• No vaginal douching or intimate gels for at least 48 hours before testing.

• No sexual intercourse 24–48 hours prior to sample collection.

• Avoid vaginal medications (globules, creams, tablets) for at least 72 hours unless otherwise instructed by a physician.

• Do not test during menstruation; the optimal time is 2–3 days after the end of the cycle.

• Intimate hygiene: only external washing with water is allowed on the day of the test.