20.500.12556/DiRROS-31242 Comprehensive diagnosis of abnormal vaginal discharge using qpcr-based microbial dysbiosis indices Background/Objectives: Abnormal vaginal discharge (AVD) is a common complaint among women of reproductive age, often involving multiple, overlapping etiologies, most commonly bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic vaginitis (AV), and sexually transmitted infections (STIs). We aimed to evaluate a syndromic diagnostic approach by developing qPCR-derived dysbiosis indices for BV, VVC, and AV, subsequently comparing their performance against established reference methods and clinician-assigned diagnoses. Methods: Vaginal swabs were collected in a case–control design from 74 symptomatic and 64 asymptomatic women at two clinics in Slovenia. Commercial qPCR assays quantified the microbial species associated with AVD. Relative abundances were integrated into novel dysbiosis indices. Diagnostic performance was validated against the Nugent scoring system (for BV), semiquantitative Candida culture with clinical symptoms (for VVC), and Hay–Ison criteria (for AV). Results: In this internally validated study, dysbiosis indices demonstrated high agreement with their respective reference tests and outperformed clinician-assigned diagnoses across all three conditions. The syndromic approach further revealed that mixed etiologies were frequent, leading to a diagnostic resolution for this patient subset. Conclusions: qPCR-based microbial dysbiosis indices offer a robust alternative to microscopy, particularly in settings where microscopy is not routinely performed. This method improves the accuracy of AVD evaluation and supports more targeted clinical management. vaginal discharge bacterial vaginosis aerobic vaginitis candida sexually transmitted infections izcedek iz nožnice bakterijska vaginoza aerobni vaginitis kandida spolno prenosljive okužbe true false true MDPI AG Angleški jezik Slovenski jezik Neznano 2026-07-23 09:21:38 2026-07-23 09:21:39 2026-07-27 10:11:37 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 23. 7. 2026; Soavtorji: Vesna Fabjan Vodušek, Matjaž Retelj, Barbara Sodec, Martina Bučar, Jasna Kostanjšek, Marijana Klarič Kamin,Veronika Testen, Nataša Tul Mandić; str. 1-14 issue 13, [article no.] 2075 Vol. 16 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2026-05-18 2026-06-30 2026-01-01 616.8:579.6 2075-4418 10.3390/diagnostics16132075 285771779 vovko_comprehensive_2026.pdf vovko_comprehensive_2026.pdf 1 AEF2216C64DAD627EDCEB94E2E5538E8 618a358a3e4698962e7ca7b57e932883423c70ac727f29008642803eabdababb 3d450401-8667-11f1-a96a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48233 https://www.mdpi.com/2075-4418/16/13/2075 1 267b9a27-8667-11f1-a96a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48232 Nacionalni laboratorij za zdravje, okolje in hrano Univerzitetni klinični center Ljubljana 0 0 0