Version July 2025
| Nucleic acid amplification tests (NAATs) | pH and microscopy | Culture | |
| Advantages | Highly sensitive and specific for organism | Performed at point-of-care (ie, laboratory not needed) | Identifies species (eg, candida speciation) |
| Specimen can be collected by patient or clinician | Allows for immediate diagnosis and targeted treatment | Can be used for drug susceptibility testing | |
| Does not require specialized clinician training | Low cost and requires minimal equipment | ||
| Disadvantages | Requires clinician education to interpret results | Reduced sensitivity and specificity (ie, an elevated pH is not sensitive or specific to one disease) | Diagnostic delay (requires several days for results) |
| Longer time for diagnosis (laboratory test) | Laboratory test required if microscopy inconclusive or not diagnostic but clinical suspicion for infection is high | Requires laboratory and trained personnel | |
| Requires specialized equipment, which may be costly | Requires clinician training for pelvic examination, pH testing, and microscopy | Unhelpful for bacterial infection because of normal bacterial colonization of vagina (with exceptions of Group A and Group B Streptococcus) | |
| Tests for gonorrhea and chlamydia may require separate swabs | Separate tests required for gonorrhea and chlamydia | ||
| Can identify organisms that are not pathogens | |||
| Diagnostic accuracy | >90%[1-3] | Approximately 50% compared with NAAT or culture[1-3] | Historical gold standard[1-3] |
| (Preferred test for trichomonas) | (Wide range of diagnostic accuracy) | (Is being replaced by NAAT in many settings because of high test concordance) |
