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A routine culture of the lower genital tract should include a Gram stain for bacterial vaginosis, using the Nugent criteria, with yeast and intracellular gram-negative diplococci also reported if seen in the direct smear. The routine culture should only report Neisseria gonorrhoeae, yeast, and group B streptococcus, if present. Staphylococcus aureus is reported only following a specific request for toxic shock work-up and then the isolate must be sent for toxin testing. Routine screening of vaginal specimens for S. aureus is not recommended. A useful reference is Cumitech 17A: Laboratory Diagnosis of Female Genital Tract Infections” (1993).
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