Figure 1: Examples of Gram-stained slides from women with (right, Nugent score = 9) and without (left, Nugent score = 1) BV.
In women with a lactobacilli-dominated microbiome (left), long purple rods are the main morphotype. In contrast, women with BV tend to have a lot more bacteria overall, with a significant fraction that do not stain as Gram-positive (i.e. pink). Morphotypes in BV tend not to be long Gram-positive rods. Although not part of the Nugent scoring system, women with BV tend to have large conglomerations of bacteria associated with epithelial cells as seen in the upper right quadrant.