Assessment of a Gram-stained slide using the Nugent score has replaced culture as the preferred test to diagnose bacterial vaginosis. While Gardnerella is the most common anaerobe found in bacterial vaginosis, other anaerobic organisms are often present along with a decrease in the amount of "usual flora" (eg, Lactobacillus species). This system uses a 0- to 4-point scale to calculate the weighted sum of the following 3 bacterial morphotypes: Lactobacillus, Gardnerella/Bacteroides, and Mobiluncus species. Total score of 0 to 3 is considered normal. Total score of 4 to 6 is considered intermediate stage Total score of 7-10 is considered Bacterial vaginosis.