Added Benefit of Nucleic Acid Amplification Testing for the Diagnosis of Trichomonas vaginalis Among Men and Women Attending a Sexually Transmitted Diseases Clinic

Muzny, Christina A.; Blackburn, Reaford J.; Sinsky, Richard J.; Austin, Erika L.; Schwebke, Jane R.

doi:10.1093/cid/ciu446

Cited by 51 publications

(43 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study from the Cleveland Clinic in September 2016 [15] showed a detection rate of Trichomonas in urinary cytology as only 0.1% (73 cases of 60,000 specimens) over a 30-year period. This contrasts with reported rates of up to 20% trichomoniasis in patients attending sexually transmitted diseases clinics [2,6] . Also, male partners of women with trichomoniasis were infected in surprising 72%, most of them being asymptomatic [11] .…”

Section: Discussioncontrasting

confidence: 79%

“…With newer methods such as nucleic acid amplification [5,6] , the prevalence of Trichomonas and Chlamydia in men attending a sexually transmitted diseases clinic were shown to be as high as 17 and 19%, respectively [2] . In men with non-gonococcal urethritis, 19.9% were infected with Trichomonas [6] . Equally significant is the detection of HPV in human semen specimen in 14.9% [7] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sperm Sediment Cytology: A New Technique for Diagnosing Occult Urologic Infections

Sapozhkova¹,

Kasoyan²,

Kovalchuk³

et al. 2017

Acta Cytologica

View full text Add to dashboard Cite

Background: Ill-defined chronic symptoms such as itching, burning, urethral discharge, and pelvic pain are not uncommon in male urologic patients. Often, microscopic urinalysis, bacterial cultures, and laboratory testing are non-contributory. We have developed a technique for sperm sedimentation and used the cytologic examination of the sediment routinely in more than 4,000 patients with urologic complaints over the last 5 years. Case: We present 3 exemplary cases, documenting the diagnostic power of sperm sediment cytology (SSC). In all 3 cases, conventional laboratory testing failed to reveal a causative agent. Case 1 is that of a 28-year-old male patient with a history of occasional swelling of the lymph nodes in the left inguinal region for 1 year. Case 2 is that of a 51-year-old male patient with a history of itching and burning of the urethra of 2 months' duration. Case 3 is that of a 22-year-old female patient with copious vaginal discharge after intercourse for 18 months, non-responsive to treatment. Conclusion: We were able to identify causative pathologic organisms in the sediment of all patients or their partner. Subsequent specific treatment did clear and alleviate the symptoms documenting the clinical relevance of this new technique. In our experience, SSC has proven to be a valuable technique for diagnosing occult urologic infections.

show abstract

Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Sperm Sediment Cytology: A New Technique for Diagnosing Occult Urologic Infections

Sapozhkova¹,

Kasoyan²,

Kovalchuk³

et al. 2017

Acta Cytologica

View full text Add to dashboard Cite

show abstract

“…Eleven of the 24 missed STI diagnoses were due to T. vaginalis. T. vaginalis is the most common nonviral STI and is often missed by non-NAAT methods (4,15). In a recent study including women Ն16 years of age attending a sexually transmitted disease clinic utilizing NAAT methods (14), the overall prevalence of T. vaginalis was 27%, with the highest prevalence (34%) in women Ͼ40 years of age.…”

Section: Discussionmentioning

confidence: 99%

Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department

et al. 2015

View full text Add to dashboard Cite

dUrinary tract infections (UTIs) and sexually transmitted infections (STIs) are commonly diagnosed in emergency departments (EDs). Distinguishing between these syndromes can be challenging because of overlapping symptomatology and because both are associated with abnormalities on urinalysis (UA). We conducted a 2-month observational cohort study to determine the accuracy of clinical diagnoses of UTI and STI in adult women presenting with genitourinary (GU) symptoms or diagnosed with GU infections at an urban academic ED. For all urine specimens, UA, culture, and nucleic acid amplification testing for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis were performed. Of 264 women studied, providers diagnosed 175 (66%) with UTIs, 100 (57%) of whom were treated without performing a urine culture during routine care. Combining routine care and study-performed urine cultures, only 84 (48%) of these women had a positive urine culture. Sixty (23%) of the 264 women studied had one or more positive STI tests, 22 (37%) of whom did not receive treatment for an STI within 7 days of the ED visit. Fourteen (64%) of these 22 women were diagnosed with a UTI instead of an STI. Ninety-two percent of the women studied had an abnormal UA finding (greater-than-trace leukocyte esterase level, positive nitrite test result, or pyuria). The positive and negative predictive values of an abnormal UA finding were 41 and 76%, respectively. In this population, empirical therapy for UTI without urine culture testing and overdiagnosis of UTI were common and associated with unnecessary antibiotic exposure and missed STI diagnoses. Abnormal UA findings were common and not predictive of positive urine cultures. U rinary tract infections (UTIs) are diagnosed in over 1 million emergency department (ED) visits each year in the United States (1). Sexually transmitted infections (STIs) are also commonly diagnosed in the ED. The Centers for Disease Control and Prevention estimates that nearly 20 million new STIs occur annually, many of which go undiagnosed and unreported (2). Lower UTIs and many STIs have overlapping symptomatology, including the traditional UTI symptoms of dysuria, frequency, and urgency. In addition, abnormal urinalysis (UA) findings of positive leukocyte esterase and pyuria are common in both UTIs and STIs (3-6). Thus, distinguishing between these infections can be challenging.Previous studies in ED settings evaluating women diagnosed with UTIs have demonstrated that only about 50% will have a positive urine culture and 10 to 50% will have an STI (5, 7-10). These studies suggest that UTIs are overdiagnosed and STIs are underdiagnosed in the ED. However, previous studies in the ED setting have several limitations. First, some studies (5, 8) used a cutoff of Ն10 4 CFU/ml of a single uropathogen to define a positive urine culture, which may be inappropriately high for some organisms and populations (11, 12). Thus, the incidence of UTI may have been underestimated. Second, some studies may have underdiagnosed STIs b...

show abstract

“…In contrast to trichomoniasis in female subjects, the association between T . vaginalis infection and older age in male subjects is not fully understood [35, 36]. Previous surveillances in the United States indicated that the highest prevalence of T .…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014

et al. 2016

View full text Add to dashboard Cite

Trichomoniasis, which is caused by Trichomonas vaginalis, is one of the most common non-viral sexually transmitted infections; however, limited population-based data are available that describe patterns and trends of the disease. We summarized insurance claims of trichomoniasis cases reported during 2009–2014 to South Korea Health Insurance Review and Assessment Service. The average annual incidence in South Korea was 276.8 persons per 100,000 population, and a substantial sex-associated variation was observed. The incidence rate among female subjects trended upward over 6 years, that is, it increased from 501 in 2009 to 625.8 in 2014 per 100,000 female population, which indicates a 25% overall increase. This trend was sharpest in the ≥60 years group of female population. However, a 66% decrease in incidence rates was observed among male subjects (23.7 in 2009 to 15.7 in 2014 per 100,000 male population). Further, substantial decrease was observed in the ≥40 years groups of male population. The incidence of trichomoniasis varied across regions and was the highest in Jeju province of South Korea. Overall, as the incidence of trichomoniasis appears to have increased in South Korea during 2009–2014, the disease burden is increasing; hence, there is a need to better understand the disease transmission.

show abstract

Added Benefit of Nucleic Acid Amplification Testing for the Diagnosis of Trichomonas vaginalis Among Men and Women Attending a Sexually Transmitted Diseases Clinic

Abstract: TV prevalence among men and women was high in this study, suggesting that both groups should be routinely screened, including those aged >40 years. Improved detection of TV by routine implementation of NAATs should result in better control of this common, treatable STI.

Cited by 51 publications

References 32 publications

Sperm Sediment Cytology: A New Technique for Diagnosing Occult Urologic Infections

Sperm Sediment Cytology: A New Technique for Diagnosing Occult Urologic Infections

Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department

Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014

Contact Info

Product

Resources

About