Nucleic Acid Amplification Testing Compared With Cultures, Gram Stain, and Microscopy in the Diagnosis of Vaginitis

Danby, Claire S.; Althouse, Andrew D.; Hillier, Sharon L.; Wiesenfeld, Harold C.

doi:10.1097/lgt.0000000000000576

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…It has been reported that WMM with low sensitivity (48.50%) are prone to underdiagnosis of VVC. 26 WMM, a diagnostic method that cannot distinguish strain species is difficult to meet the needs of clinical precision medicine. Interestingly, the diagnostic performance of PCR-QDFA for all Candida strains within the PCR-QDFA targets was comprehensively evaluated.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Polymerase Chain Reaction Coupled with Quantum Dot Fluorescence Analysis for Diagnosis of Candida Infection in Vulvovaginal Candidiasis Practice

Fan¹,

Li²,

Chen³

et al. 2023

IDR

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Purpose Time-consuming culture methods and wet-mount microscopy (WMM) with low sensitivity have difficulties in diagnosing Vulvovaginal candidiasis (VVC). Rapid and highly sensitive polymerase chain reaction coupled with quantum dot fluorescence analysis (PCR-QDFA) for the diagnosis of VVC has not been reported to date. This study was the first to evaluate the performance of PCR-QDFA for diagnosis of Candida strains in the leukorrhea samples from patients with suspected VVC. Patients and Methods Leukorrhea samples from all visited patients were taken from the vagina using vaginal swabs by clinicians. We evaluated patients admitted with suspected VVC who completed WMM for diagnosis and reported the diagnostic effectiveness of PCR-QDFA and Candida culture (gold standard) when testing leucorrhea samples. Results A total of 720 leukorrhea samples from 387 VVC-positive patients and 333 VVC-negative patients were included in this study. Of the 387 leukorrhea samples from the VVC-positive patients, 391 Candida strains were identified by culture. 99.23% (388/391) Candida strains were included in the PCR-QDFA list. The 388 Candida strains belonged to four different species of Candida , including C. albicans (n = 273, 70.36%), C. glabrata (n = 85, 21.91%), C. tropicalis (n = 16, 4.12%), and C. krusei (n = 14, 3.61%). PCR-QDFA diagnosed Candida strains in 340/384 (88.54%) of the leucorrhea samples with Candida strains infection. The sensitivity of PCR-QDFA for C. albicans, C. glabrata, C. tropicalis , and C. krusei was 89.01%, 85.88%, 81.25% and 92.86%, respectively. The specificity of PCR-QDFA for C. albicans, C. glabrata, C. tropicalis and C. krusei was 93.69%, 99.37%, 99.71%, and 99.57%, respectively. Conclusion The highly sensitive and specific PCR-QDFA technique can be exploited as a rapid (approximately 4 h) diagnostic tool for common Candida strains of leucorrhea samples from patients with suspected VVC.

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Polymerase Chain Reaction Coupled with Quantum Dot Fluorescence Analysis for Diagnosis of Candida Infection in Vulvovaginal Candidiasis Practice

Fan¹,

Li²,

Chen³

et al. 2023

IDR

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“…17 Nucleic acid amplification testing outperforms microscopy for both yeast vaginitis and trichomoniasis, but microscopy was found to be more sensitive than culture or nucleic acid amplification testing for bacterial vaginosis diagnosis in one study. 23 This may suggest a role for bacterial vaginosis nucleic acid amplification testing if microscopy is negative for symptomatic patients. Although several molecular diagnostic tests have FDA clearance and published clinical validity compared with standard testing modalities, they are not widely incorporated into clinical guidelines; thus, many payer policies may continue to deny coverage for nucleic acid amplification testing among nonpregnant patients.…”

Section: The Modern Approachmentioning

confidence: 99%

Section: The Modern Approachmentioning

confidence: 99%

A Comparison of Newer and Traditional Approaches to Diagnosing Vaginal Infections

Powell,

Goje,

Nyirjesy

2024

Obstetrics &Amp; Gynecology

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Molecular diagnostic testing (eg, polymerase chain reaction [PCR]–based vaginitis testing) is widely used in clinical practice, although vaginitis experts have reservations about its use for vaginitis diagnosis. As with any new technology, cost to the health system is a large concern. Although clinical evaluation of signs and symptoms along with wet mount microscopy is traditionally used for vaginitis diagnosis, it is less accurate compared with molecular diagnostic testing. Here we review the benefits of adopting newer molecular diagnostics into routine gynecologic practice with some guidance from vaginitis experts that favor both traditional and more modern approaches. We argue that instead of trying to resist the oncoming tide of molecular diagnostics, we can embrace them and put them to appropriate use to effect rapid, accurate, and more flexible diagnosis of vaginitis conditions for our patients.

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“…• втрату або зменшення кількості Lactobacillus із одночасним збільшенням чисельності інших видів бактерій -переважно G. vaginalis, анаеробних грамнегативних паличок [22,32,33], • утворення летких амінів новою бактеріальною мікробіотою і зниження продукування молочної кислоти [31], • підвищення рН піхви понад 4,5 (нормальний рН піхви жінок репродуктивного віку зазвичай коливається від 4,0 до 4,5). Відсутність клінічних ознак запалення є підставою для терміну «вагіноз», а не «вагініт».…”

Section: патологічні зміни у вагінальному середовищіunclassified

Modern approaches to restoring vaginal microbiocenosis

Taran,

Bulavenko,

Kukuruza

et al. 2024

RHW

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The article presents literary data on the morphology and types of vaginal lactobacilli, pathological changes in the vaginal environment, as well as modern possibilities of restoring the vaginal microflora of a woman’s organism. Certain regularities regarding the connection of bacterial vaginosis with intestinal dysbiosis have been observed, which indicates a single dysbiotic process in the organism with a dominant manifestation either in the sexual or digestive system.A review of scientific publications of recent years shows the significant influence of intestinal dysbiosis, infectious and inflammatory diseases of the stomach and intestines, as well as the oral use of antibacterial drugs on the quantitative and qualitative composition of the vaginal microflora in women. It was found that an increased number of opportunistic microorganisms (85%) and a decreased number of lactobacilli and bifidobacteria (less than 70%) in the intestine are associated with a rise in the content of opportunistic microorganisms in the vaginal biota in women with infectious and inflammatory diseases of the reproductive system. This is explained by the ability of saprophytes and opportunistic microorganisms to penetrate into the reproductive organs of women by increasing the permeability of the mucous membrane of the intestinal wall, as well as into the vascular bed, which can be observed, for example, on the background of antibiotic use. The antibiotic use in a number of cases leads to a closed circle, when the need for antibacterial therapy to eliminate one infection leads to a deepening of dysbiosis and an increased number of other pathogens.Numerous studies have demonstrated the effectiveness of selective decontamination (selective elimination of pathogens) in combination with a probiotic, prebiotic or synbiotic to restore vaginal microbiocenosis.Our experience of using an oral synbiotic (1 capsule contains 5 billion colony-forming units of Lactobacillus plantarum lyophilizate pcs. 8Р-AZ, Lactobacillus fermentum pcs. 90Т-С4 and prebiotic inulin, once a day 30 minutes before meal for 7–10 days) in a complex therapy of bacterial vaginosis in non-pregnant women of reproductive age indicates faster elimination of systemic dysbiosis and restoration of normal intravaginal flora. Thus, regression of complaintsand normalization of objective data was determined on average for 2.9 days versus 4.7 days in women who were not administered the drug.The obtained data show that a systemic synbiotic containing a lyophilized microbial mass of probiotic lactobacteria, products of their metabolism and inulin (prebiotic) creates an additional effect in restoring normal biocenosis and the immune mechanism of ensuring colonization resistance of the body’s mucous membranes.

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Nucleic Acid Amplification Testing Compared With Cultures, Gram Stain, and Microscopy in the Diagnosis of Vaginitis

Cited by 9 publications

References 18 publications

Clinical Evaluation of Polymerase Chain Reaction Coupled with Quantum Dot Fluorescence Analysis for Diagnosis of Candida Infection in Vulvovaginal Candidiasis Practice

Clinical Evaluation of Polymerase Chain Reaction Coupled with Quantum Dot Fluorescence Analysis for Diagnosis of Candida Infection in Vulvovaginal Candidiasis Practice

A Comparison of Newer and Traditional Approaches to Diagnosing Vaginal Infections

Modern approaches to restoring vaginal microbiocenosis

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