Real‐Time PCR Improves Detection of Trichomonas vaginalis Infection Compared With Culture Using Self‐Collected Vaginal swabs

Abstract

OBJECTIVE: To compare a real-time polymerase chain reaction (PCR) assay with broth culture for the detection of Trichomonas vaginalis using self-collected vaginal swabs. METHODS: Self-collected vaginal swabs were obtained from adolescent and young adult African-American women participating in HIV-1 prevention programs. T. vaginalis culture was performed using the InPouch TV System. Samples for the real-time PCR assay were collected using the BDProbeTec ET Culturette Direct Dry Swab system and tested in a laboratory-developed assay which targeted a repeated sequence of the genome. Discrepant samples that were culture negative and positive in the real-time PCR assay were tested in a confirmatory PCR which targeted a different region of the T. vaginalis genome, the18S ribosomal DNA gene. RESULTS: Of the 524 specimens tested by both culture and real-time PCR, 36 were culture positive and 54 were positive in the real-time PCR assay; 16 of the 18 discrepant specimens were also positive in the confirmatory PCR assay. Using a modified gold standard of positive by culture or positive in both PCR assays, the sensitivity of the real-time PCR assay was 100% and the specificity was 99.6%, whereas culture had a sensitivity of 69.2% and a specificity of 100%. CONCLUSIONS: The real-time PCR assay was sensitive and specific for the detection of T. vaginalis DNA from self-collected vaginal swab specimens. The ability to use the BDProbeTec dry swab system for the real-time PCR testing allowed for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and T. vaginalis from a single specimen.

Comparison of Aptima Trichomonas vaginalis Transcription-Mediated Amplification Assay and BD Affirm VPIII for Detection of T. vaginalis in Symptomatic Women: Performance Parameters and Epidemiological Implications

“…Recent literature suggests an association between T. vaginalis infection and the sequelae of other sexually transmitted infections (STIs), including low birth weight, premature rupture of membranes, preterm labor, atypical pelvic inflammatory disease, infertility, prolonged carriage of human papillomavirus (HPV), and an increased risk for acquiring HIV (9,10,13,18,21,31,32). Current methods used for the diagnosis of T. vaginalis, including wet mount microscopy, rapid antigen testing, and culture, have been shown to have poor sensitivity compared to molecular amplification methods (6,14,17,19,24,25,27). In addition, variable performance occurs with antigen testing and wet mount microscopy, depending on whether patients are symptomatic or asymptomatic (17, 26).…”

An Algorithm of a Laboratory Examination of Patients for Neisseria Gonorrhoeae, Chlamydia Trachomatis, Mycoplasma Genitalium and Trichomonas Vaginalis Infections Using the Polymerase Chain Reaction and the Transcriptional Amplification Reaction

“…[18] при изучении 16% образцов методом бактериоскопии был получен «сомнитель-ный» результат. В зарубежных работах чувствитель-ность МС определена в пределах 30-70% [29][30][31][32][33]. КП при диагностике ТИ требует длительного куль-тивирования (до 7-9 сут), особенно для исключе-ния трихомонадной инфекции.…”

“…К тому же трихомо-нады весьма требовательны к питательным средам и температурному режиму. В среднем чувствитель-ность КП, по результатам зарубежных исследова-ний, составляет 60-95% [29][30][31][32][33]. При несоблюде-нии этих условий чувствительность КП может быть невысокой -54,5% [18].…”

“…В зарубежных исследованиях показано, что МБМ на сегодня обладают самой высокой чувстви-тельностью и специфичностью при диагностике ТИ -от 85 до 100% [29][30][31][32][33]. Достигается это благодаря тому, что генетические мишени, которые выявля-ются МБМ, присутствуют в геноме во множестве копий, поэтому возможно выявление даже единич-ных клеток.…”

Real-time polymerase chain reaction (PCR) detection of Trichomonas vaginalis from urine samples of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) patients in Limpopo Province, South Africa

“…A real-time PCR protocol was developed from previously described protocol by Caliendo et al (2005). PCR primers used for the detection of T. vaginalis were TV forward 5'-CATTGACCACACGGACAAAAAG-3' and TV reverse 5'-CGAAGTGCTCGAATGCGA-3' primers.…”