Immunocytochemistry Improving the Diagnosis of Trichomonas vaginalis Infections (original) (raw)
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Journal of Clinical Microbiology, 2005
Trichomonas vaginalis infection is estimated to be the most widely prevalent nonviral sexually transmitted infection in the world. Wet-mount microscopy is the most common diagnostic method, although it is less sensitive than culture. The OSOM Trichomonas Rapid Test (Genzyme Diagnostics, Cambridge, Mass.) (referred to here as OSOM) is a new point-of-care diagnostic assay for T. vaginalis that uses an immunochromatographic capillary flow (dipstick) assay and provides results in 10 min. The purpose of this study was to determine the test characteristics of OSOM compared to those of a composite reference standard (CRS) comprised of wet-mount microscopy and T. vaginalis culture. This multicenter cross-sectional study enrolled sexually active women >18 years of age who presented with symptoms of vaginitis, exposure to T. vaginalis, or multiple sexual partners. Vaginal-swab specimens were obtained for T. vaginalis culture, wet mount, and rapid testing. The prevalence of T. vaginalis in this sample was 23.4% (105 of 449) by the CRS. The sensitivity and specificity of OSOM vaginal-swab specimens were 83.3 and 98.8%, respectively, while wet mount had a sensitivity and specificity of 71.4 and 100%, respectively, compared to the CRS. OSOM performed significantly better than wet mount (P ؍ 0.004) and detected T. vaginalis in samples that required 48 to 72 h of incubation prior to becoming culture positive. The performance of the rapid test was not affected by the presence of coinfections with chlamydia and gonorrhea. The OSOM Trichomonas Rapid Test is a simple, objective test that can be expected to improve the diagnosis of T. vaginalis, especially where microscopy and culture are unavailable.
Journal of Clinical Microbiology, 2005
Trichomonas vaginalis infection is estimated to be the most widely prevalent nonviral sexually transmitted infection in the world. Wet-mount microscopy is the most common diagnostic method, although it is less sensitive than culture. The OSOM Trichomonas Rapid Test (Genzyme Diagnostics, Cambridge, Mass.) (referred to here as OSOM) is a new point-of-care diagnostic assay for T. vaginalis that uses an immunochromatographic capillary flow (dipstick) assay and provides results in 10 min. The purpose of this study was to determine the test characteristics of OSOM compared to those of a composite reference standard (CRS) comprised of wet-mount microscopy and T. vaginalis culture. This multicenter cross-sectional study enrolled sexually active women >18 years of age who presented with symptoms of vaginitis, exposure to T. vaginalis, or multiple sexual partners. Vaginal-swab specimens were obtained for T. vaginalis culture, wet mount, and rapid testing. The prevalence of T. vaginalis in this sample was 23.4% (105 of 449) by the CRS. The sensitivity and specificity of OSOM vaginal-swab specimens were 83.3 and 98.8%, respectively, while wet mount had a sensitivity and specificity of 71.4 and 100%, respectively, compared to the CRS. OSOM performed significantly better than wet mount (P ؍ 0.004) and detected T. vaginalis in samples that required 48 to 72 h of incubation prior to becoming culture positive. The performance of the rapid test was not affected by the presence of coinfections with chlamydia and gonorrhea. The OSOM Trichomonas Rapid Test is a simple, objective test that can be expected to improve the diagnosis of T. vaginalis, especially where microscopy and culture are unavailable.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006
Objectives: The aim of this study was to compare wet mount-, Giemsa stain-, acridine orange fluorescent stain-, cultivation-and polymerase chain reaction (PCR)-based approaches to establish which method or combination of methods was most effective in the laboratory diagnosis of trichomoniasis. Study design: Out of 200 investigated patients with various gynecological complaints, Trichomonas vaginalis infection was detected in 27 (13.5%) by any of methods investigated. Among women with trichomonads, a typical clinical finding was presented in only nine. For analysis of sensitivity and specificity of the methods used, the receiver operating characteristic (ROC) curve concept with culture as a gold standard was applied. Results: Infection was diagnosed by wet mount in 14 (7.0%) women, by Giemsa stain in 11 (5.5%) and by acridine orange stain in 16 (8.0%) women. In 21 (10.5%) women, it was diagnosed by culture in Diamond's medium, and in 22 (11.0%) by PCR. For the initial diagnosis of trichomoniasis, wet preparation is the test that is widely available in most STD clinics, but its sensitivity is poor (66.67%). Giemsa stain shows a low sensitivity of 52.38%. Acridine orange shows reasonable sensitivity and specificity of 71.43% and 99.44%, respectively. The sensitivity and specificity of PCR (80.95% and 97.21%) did not exceed that of culture. Conclusion: With regard to the fact that trichomoniasis can have an atypical or even asymptomatic course, in order to accurately diagnose this disease, microbiological investigation is necessary. Comparison of different methods showed that at least two techniques, such as culture and acridine orange staining, have the potential for better diagnosis of T. vaginalis infection. PCR detection of infection has been demonstrated to be highly specific and sensitive, but its availability and cost effectiveness are in question. PCR could provide an alternative for laboratory diagnosis of trichomoniasis by culture. #
Detection of Trichomonas vaginalis antigen in women by enzyme immunoassay
Journal of Clinical Pathology, 1987
An enzyme immunoassay (EIA) was developed for the detection of Trichomonas vaginalis antigen in vaginal swabs. Four hundred and eighty two women attending a sexually transmitted disease (STD) clinic were tested; 44 (9 1 %) were positive by culture, 32 (6-6%) were positive by wet film examination, and 54 (11 2%) were considered to be positive for trichomonal antigen by EIA. Taking culture as the reference method, the EIA had a sensitivity of 93-2% and a specificity of 97 5%. The predictive value of a positive test was 82% and that of a negative test was 99 3%.
Performance of a New, Rapid Assay for Detection of Trichomonas vaginalis
Journal of Clinical Microbiology, 2004
Trichomonas vaginalis infection is highly prevalent, may have serious health consequence, and is readily treatable. However, screening has been limited by currently available tests, which tend to be insensitive, expensive, or require a delay before results are reported. The XenoStrip-Tv (Xenotope Diagnostics, Inc., San Antonio, Tex.) was evaluated on vaginal swab specimens from 936 women attending sexually transmitted disease clinics in Seattle, Wash. (n ؍ 497), and Birmingham, Ala. (n ؍ 439). T. vaginalis prevalence by culture (InPouch; Biomed) was 8.7% in Seattle and 21.0% in Birmingham. Compared to culture, the XenoStrip assay in Seattle was 76.7% (95% confidence interval [95% CI] ؍ 61.4 to 88.2) sensitive and 99.8% (95% CI ؍ 98.8 to 99.9) specific, and in Birmingham it was 79.4% (95% CI ؍ 69.6 to 87.1) sensitive and 97.1% (95% CI ؍ 94.8 to 98.6) specific. The positive predictive values were 97.1% in Seattle and 87.9% in Birmingham; the negative predictive values were 97.8 and 94.7%, respectively. Rapid test performance did not vary by vaginal symptoms or by the presence of other vaginal or cervical syndromes or infections. The sensitivity did vary by day of culture-positive result, with a 71% decline in XenoStrip sensitivity for every additional day delay until T. vaginalis was first detected in cultures (odds ratio ؍ 0.29, 95% CI ؍ 0.18 to 0.49). The rapid assay was more sensitive than wet preparation microscopy (78.5% versus 72.4% [P ؍ 0.04]) but was less specific (98.6% versus 100% [P ؍ 0.001]). The XenoStrip rapid assay is well suited for use in settings with a moderately high prevalence of T. vaginalis infection, particularly when microscopy is not practical.
A Comparison of Cytological and Parasitological Methods in the Diagnosis of Trichomonas vaginalis
Turkiye Parazitol …, 2008
Trichomonas vaginalis (T. vaginalis), which causes urogenital system infections in humans, develops symptomatically and asymptomatically. T. vaginalis in females is diagnosed using direct microscopy, Giemsa staining, and cultivation methods for examination of samples derived from the vaginal posterior fornix. Serologic methods can also be employed. In cytological diagnosis, the ectocervical smear is examined using the Papanicolaou (PAPS) stain. The aim of the present study was to compare the efficacy of the methods used in cytological and parasitological diagnosis. For this purpose, 506 female patients who visited the Obstetrics and Gynecology policlinic of the Academic Hospital of the Faculty of Medicine, Inönü University during a course of six years were involved in this study. The samples derived from the vaginal posterior fornix were examined in the parasitology laboratory, while the ectocervical samples were examined in the cytology laboratory. T. vaginalis was detected in 4.6% of the samples examined in parasitology laboratory, while parasites were found in only 0.9% of the samples taken to the cytology laboratory. The statistical analysis revealed a significant difference (P<0.05). It was concluded that parasitological methods are more sensitive than cytological methods in the diagnosis of T. vaginalis.
Comparison of Three Diagnostic Methods for Trichomonas vaginalis Detection in a Low-Resource Setting
Journal of Advances in Medicine and Medical Research
Aims: To comparatively evaluate the efficiency of three simple trichomoniasis diagnostic techniques in a low-resource setting at the Baixada Fluminense region, Province of Rio de Janeiro, Brazil. Place and Duration of Study: The sample was obtained from the medical records of women attending the Iguaçu University Clinic's Gynaecology Outpatient Clinic from January to December 2020. The sample consisted of medical records of 135 women aged 17 to 78 years. Methodology: With the aid of a sterile and disposable bi-valve speculum, vaginal secretion was collected with a swab from the vaginal sac. The secretion was used for smears in two slides for wet mount examination and Papanicolaou staining and then seeded in a tube with 6 ml of Diamond's culture medium. Results: The results showed that among the 135 women with clinical signs of vulvovaginitis, 65 (48.15%) were infected by Trichomonas vaginalis. The positivity rates displayed significant differences according to the detection ...
Iraqi Journal of Science, 2020
Trichomonas vaginalis is an eukaryotic parasite that causes the most common non-viral sexually transmitted infection, trichomoniasis. This disease is responsible for many serious health problems such as preterm birth. More than half of the infected women do not develop symptoms, which makes it difficult to diagnose the disease. In this study, a specific indirect ELISA method was developed to detect anti-Trichomonas vaginalis IgM and IgG immunoglobulins in the sera of infected females. The aim of this study was to investigate the sensitivity of a simple ELISA procedure in comparison to the classical urine examination and vaginal wet mount preparation for the diagnosis of T. vaginalis. The sensitivity of the indirect ELISA was compared with the classical vaginal discharge swab and urine microscopic examination, and the results showed sensitivities of 65.5% and 57.2%, respectively. Furthermore, the infection was measurable as acute or chronic with the refined test.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2014
Out of 95 female patients of reproductive age group (15-45 years),Trichomonas vaginalis infection was detected in 16 patients (16.8%).Vaginal discharge was the most prevalent symptoms, found in twenty two patients (23.2%).The highest positivity was found in the age group 25-35 years which represent the group of high sexual activity. Wet mount examination for T. vaginalis was positive in 6.3% of cases, whereas, Giemsa staining and Acridine orange staining were positive in 10.5% and 16.8% of cases respectively. Although wet mount examination is the most commonly used test in routine diagnosis of Trichomonas vaginalis infection, but staining techniques should be used as an additional diagnostic test in order to diagnose cases missed either due to unavailability of immediate microscopic facility or delay in the transport of samples to the laboratory for culture. K e y w o r d s Trichomonas vaginalis,
Journal of Clinical Microbiology, 2003
Trichomonas vaginalis infection is highly prevalent worldwide and is associated with urethritis, prostatitis, and urethral strictures in men. However, the natural history and importance of T. vaginalis in men are poorly understood, in part because of difficulties in diagnosing infection. Traditional detection methods rely on culture and wet-mount microscopy, which can be insensitive and time consuming. Urethral swabs are commonly used to detect T. vaginalis in men, but discomfort from specimen collection is a barrier to large studies. One thousand two hundred twenty-five Malawian men attending sexually transmitted disease and dermatology clinics were enrolled in this cross-sectional study to validate detection by urine-based PCR-enzyme-linked immunosorbent assay (ELISA) with urine and urethral swab culture as the reference standard. This assay for detection of amplified T. vaginalis DNA in first-catch urine (<30 ml) performed with a sensitivity of 92.7%, a specificity of 88.6%, and an adjusted specificity of 95.2% compared to culture of urethral swabs or urine sediment. For clinical research settings in which urethral swabs are not available and culture is not feasible, the urine-based PCR-ELISA may be useful for detection of trichomoniasis in men.