Can Chlamydial Cervicitis Influence Diagnosis of Bacterial Vaginosis?

Romanik, Małgorzata; Ekiel, Alicja; Friedek, Daniela; Martirosian, Gayane

doi:10.1128/jcm.43.9.4914-4915.2005

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…For Trichomonas vaginalis, wet mount is both sensitive and specific for detecting the pathogen and microscopy of stained colonies is also useful. As previously proposed by Romanik et al (2005), the sensitivity (78.5%) for BV by wet mount depends on identification of clue cells. It is sensitive and useful for high risk group such as brothel/hotel and the STI clinic group.…”

Section: Discussionmentioning

confidence: 62%

See 1 more Smart Citation

Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Niemogha¹,

Smith²,

Goodluck³

et al. 2011

Sierra Leone j. biomed. res.

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Laboratory diagnosis of Chlamydia and vaginitis in sexually active females has been limited by unavailability of a sequential method/rapid technique for simple diagnosis. Six hundred (600) adult females from hotel/brothel, Sexually Transmitted Infections (STIs) Clinic, Obstetrics/Gynaecology Clinic, Family Planning Clinic and Healthy controls were investigated for Chlamydia, Candida, trichomoniasis and bacterial vaginosis (BV). This was done using microscopy: wet mount, stained vaginal secretion and stained smear after culture. Results showed that there were 72% infections in the female groups. The brothel and STI group had infection in the range (70-86%). Chlamydial infection was highest in the STI group while Candida infection was highest in the healthy (control) females. Bacterial vaginosis was distributed in all groups. As pvalue increased, f-value increased indicating constant co-infection of Candida and BV in Chlamydia positive females. Microscopy by direct detection from sample and stained smear after culture were in the range: 56-86%. Direct microscopy for BV was 78.5% and stained smear after culture, 57.1%. Sensitivity and specificity of the techniques showed that detection of Chlamydia was less sensitive by direct microscopy of sample but sensitivity and specificity of stained smear after culture were high. Immunoassay (32.2%) was also less sensitive. Sensitivity and specificity of wet mount microscopy for Candida, Trichomoniasis and BV were in the range 62.5-80% and 62.5-97.8% respectively. Wet mount has high sensitivity and specificity for detecting agents of vaginitis and may be useful for routine use and for diagnosis where disease is absent, thus, making identification more cost effective.

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Section: Discussionmentioning

confidence: 62%

“…Vaginal samples were swabbed and plated on CAN and incubated in carbon dioxide candle extinction jar at 37°C for (24-48) hrs. Thereafter, growth was analysed for likely pathogens (Cowan and Steel, 1993;Romanik et al, 2005). Anaerobic cultures were not done because of unavailability of some necessary reagents.…”

Section: Culture In Synthetic Mediamentioning

confidence: 99%

Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Niemogha¹,

Smith²,

Goodluck³

et al. 2011

Sierra Leone j. biomed. res.

View full text Add to dashboard Cite

show abstract

“…This algorithm was not a major source of error however, since only 6 women with “normal” signs and symptoms had CV according to DNA. Co-infections may blur expected distinctions between BV, TV and CV (Romanik, Ekiel, Friedek, & Martirosian, 2005). Another potential source of error in self-diagnosis of BV is that the standard for BV was identification of G. vaginalis DNA by Affirm.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Vaginal Symptom Self-Diagnosis Algorithms for Deployed Military Women

Ryan‐Wenger

Neal²,

Jones³

et al. 2010

Nursing Research

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Background Deployed military women have an increased risk for development of vaginitis due to extreme temperatures, primitive sanitation, hygiene and laundry facilities, and unavailable or unacceptable health care resources. The Women in the Military Self-Diagnosis (WMSD) and Treatment Kit was developed as a field-expedient solution to this problem. Objectives The primary study aims were to evaluate the accuracy of women’s self-diagnosis of vaginal symptoms and 8 diagnostic algorithms, and to predict potential self-medication omission and commission error rates. Method Participants included 546 active duty, deployable Army (43.3%) and Navy (53.6%) women with vaginal symptoms who sought health care at troop medical clinics on base. In the clinic lavatory, women conducted a self-diagnosis using a sterile cotton swab to obtain vaginal fluid, a FemExam® card to measure positive or negative pH and amines, and the investigator-developed WMSD Decision-Making guide. Potential self-diagnoses were “bacterial infection” (bacterial vaginosis and/or trichomonas vaginitis - BV/TV), “yeast infection” (candida vaginitis – CV), “no infection/normal”, or “unclear.” The Affirm VPIII® laboratory reference standard was used to detect clinically significant amounts of vaginal fluid DNA for organisms associated with BV, TV and CV. Results Women’s self-diagnostic accuracy was 56% for BV/TV and 69.2% for CV. False positives would have led to a self-medication commission error rate of 20.3% for BV/TV and 8% for CV. Potential self-medication omission error rates due to false negatives were 23.7% for BV/TV and 24.8% for CV. The positive predictive power (PPV) of diagnostic algorithms for BV/TV ranged from 0 to 78.1%, and for CV was 41.7%. Discussion The algorithms were based on clinical diagnostic standards. The non-specific nature of vaginal symptoms, mixed infections, and a faulty device intended to measure vaginal pH and amines explain why none of the algorithms reached the goal of 95% accuracy. The next prototype of the WMSD Kit will not include non-specific vaginal signs and symptoms in favor of recently available point-of-care devices that identify antigens or enzymes of the causative BV, TV, and CV organisms.

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“…Infection is suggested by many scholars as one of the main causes of PROM (9). Following rupture of the fetal membrane, the chance of ascending infection of the amniotic cavity by vaginal bacteria is significantly increased.…”

Section: Discussionmentioning

confidence: 99%

Increased sTREM-1 in pregnant women with premature rupture of membranes and subclinical chorioamnionitis

Wang

Zhang

et al. 2011

Mol Med Report

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Abstract. Premature rupture of membranes (PROM) is a common obstetric complication frequently occurring with concomitant chorioamnionitis. The present study aimed to evaluate levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and amniotic fluid in pregnant women with PROM and to compare sTREM-1 with the commonly used laboratory indicators, serum C-reactive protein (CRP) and white blood cell (WBC) count. A total of 55 pregnant women with PROM were enrolled. Their venous blood and amniotic fluid were collected at delivery. sTREM-1 concentrations in the serum and amniotic fluid were determined by enzyme-linked immunosorbent assay. The measured data were compared with the pathological results of the placenta and fetal membrane. Meanwhile, sTREM-1 was compared with the laboratory indicators, serum CRP and WBC count. Serum and amniotic fluid sTREM-1 levels were significantly higher in pregnant women with subclinical chorioamnionitis compared to pregnant women without chorioamnionitis. Serum concentration of sTREM-1 yielded a sensitivity of 81.8% and a specificity of 77.3% for the prediction of subclinical chorioamnionitis. The amniotic fluid concentration of sTREM-1 resulted in a sensitivity of 81.8% and a specificity of 86.4% for the prediction of subclinical chorioamnionitis. In conclusion, serum and amniotic fluid sTREM-1 levels may emerge as early biological indicators for predicting PROM complicated with subclinical chorioamnionitis. sTREM-1 levels are superior to WBC count in predicting subclinical chorioamnionitis. IntroductionPremature rupture of membranes (PROM) refers to the rupture of membranes occurring prior to the onset of labor. As a common obstetric complication, it occurs in 2.7-17% of total deliveries and its incidence continues to rise (1). The mechanisms of PROM are not fully clear, and major causes responsible for PROM include infection, structural abnormalities of the fetal membrane, amniotic villus degeneration and micronutrient deficiencies. Although the etiology of PROM is multifactorial, epidemiological, clinical and molecular biology data have confirmed that ascending infection-caused genital tract inflammation plays a major role in the occurrence of PROM (2). Approximately 60% of PROM cases have concomitant chorioamnio nitis, and infection is proportionately more common when fewer gestational weeks have elapsed at the time of PROM occurrence (3). Prolonged duration of PROM boosts the risk of infection (4,5). Romero et al reported that the positive rate of bacterial culture using samples from transabdominal amniocentesis of PROM patients was 38% (6). It is now widely accepted that PROM and premature labor are a group of clinical syndromes closely associated with infection of the amniotic cavity.PROM complicated with chorioamnionitis is a common cause of perinatal infant mortality. It may lead to intrauterine infection, preterm labor of fetuses and low survival rate. In addition, it may result in maternal puerperal infection and even sepsis. It is difficult ...

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Can Chlamydial Cervicitis Influence Diagnosis of Bacterial Vaginosis?

Cited by 6 publications

References 5 publications

Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Chlamydia and Vaginitis in Sexually Active Females: Classical Identification Methods for Effective Control

Accuracy of Vaginal Symptom Self-Diagnosis Algorithms for Deployed Military Women

Increased sTREM-1 in pregnant women with premature rupture of membranes and subclinical chorioamnionitis

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