Diagnosis of some genital-tract infections: part 1. An historical perspective

Abstract

Making a prompt and accurate diagnosis of genital tract infections is the key to instituting appropriate treatment and the linchpin of sexually transmitted infection control. We present a brief history, not covering syphilis, of diagnostic events for each of six bacteria and one protozoan from the time of discovery up to the molecular revolution. The latter is touched upon but its impact will form the substance of a further presentation. Here, hindsight is helpful in understanding the way in which progress was made over 135 years, often when microbiology, not even seen as a distinct discipline, had a difficult time in providing what was required in terms of dependable diagnostic techniques. Gram-staining, growth on artificial media, growth in cultured cells, enzyme immunoassays, metabolic and immunofluorescence tests have all had their place and some still do despite the avalanche of the molecular era. Serology to determine the existence of organism-specific antibodies has been important in managing syphilis, but has only sometimes been helpful in supporting a diagnosis for other infections and has rarely been the primary deciding factor.

Diagnosis of some genital-tract infections: part 2. Molecular tests and the new challenges

“…We previously gave an historical account of tests used to diagnose six sexually transmitted bacterial infections, and one protozoal, up to the advent of molecular tests. 1 These have now overtaken almost all others at a time when the digital era has seen a revolution in health-seeking behaviour with an unprecedented growth in the commercial market for sexually transmitted infection (STI) tests. The public may now seek testing and treatment at home with information and access provided on-line, sometimes without involvement of a STI specialist or NHS provider.…”

Evaluation of a Hydrogel-Based Diagnostic Approach for the Point-of-Care Based Detection of Neisseria gonorrhoeae

“…An important factor contributing to the rising prevalence of gonorrhea is treatment delay, whereby a patient may wait for a positive diagnostic test result before treatment is initiated [ 15 ]. Sometimes, despite the availability of laboratory facilities, the delays in reporting results severely hinders timely treatment [ 6 ].…”

Understanding the terms we use: support for using ‘sexually shared microbiota’ (SSM)

“…3 This article adds further to the debate [6][7][8][9][10][11] on the meaning and use of the terms 'sexually transmitted infection' (STI) and 'sexually transmitted disease' (STD) and considers whether they remain fit for purpose when applied to all genital-tract microbiota. Traditional STI organisms 12 (bacterial, viral, protozoal and fungal) are transmitted from an individual to a recipient host mainly during sexual activity, to become attached to or to penetrate cells of the genital tract or other site(s) of the host and multiply, causing an infection. This event, usually in association with a subsequent immunological reaction, may cause damage, sometimes of sufficient severity to bring about disease with associated symptoms and signs.…”