High Rates of<i>Trichomonas vaginalis</i>among Men Attending a Sexually Transmitted Diseases Clinic: Implications for Screening and Urethritis Management

Schwebke, Jane R.; Hook, Edward W.

doi:10.1086/376558

Cited by 109 publications

(69 citation statements)

References 25 publications

(18 reference statements)

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“…The subacute nature of this population, suggesting a substantial proportion of asymptomatic females, is relevant. A number of publications have documented T. vaginalis detection from asymptomatic patients (22,24,25,27). In one of these studies, Schwebke and Hook (25) reported an increased T. vaginalis detection rate in asymptomatic males compared to that in males with symptoms (P ϭ 0.009).…”

Section: Discussionmentioning

confidence: 99%

“…A number of publications have documented T. vaginalis detection from asymptomatic patients (22,24,25,27). In one of these studies, Schwebke and Hook (25) reported an increased T. vaginalis detection rate in asymptomatic males compared to that in males with symptoms (P ϭ 0.009). The T. vaginalis detection rate (9.3%) exceeded the detection rates of C. trachomatis (5.7%) and N. gonorrhoeae (1.4%) (P values of Ͻ0.0002 for both) in the current assessment of female epidemiology.…”

Section: Discussionmentioning

confidence: 99%

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Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

et al. 2012

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bRecent literature has reported increased accuracy of Trichomonas vaginalis transcription-mediated amplification (TMA)-based analyte-specific reagent (ASR) testing in female populations. A retrospective investigation assessed 7,277 female first-void urine, cervical, or vaginal specimens submitted from a high-prevalence sexually transmitted infection (STI) community to characterize prevalence of disease etiologies. The most common STI phenotype reflected detection of solely T. vaginalis (54.2% of all health care encounters that resulted in STI detection). In females with detectable T. vaginalis, codetection of Chlamydia trachomatis and Neisseria gonorrhoeae occurred in 7.8% and 2.7% of health care encounters, respectively. The mean age of women with detectable T. vaginalis (30.6) was significantly higher than those for women with C. trachomatis or N. gonorrhoeae (22.3 and 21.6, respectively; P < 0.0001). T. vaginalis was the predominant sexually transmitted agent in women over the age of 20 (P < 0.0002). C. trachomatis was the most commonly detected agent in females under the age of 21, particularly from cervical specimens. However, first-void urine detection rates for T. vaginalis and C. trachomatis within this age demographic demonstrated no difference (P ‫؍‬ 0.92). While overall and cervical specimen-derived detection of T. vaginalis within African American majority geographical locales outweighed that within majority Caucasian geographical regions (P < 0.004), this difference was not noted with first-void urine screening (P ‫؍‬ 0.54). Health care professionals can consider TMA-based T. vaginalis screening for a wide age range of patients; incorporation of first-void urine specimens into screening algorithms can potentiate novel insight into the epidemiology of trichomoniasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

et al. 2012

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“…Although the overall prevalence of T. vaginalis in women was approximately 10 to 15% less in this subacute care demographic compared to emergent care populations (16,23,24), significant T. vaginalis detection rates in both males and females (Table 2), as well as statistically increased T. vaginalis detection rates over those of C. trachomatis and N. gonorrhoeae provide evidence supporting consistent molecular screening for this agent. Indeed, appreciable T. vaginalis detection rates have been demonstrated in both symptomatic and asymptomatic populations (25,27,28). …”

Section: Discussionmentioning

confidence: 99%

“…A paucity of studies has examined the role of laboratory diagnosis for management of trichomoniasis in men (2,12,25,28). One of these studies (28) utilized DNA amplification technology to demonstrate detection of T. vaginalis in a greater proportion of asymptomatic males (51.4%) than in those with symptoms (23%; P ϭ 0.009).…”

Section: Discussionmentioning

confidence: 99%

Three-Year History of Transcription-Mediated Amplification-Based Trichomonas vaginalis Analyte-Specific Reagent Testing in a Subacute Care Patient Population

Napierala

Munson

et al. 2011

J Clin Microbiol

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A total of 7,899 specimens submitted for live clinical Trichomonas vaginalis analyte-specific reagent (ASR) screening from 2008 to 2010 were audited on the basis of patient gender, specimen source, molecular Neisseria gonorrhoeae and Chlamydia trachomatis results, and relative light unit (RLU) data yielded by T. vaginalis ASR. Only 1.4% of the screening was ordered by emergency department clinicians. The screening volume in 2010 was 126% higher than that in 2008. The proportions of annual female and male screening remained consistent throughout the 3-year interval (ϳ92 and 8%, respectively). Although 71.8 and 9.5% of screening was performed on endocervical and vaginal specimens, respectively, over the 3-year period, no significant difference was noted in the T. vaginalis detection rates (8.9 and 8.6%, P ‫؍‬ 0.85). Increased T. vaginalis detection was derived from female urine specimens (12.6%) compared to female genital swabs (P ‫؍‬ 0.0004). The proportion of female urine screening increased during the 3-year interval (P < 0.0002). T. vaginalis detection rate in males was 6.6%, with no difference between urethral and urine T. vaginalis detection (P ‫؍‬ 0.53). The mean RLU value for 714 positive specimens was 3,971,441; analogous values for each female specimen source and combined male source testing showed no variance (P > 0.29). Combined-gender T. vaginalis detection rate (9.1%) was significantly greater than those of C. trachomatis (5.9%) and N. gonorrhoeae (1.5%; P < 0.0002). Equivocal results presented at a rate of 0.4%. T. vaginalis ASR is an increasingly utilized assay that yields higher detection rates than other sexually transmitted infection etiologies in this community subacute care setting.

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“…Several commercially available real-time PCR assays enable this double detection (3). Trichomonas vaginalis is the most prevalent nonviral sexually transmitted disease pathogen in the world, but it remains poorly diagnosed, as are Mollicutes (Ureaplasmas and Mycoplasmas), which are difficult to cultivate (4)(5)(6). The latter bacteria are involved in early pregnancy loss, stillbirth, preterm birth, and neonatal morbidity, as well as male infertility (6-9), although they are also commonly identified in the vaginal flora of 40% to 80% of healthy women, depending on the population (6, 7).…”

mentioning

confidence: 99%

Assessment of Coinfection of Sexually Transmitted Pathogen Microbes by Use of the Anyplex II STI-7 Molecular Kit

et al. 2015

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f Anyplex STI-7 is a new molecular kit that detects seven sexually transmitted pathogens. Among 202 subjects screened for genital infection, 143 (70.4%) were diagnosed with at least one pathogen, in concordance with reference methods. In addition, the Anyplex STI-7 demonstrated coinfections, such as that with Ureaplasma parvum and Chlamydia trachomatis, in young women. Since the consequences of genital infections through sexually transmitted diseases (STDs) can be as severe as sterility and disseminated infections, molecular assays detecting bacterial pathogens, such as Chlamydia trachomatis and Neisseria gonorrhoeae, were shown to be relevant not only in patent infections but also in paucisymptomatic sexually active women (1, 2). Several commercially available real-time PCR assays enable this double detection (3). Trichomonas vaginalis is the most prevalent nonviral sexually transmitted disease pathogen in the world, but it remains poorly diagnosed, as are Mollicutes (Ureaplasmas and Mycoplasmas), which are difficult to cultivate (4-6). The latter bacteria are involved in early pregnancy loss, stillbirth, preterm birth, and neonatal morbidity, as well as male infertility (6-9), although they are also commonly identified in the vaginal flora of 40% to 80% of healthy women, depending on the population (6, 7). Among them, Ureaplasma parvum is an overlooked pathogen.The Anyplex II STI-7 kit (STI-7, Seegene, Eurobio) is a multiplex real-time PCR assay relying on a newly developed tagging oligonucleotide cleavage and extension technology (TOCE). This assay is marketed to simultaneously detect seven microorganisms involved in sexually transmitted infections: C. trachomatis (CT), N. gonorrhoeae (NG), T. vaginalis (TV), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and U. parvum (UP). Our study aimed to evaluate this assay's performances in diagnosing and screening for STDs in our hospital cohort. The results were compared to those of validated methods. In addition, we looked for the coexistence of pathogens, which is usually undetected. Two or more pathogens were highly prevalent, especially in sexually active young women with or without symptoms of infection.A total of 213 specimens from 202 patients were tested from January to June 2012. The specimens came from 94 vaginal swabs, 46 cervical swabs, 61 first-void urine samples, and 12 pelvic aspirated fluid samples. Cervical and urethral swabs were discharged in 3 ml of M4-RT medium (Abbott), and other samples were put into sterile tubes with no additives and transported to the lab within 12 h. All specimens were submitted to the Abbott RealTime CT/NG assay (Abb CT/NG ) used routinely in our lab for detection of CT and NG. Samples were processed and interpreted as recommended by the manufacturer using the Abbott m2000 apparatus.Results were given as positive, negative, or equivocal, the latter being retested and reclassified positive or negative. For the STI-7 assay, DNA was extracted from 190 l of the sample (M4-RT medium, urine, or...

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High Rates ofTrichomonas vaginalisamong Men Attending a Sexually Transmitted Diseases Clinic: Implications for Screening and Urethritis Management

Cited by 109 publications

References 25 publications

Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

Three-Year History of Transcription-Mediated Amplification-Based Trichomonas vaginalis Analyte-Specific Reagent Testing in a Subacute Care Patient Population

Assessment of Coinfection of Sexually Transmitted Pathogen Microbes by Use of the Anyplex II STI-7 Molecular Kit

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