Retrospective Assessment of Transcription-Mediated Amplification-Based Screening for Trichomonas vaginalis in Male Sexually Transmitted Infection Clinic Patients

Munson, Erik; Wenten, David; Phipps, Paula; Gremminger, Roger; Schuknecht, Mary Kay; Napierala, Maureen; Hamer, Deb; Olson, Robin; Schell, Ronald F.; Hryciuk, Jeanne E.

doi:10.1128/jcm.00455-13

Cited by 16 publications

(13 citation statements)

References 34 publications

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“…Only one specimen (0.5%) yielded a positive result by alternative-target TMA. This rate of discordant results was less than the 1.6% to 4.6% values reported for T. vaginalis alternative-target testing (24,27,28). The parasitic species Trichomonas tenax has substantial genetic homology with T. vaginalis (29), which hypothetically could contribute to decreased specificity of T. vaginalis alternative-target TMA, (18) documented an approximate 19% detection rate among female STI clinic patients.…”

Section: Discussionmentioning

confidence: 58%

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

et al. 2016

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Following analysis of primary cervix, vagina, and first-void female urine specimens for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis via commercial transcription-mediated amplification (TMA), residual material was subjected to Mycoplasma genitalium research-use-only TMA. Representation within a 2,478-specimen retrospective study set was established by comparison to a 6-month audit of clinical C. trachomatis TMA (12,999 specimens) on the basis of the C. trachomatis detection rate, specimen source distribution, clinic location, and age. M. genitalium was detected in 282 (11.4%) patients. This rate was higher than those seen with T. vaginalis (9.0%; P ‫؍‬ 0.005), C. trachomatis (6.2%), and N. gonorrhoeae (1.4%). Positive M. genitalium results were confirmed by repeat testing or alternative-target TMA at a rate of 98.7%. The mean age of the M. genitalium-infected females (24.7 years) was lower than that of the T. vaginalis-infected females (mean, 30.1 years; P < 0.0001) and higher than that of the C. trachomatis-infected females (mean, 23.8 years; P ‫؍‬ 0.003). Of 566 patient encounters positive for at least one sexually transmitted infection (STI), 35.9% exhibited sole detection of M. genitalium (P < 0.0004 versus sole detection of other STI agents) and 26.1% were solely positive for T. vaginalis (P < 0.0002 versus C. trachomatis). The M. genitalium and T. vaginalis detection rates among 755 patients at urban emergency departments were 14.6% and 13.0%, respectively (P ‫؍‬ 0.37). A 10.0% M. genitalium detection rate from other facilities exceeded that of T. vaginalis (7.2%; P ‫؍‬ 0.004). Incorporation of M. genitalium TMA into comprehensive testing programs would detect M. genitalium in a significant proportion of females, particularly those in outpatient obstetrics and gynecology (OB/GYN) settings. T he sexually transmitted infection (STI) agentMycoplasma genitalium has historically had a role of pathogenicity in male nongonococcal urethritis (1). Recent evidence has implicated the bacterium in clinically significant disease in females (2, 3). Additional studies suggest that M. genitalium infection promotes HIV acquisition (4-6) and virus shedding (7,8). Moreover, in a recent meta-analysis, Lis et al. (9) reported significant associations between M. genitalium infection and cervicitis, pelvic inflammatory disease, preterm birth, and spontaneous abortion.Until recently, a lack of reliable testing options has curtailed laboratory diagnosis of M. genitalium infection. Culture and serologic modalities have been limited by sensitivity and/or cross-reactivity with other mycoplasmas (1) and are becoming supplanted by molecular diagnostics, largely on a research basis. PCR-based assays have correlated M. genitalium DNA burden with clinical condition (10, 11) and treatment efficacy (12) in males. Quantitative molecular analysis has sought to study progression of genital disease in females (13). In the realm of laboratory diagnosis, initial studies of target capture-based transcription-mediated amp...

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Section: Discussionmentioning

confidence: 58%

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

et al. 2016

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“…82 Pharyngeal T. vaginalis has been identified among predominantly asymptomatic STI clinic attendees in the US, although most (>90%) infections were identified among heterosexual men. 83 Taken together, these studies suggest that T. vaginalis rarely colonises the pharynx or anogenital mucosa of MSM, even in settings where the heterosexual community prevalence of T. vaginalis is substantial. Testing for T. vaginalis among asymptomatic Australian MSM is therefore not recommended.…”

Section: Trichomonas Vaginalismentioning

confidence: 97%

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

et al. 2014

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Abstract.Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009-May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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“…TMA-based detection of other STI agents has been documented from male urogenital (T. vaginalis, M. genitalium) and pharyngeal (T. vaginalis) specimens (12,13,15,16). C. trachomatis and N. gonorrhoeae screening from both urine and extraurogenital sources in this study resulted in 228 instances of STI (15.3% incidence rate) (Fig.…”

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confidence: 99%

“…Moreover, differences in clinical and in vitro detection rates yielded by transcription-mediated amplification (TMA) versus DNA amplification modalities have been demonstrated (4)(5)(6)(7)(8)(9), likely owing to target capture-based removal of endogenous inhibitors (10,11). Detection of Trichomonas vaginalis RNA from pharyngeal specimens (12) and Mycoplasma genitalium RNA from urine specimens (13) of male STI clinic attendees has recently been reported on the basis of commercial TMA assays. The purpose of this investigation was to assess both the capacity of TMA for detection of M. genitalium from pharyngeal and rectal specimens and the potential for multispecimen analysis in the overall identification of male carriers of STI agents.…”

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confidence: 99%

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Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

Munson

Wenten²,

Jhansale³

et al. 2017

J Clin Microbiol

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Of 1,493 encounters of males at a sexually transmitted infection (STI) clinic in a community with a high prevalence of STI, Chlamydia trachomatis was detected in 8.7% and Neisseria gonorrhoeae was detected in 6.6%. Additional Trichomonas vaginalis and Mycoplasma genitalium screening found 17.4% and 23.9% of the encounters, respectively, to be positive for STI. STI agents were detected in 13.7% of urine specimens; addition of pharyngeal and rectal collections to the analysis resulted in detection of STI agents in 19.0% and 23.9% of encounters, respectively. A total of 101 (23.8%) encounters of identified STI involved sole detection of M. genitalium. Expansion of the STI analyte panel (including M. genitalium) and additional specimen source sampling within a comprehensive STI screening program increase identification of male STI carriers. KEYWORDS Mycoplasma genitalium, transcription-mediated amplification,Trichomonas vaginalis E xtraurogenital screening for agents of sexually transmitted infection (STI) has been advocated in a number of clinical and public health scenarios (1). Studies have reported increased rates of Chlamydia trachomatis and Neisseria gonorrhoeae detection from pharyngeal and rectal specimens via nucleic acid amplification testing compared to rates found with culture (2-7). Moreover, differences in clinical and in vitro detection rates yielded by transcription-mediated amplification (TMA) versus DNA amplification modalities have been demonstrated (4-9), likely owing to target capture-based removal of endogenous inhibitors (10, 11). Detection of Trichomonas vaginalis RNA from pharyngeal specimens (12) and Mycoplasma genitalium RNA from urine specimens (13) of male STI clinic attendees has recently been reported on the basis of commercial TMA assays. The purpose of this investigation was to assess both the capacity of TMA for detection of M. genitalium from pharyngeal and rectal specimens and the potential for multispecimen analysis in the overall identification of male carriers of STI agents.(Results of this work were presented in part at ASM Microbe, Boston, MA, 16 to 20 June 2016.)With an Institutional Review Board-approved protocol, screening practices for male attendees of a Milwaukee, WI, STI clinic were audited from March 2014 through December 2015. The high-STI-prevalence nature of this community was noted previously (14). Aliquots of first-void urine were dispensed into Aptima urine specimen transport tubes (Hologic, San Diego, CA). Pharyngeal and rectal swab specimens were obtained using the Aptima unisex swab specimen collection kit (Hologic).

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Retrospective Assessment of Transcription-Mediated Amplification-Based Screening for Trichomonas vaginalis in Male Sexually Transmitted Infection Clinic Patients

Cited by 16 publications

References 34 publications

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

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