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Journal of Clinical Microbiology, November 1998, p. 3205-3210, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Diagnosis of Trichomonas vaginalis Infection by PCR Using Vaginal Swab Samples

Guillermo Madico,1,2 Thomas C. Quinn,1,3 Anne Rompalo,1 Kelly T. McKee Jr.,4 and Charlotte A. Gaydos1,*

School of Hygiene and Public Health and School of Medicine, The Johns Hopkins University, Baltimore, Maryland1; Cayetano Heredia University, Lima, Peru;2 National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland3; and Womack Army Medical Center, Fort Bragg, North Carolina4

Received 13 April 1998/Returned for modification 8 June 1998/Accepted 3 August 1998

Trichomonas vaginalis infection is the most prevalent nonviral sexually transmitted disease (STD) in the world. A PCR test using vaginal swab samples for the detection of T. vaginalis was developed to add T. vaginalis infection to the growing list of STDs that can be detected by DNA amplification techniques. A primer set, BTUB 9/2, was designed to target a well-conserved region in the beta-tubulin genes of T. vaginalis. All strains (15 of 15) of T. vaginalis tested were successfully detected by PCR giving a single predicted product of 112 bp in gel electrophoresis. No such targeted product was amplified with DNA from Trichomonas tenax, Trichomonas gallinae, Chlamydia trachomatis, Neisseria gonorrhoeae, Giardia lamblia, Chilomastix sulcatus, Dientamoeba fragilis, and Entamoeba histolytica. An optimal analytical sensitivity of one T. vaginalis organism per PCR was achieved. Culture, performed with the Inpouch TV culture system, was examined daily with a light microscope to identify T. vaginalis. Twenty-three of 350 (6.6%) vaginal swab samples from women attending an army medical clinic were culture positive for T. vaginalis. Of these culture positive specimens, PCR detected 22 of 23 (96%) with primer set BTUB 9/2, and wet preparation detected only 12 of 23 (52%). Seventeen specimens were BTUB 9/2-PCR positive and culture negative. Ten of these discordant specimens were determined to be as true positive by PCR using primer sets TVA 5-1/6 and/or AP65 A/B, which target different regions in the T. vaginalis genome, and seven were determined to be false positive. The sensitivity of BTUB 9/2-PCR was 97% and the specificity was 98%. The sensitivities of culture and wet preparation were 70 and 36%, respectively. The diagnosis of T. vaginalis infection by PCR is a sensitive and specific method that could be incorporated into a joint strategy for the screening of multiple STDs by using molecular amplification methods.

* Corresponding author. Mailing address: The Johns Hopkins University, Infectious Disease Division, 1154 Ross Research Bldg., 720 Rutland Ave., Baltimore, MD 21205. Phone: (410) 614-0932. Fax: (410) 614-9775. E-mail: cgaydos{at}welchlink.welch.jhu.edu.

Journal of Clinical Microbiology, November 1998, p. 3205-3210, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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