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Journal of Clinical Microbiology, October 2008, p. 3368-3374, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00564-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Impact of Trichomonas vaginalis Transcription-Mediated Amplification-Based Analyte-Specific-Reagent Testing in a Metropolitan Setting of High Sexually Transmitted Disease Prevalence{triangledown}

Erik Munson,1,2* Maureen Napierala,1 Robin Olson,1 Tina Endes,1,{dagger} Timothy Block,1 Jeanne E. Hryciuk,1 and Ronald F. Schell3,4,5

Wheaton Franciscan and Midwest Clinical Laboratories, Wauwatosa, Wisconsin 53226,1 College of Health Sciences, University of Wisconsin—Milwaukee, Milwaukee, Wisconsin 53201,2 Wisconsin State Laboratory of Hygiene,3 Departments of Bacteriology,4 Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin 537065

Received 25 March 2008/ Returned for modification 13 June 2008/ Accepted 19 August 2008

Trichomoniasis is a significant sexually transmitted disease (STD) in the spectrum of public health and primary care because of its association with agents such as human immunodeficiency virus and Neisseria gonorrhoeae. However, its true significance may be underestimated due to diagnostic modalities that exhibit poor sensitivity. A total of 1,086 genital specimens from two urban emergency departments, a suburban urgent-care facility, and a metropolitan outpatient physician group were subjected to transcription-mediated amplification-based Trichomonas vaginalis analyte-specific-reagent (ASR) testing (Gen-Probe, Inc.). The rate of positive molecular ASR results (14.5%) doubled that of direct saline preparation (7.0%; P < 0.0002). Analogous increases were observed at one emergency department and within the outpatient physician group (P < 0.0002). No significant increase in the rate of positive molecular ASR results was observed from the facilities that encountered a lower frequency of black/African American patients. While positive T. vaginalis findings via direct saline preparation did not have a significant association with concomitant Chlamydia trachomatis or N. gonorrhoeae infection overall, a positive T. vaginalis ASR result was a better predictor of concomitant C. trachomatis or N. gonorrhoeae infection (odds ratios of 2.34 and 4.46, respectively; P < 0.0001). The increased rate of positive T. vaginalis ASR results was observed in both point-of-care (P = 0.02 versus direct saline preparation) and laboratory (P = 0.003) testing. Highly sensitive T. vaginalis molecular ASR not only transcends issues of specimen integrity and microscopic acumen but also has an increased ability to predict the likelihood of additional STDs in defined populations.

* Corresponding author. Mailing address: Wheaton Franciscan Laboratory, 11020 West Plank Court, Suite 100, Wauwatosa, WI 53226. Phone: (414) 256-1479. Fax: (414) 256-5566. E-mail: Erik.Munson{at}wfhc.org

{triangledown} Published ahead of print on 27 August 2008.

{dagger} Present address: Wheaton Franciscan Medical Group, Franklin, WI 53132.

Journal of Clinical Microbiology, October 2008, p. 3368-3374, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00564-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Shafir, S. C., Sorvillo, F. J., Smith, L. (2009). Current Issues and Considerations Regarding Trichomoniasis and Human Immunodeficiency Virus in African-Americans. Clin. Microbiol. Rev. 22: 37-45 [Abstract] [Full Text]  


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