This Article Full Text (PDF) Other Versions of this Article: JCM.00564-08v1 46/10/3368    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Google Scholar Articles by Munson, E. Articles by Schell, R. F. PubMed PubMed Citation Articles by Munson, E. Articles by Schell, R. F.

 Previous Article  |  Next Article 

J. Clin. Microbiol. doi:10.1128/JCM.00564-08
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. 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

Wheaton Franciscan and Midwest Clinical Laboratories, Wauwatosa, Wisconsin 53226; College of Health Sciences, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin 53201; and Wisconsin State Laboratory of Hygiene, and Departments of Bacteriology, and Medical Microbiology and Immunology, University of Wisconsin, Madison, Wisconsin 53706

^* To whom correspondence should be addressed. Email: Erik.Munson{at}wfhc.org.

	Abstract

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 HIV and Neisseria gonorrhoeae. However, its true significance may be underestimated due to diagnostic modalities that exhibit poor sensitivity. 1086 genital specimens from two urban emergency departments, a suburban urgent-care facility, and a metropolitan outpatient physician group were tested with the transcription-mediated amplification (TMA)-based Trichomonas vaginalis analyte-specific reagent (ASR; Gen-Probe, Incorporated). The rate of positive molecular ASR result (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 rate of positive molecular ASR result 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 C. 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 2.34 and 4.46, respectively; P < 0.0001). The increased rate of positive T. vaginalis ASR result 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, in defined populations, has an increased ability to predict the likelihood of additional STD.