Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

Optimization of Trichomonas vaginalis Diagnosis during Pregnancy at a University Hospital, Argentina

  • Testardini, Pamela (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Vaulet, Maria Lucia Gallo (Clinical Immmunology and Virology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Entrocassi, Andrea Carolina (Clinical Immmunology and Virology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Menghi, Claudia (Clinical Parasitology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Eliseht, Martha Cora (Lower Genital Tract, Obstetrics Division, Department of Tocogynecology, Hospital de Clinicas, Universidad de Buenos Aires) ;
  • Gatta, Claudia (Clinical Parasitology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Losada, Mirta (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Touzon, Maria Sol (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Corominas, Ana (Clinical Immmunology and Virology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Vay, Carlos (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Tatti, Silvio (Lower Genital Tract, Obstetrics Division, Department of Tocogynecology, Hospital de Clinicas, Universidad de Buenos Aires) ;
  • Famiglietti, Angela (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Fermepin, Marcelo Rodriguez (Clinical Immmunology and Virology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires) ;
  • Perazzi, Beatriz (Clinical Bacteriology Laboratory, Department of Clinical Biochemistry, Hospital de Clinicas, Facultad de Farmacia y Bioquimica, Universidad de Buenos Aires)
  • Received : 2015.06.01
  • Accepted : 2015.11.04
  • Published : 2016.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this study was to evaluate different methods for Trichomonas vaginalis diagnosis during pregnancy in order to prevent maternal and perinatal complications. A total of 386 vaginal exudates from pregnant women were analyzed. T. vaginalis was investigated by 3 types of microscopic examinations direct wet mount with physiologic saline solution, prolonged May-Grunwald Giemsa (MGG) staining, and wet mount with sodium-acetate-formalin (SAF)/methylene blue method. PCR for 18S rRNA gene as well as culture in liquid medium were performed. The sensitivity and specificity of the microscopic examinations were evaluated considering the culture media positivity or the PCR techniques as gold standard. The frequency of T. vaginalis infection was 6.2% by culture and/or PCR, 5.2% by PCR, 4.7% by culture, 3.1% by SAF/methylene blue method and 2.8% by direct wet smear and prolonged MGG staining. The sensitivities were 83.3%, 75.0%, 50.0%, and 45.8% for PCR, culture, SAF/methylene blue method, and direct wet smear-prolonged MGG staining, respectively. The specificity was 100% for all the assessed methods. Microscopic examinations showed low sensitivity, mainly in asymptomatic pregnant patients. It is necessary to improve the detection of T. vaginalis using combined methods providing higher sensitivity, such as culture and PCR, mainly in asymptomatic pregnant patients, in order to prevent maternal and perinatal complications.

Keywords

References

  1. Heine P, Mc Gregor JA. Trichomonas vaginalis: a reemerging pathogen. Clin Obstet Gynecol 1993; 36: 137-144. https://doi.org/10.1097/00003081-199303000-00019
  2. Laga M, Manoka A, Kivuvu M, Malele B, Tuliza M, Nzila N, Goeman J, Behets F, Batter V, Alary M. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS 1993; 7: 95-102. https://doi.org/10.1097/00002030-199301000-00015
  3. Silver BJ, Guy RJ, Kaldor JM, Jamil MS, Rumbold AR. Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis. Sex Transm Dis 2014; 41: 369-376. https://doi.org/10.1097/OLQ.0000000000000134
  4. Swygard H, Sena AC, Hobbs MM, Cohen NS. Trichomoniasis: clinical manifestations, diagnosis and management. Sex Transm Infect 2004; 80: 91-95. https://doi.org/10.1136/sti.2003.005124
  5. Krieger JN. Trichomoniasis in men: old issues and new data. Sex Transm Dis 1995; 22: 83-96. https://doi.org/10.1097/00007435-199503000-00003
  6. Schwebke JR, Burgess D. Trichomoniasis. Cin Microbiol Rev 2004; 17: 794-803. https://doi.org/10.1128/CMR.17.4.794-803.2004
  7. Patil MJ, Nagamoti JM, Metgud SC. Diagnosis of Trichomonas vaginalis from vaginal specimens by wet mount microscopy. In Pouch TV Culture System and PCR. J Glob Infect Dis 2012; 4: 22-25. https://doi.org/10.4103/0974-777X.93756
  8. Saleh AM, Abdalla HS, Satti AB, Babiker SM, Gasim GI, Adam I. Diagnosis of Trichomonous vaginalis by microscopy, latex agglutination, diamond's media, and PCR in symptomatic women, Khartoum, Sudan. Diagn Pathol 2014; 9: 49-53. https://doi.org/10.1186/1746-1596-9-49
  9. Piperaki ET, Theodora M, Mendris M, Barbitsa L, Pitiriga V, Antsaklis A, Tsakris A. Prevalence of Trichomonas vaginalis infection in women attending a major gynaecological hospital in Greece: a cross-sectional study. J Clin Pathol 2010; 63: 249-253. https://doi.org/10.1136/jcp.2009.070920
  10. Poch F, Levin D, Levin S, Dan M. Modified thioglycolate medium: a simple and reliable means for detection of Trichomonas vaginalis. J Clin Microbiol 1996; 34: 2630-2631.
  11. Costamagna SR. Trichomonas vaginalis. In Costamagna SR, ed, Parasitosis regionales, Bahia Blanca, Argentina. Editorial de la Universidad Nacional del Sur. 2004, pp 197-217.
  12. Perazzi B, Menghi C, Coppolillo E, Gatta C, Cora Eliseht M, de Torres RA, Vay C, Famiglietti A. Prevalence and comparison of diagnostic methods for Trichomonas vaginalis infection in pregnant women in Argentina. Korean J Parasitol 2010; 1: 61-65.
  13. Mayta H, Gilman R, Calderon M, Gottlieb A, Soto G, Tuero I, Sanchez S, Vivar A. 18S ribosomal DNA-based PCR for diagnosis of Trichomonas vaginalis. J Clin Microbiol 2000; 38: 2683-2687.
  14. Madico G, Quinn TC, Rompalo A, McKee Jr K, Gaydos CA. Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. J Clin Microbiol 1998; 36: 3205-3210.
  15. Gondo DC, Duarte MT, da Silva MG, de Lima Parada CM. Abnormal vaginal flora in low-risk pregnant women cared for by a public health service: prevalence and association with symptoms and findings from gynecological exams. Rev Lat Am Enfermagem 2010; 18: 919-927. https://doi.org/10.1590/S0104-11692010000500012
  16. Simoes JA, Giraldo PC, Faundes A. Prevalence of cervicovaginal infections during gestation and accuracy of clinical diagnosis. Infect Dis Obstet Gynecol 1998; 6: 129-133. https://doi.org/10.1155/S1064744998000246
  17. Perazzi B, Coppolillo E, Menghi C, Cora Eliseht M, Gatta C, Mendez O, de Toores RA, Vay C, Famiglietti A, Ruda Vega H. Microbiological study of the vaginal content during pregnancy. Obstet Ginecol Latinoam 2006; 64:129-135.
  18. Di Bartolomeo S, Rodríguez M, Sauka D, de Torres RA. Microbiologic profile in symptomatic women's genital secretions in Gran Buenos Aires, Argentina. Enferm Infecc Microbiol Clin 2001; 19: 99-102. https://doi.org/10.1016/S0213-005X(01)72577-3
  19. Radonjic IV, Dzamic AM, Mitrovic SM, Arsic Arsenijevic VS, Popadic DM, Kranjcic Zec IF. Diagnosis of Trichomonas vaginalis infection: the sensitivities and specificities of microscopy, culture and PCR assay. Eur J Obstet Gynecol Reprod Biol 2006; 126: 116-120. https://doi.org/10.1016/j.ejogrb.2005.07.033
  20. Paul H, Peter D, Pulimood SA, Abraham OC, Mathai E Prasad JH. Role of polymerase chain reaction in the diagnosis of Trichomonas vaginalis infection in human immunodeficiency virus-infected individuals fro India (South). Indian J Dermatol Venereol Leprol 2012; 78: 323-327. https://doi.org/10.4103/0378-6323.95448
  21. Shipitsyna E, Zolotoverkhaya E, Chen CY, Chi KH, Grigoryev A, Savicheva A, Ballard R, Domeika M, Unemo M. Evaluation of polymerase chain reaction assays for the diagnosis of Trichomonas vaginalis infection in Russia. J Eur Acad Dermatol Venereol 2013; 27: 217-223. https://doi.org/10.1111/j.1468-3083.2012.04593.x

Cited by

  1. Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study vol.10, pp.None, 2016, https://doi.org/10.1186/s13104-017-2581-1
  2. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016 vol.97, pp.8, 2019, https://doi.org/10.2471/blt.18.228486
  3. The International Society for the Study of Vulvovaginal Disease Vaginal Wet Mount Microscopy Guidelines: How to Perform, Applications, and Interpretation vol.25, pp.2, 2016, https://doi.org/10.1097/lgt.0000000000000595