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ABSTRACT: Trichomonas vaginalis infection in males has been largely uncharacterized. Past reports indicated increased susceptibility to other sexually-transmitted infection (STI) agents such as human immunodeficiency virus and Neisseria gonorrhoeae with concurrent T. vaginalis infection. This warrants a more thorough review of male T. vaginalis incidence. A retrospective three-year investigation of transcription-mediated amplification (TMA)-based urethral swab and first-void urine screening for T. vaginalis within a regional healthcare system was performed to address T. vaginalis prevalence in males. Of 622 total samples tested, 6.6% were positive for T. vaginalis. Delineation of all specimens by ZIP code of patient residence revealed eleven predominant ZIP codes with respect to testing volume and detection rates. Within these eleven ZIP codes, representing 78.3% of total testing volume, urine was the preferred specimen source when compared to urethral swabs. Seven of these eleven ZIP codes contained majority African American populations. The aggregate T. vaginalis detection rate trended higher than that of the remaining four ZIP codes which were comprised primarily of Caucasian populations (8.9% versus 5.0%, respectively; P = 0.15). The average age of a T. vaginalis-infected male (39.9) was significantly greater than those for Chlamydia trachomatis or N. gonorrhoeae (27.6 and 25.9, respectively; P < 0.001). Given the significant rate of T. vaginalis detection, with age distribution analogous to that reported in females, TMA-based detection of T. vaginalis can be a routine constituent within a comprehensive STI screening panel for males in high-prevalence STI communities.
Journal of clinical microbiology 10/2012; · 4.16 Impact Factor
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ABSTRACT: Trichomonas vaginalis analyte-specific reagent is a highly sensitive assay for T vaginalis detection. We report how this diagnostic innovation influenced the sexually transmitted infection ordering practice patterns of 20 subacute-care clinicians.
T vaginalis, Neisseria gonorrhoeae, and/or Chlamydia trachomatis screening data were audited on female swab submissions when only wet mount testing was available for detection of T vaginalis (2004-2007) and when T vaginalis detection options included analyte-specific reagent and wet mount (2008-2010).
Analyte-specific reagent availability resulted in more screening and detection of T vaginalis, prompted less utilization of wet mount microscopy, and increased overall RNA-based screening for N gonorrhoeae and C trachomatis (P < 0.0002).
Clinician familiarity with T vaginalis analyte-specific reagent can benefit both clinical practice and public health.
WMJ: official publication of the State Medical Society of Wisconsin 10/2012; 111(5):233-6.
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ABSTRACT: Recent literature has reported increased accuracy of Trichomonas vaginalis transcription-mediated amplification (TMA)-based analyte-specific reagent (ASR) testing in female populations. A retrospective investigation assessed 7277 female first-void urine, cervical, or vaginal specimens submitted from a high-prevalence sexually-transmitted infection (STI) community to characterize prevalence of disease etiologies. The most common STI phenotype reflected sole detection of T. vaginalis (54.2% of all healthcare encounters that resulted in STI detection). In females with detectable T. vaginalis, co-detection of Chlamydia trachomatis and Neisseria gonorrhoeae occurred in 7.8% and 2.7% of healthcare encounters, respectively. Mean age of women with detectable T. vaginalis (30.6) was significantly higher than those with C. trachomatis or N. gonorrhoeae (22.3 and 21.6, respectively; P < 0.0001). T. vaginalis was the predominant sexually-transmitted agent in women over the age of 20 (P < 0.0002). C. trachomatis was the most commonly detected agent in females under the age of 21, particularly from cervical specimens. However, first-void urine detection rates for T. vaginalis and C. trachomatis within this age demographic demonstrated no difference (P = 0.92). While overall and cervical specimen-derived detection of T. vaginalis within African American-majority geographical locales outweighed that within majority Caucasian geographical regions (P ≤ 0.004), this difference was not noted with first-void urine screening (P = 0.54). Health care professionals can consider TMA-based T. vaginalis screening for a wide age range of patients; incorporation of first-void urine specimens into screening algorithms can potentiate novel insight into the epidemiology of trichomoniasis.
Journal of clinical microbiology 09/2012; · 4.16 Impact Factor
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ABSTRACT: A total of 7,899 specimens submitted for live clinical Trichomonas vaginalis analyte-specific reagent (ASR) screening from 2008 to 2010 were audited on the basis of patient gender, specimen source, molecular Neisseria gonorrhoeae and Chlamydia trachomatis results, and relative light unit (RLU) data yielded by T. vaginalis ASR. Only 1.4% of the screening was ordered by emergency department clinicians. The screening volume in 2010 was 126% higher than that in 2008. The proportions of annual female and male screening remained consistent throughout the 3-year interval (∼92 and 8%, respectively). Although 71.8 and 9.5% of screening was performed on endocervical and vaginal specimens, respectively, over the 3-year period, no significant difference was noted in the T. vaginalis detection rates (8.9 and 8.6%, P = 0.85). Increased T. vaginalis detection was derived from female urine specimens (12.6%) compared to female genital swabs (P = 0.0004). The proportion of female urine screening increased during the 3-year interval (P < 0.0002). T. vaginalis detection rate in males was 6.6%, with no difference between urethral and urine T. vaginalis detection (P = 0.53). The mean RLU value for 714 positive specimens was 3,971,441; analogous values for each female specimen source and combined male source testing showed no variance (P ≥ 0.29). Combined-gender T. vaginalis detection rate (9.1%) was significantly greater than those of C. trachomatis (5.9%) and N. gonorrhoeae (1.5%; P < 0.0002). Equivocal results presented at a rate of 0.4%. T. vaginalis ASR is an increasingly utilized assay that yields higher detection rates than other sexually transmitted infection etiologies in this community subacute care setting.
Journal of clinical microbiology 12/2011; 49(12):4190-4. · 4.16 Impact Factor
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ABSTRACT: Real-time detection of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) in cases of clinical bacteremia may promote appropriate antimicrobial therapy and infection control. Expense inherent to molecular diagnostics may prevent laboratories from utilizing real-time PCR for this purpose. BD GeneOhm StaphSR assay master mix was reconstituted and aliquoted into SmartCycler tubes in 25-mul volumes (freshly reconstituted master mix), with a portion being frozen at -70 degrees C (frozen master mix). Incubation of 40 previously analyzed lysates from positive BacT/Alert SA and SN blood culture bottles (identified as 10 MRSA strains, 10 MSSA strains, 12 coagulase-negative Staphylococcus strains, and 8 Micrococcus strains) in freshly reconstituted master mix and master mix frozen between 1 week and 6 months generated the expected results in all PCRs. Similarly, positive- and negative-control reagents stored frozen at -70 degrees C for up to 18 weeks yielded the expected reactions. Prospective analysis of 244 positive blood culture samples utilizing 1-week-frozen master mix and freshly reconstituted master mix yielded a 1.2% discordant rate upon initial testing due to three unresolved results (two unresolved results for freshly reconstituted master mix and one unresolved result for frozen master mix). Repeat testing produced a final 100% concordance rate between the two master mix preparations. Use of master mix that was frozen up to 6 months did not compromise performance of the BD GeneOhm StaphSR assay. This modification, resulting in less reagent waste, may allow a greater number of laboratories to consider real-time PCR methodology for detection of bacteremia caused by MRSA and MSSA.
Journal of clinical microbiology 02/2010; 48(4):1408-12. · 4.16 Impact Factor
