Trichomonas vaginalis Vaginitis in Obstetrics and Gynecology Practice: New Concepts and Controversies

Assistant Professor, Division of Gynecologic Specialties, Department of Gynecology and Obstetrics.
Obstetrical & gynecological survey (Impact Factor: 1.86). 01/2013; 68(1):43-50. DOI: 10.1097/OGX.0b013e318279fb7d
Source: PubMed


Trichomonas vaginalis (TV) is the most common curable sexually transmitted infection worldwide. Annually, 7.4 million new infections are estimated in the United States, which is greater than combined new cases of Chlamydia, gonorrhea, and syphilis. Serious adverse reproductive health outcomes including pregnancy complications, pelvic inflammatory disease, and an increased risk of HIV acquisition have been linked to TV infection. There are several sensitive and specific diagnostic tests available, including a newly approved nucleic acid amplification test (NAAT) that utilizes the same instrumentation platform and clinical sample as Chlamydia and gonorrhea tests. In this article, we review TV pathogenicity, adverse reproductive health outcomes, detection, and treatment followed by clinical scenarios for which TV diagnosis may prove useful in obstetrics and gynecology practice. Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this CME activity, physicians should be better able to incorporate TV counseling and testing into standard clinical practice, compare and contrast available TV diagnostic tests, and manage TV in pregnant and nonpregnant women.

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Available from: Jenell Sheree Coleman, Jun 05, 2015
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    • "Trichomonas vaginalis infection is the most common curable STI worldwide. Trichomoniasis is associated with infertility, enhanced predisposition to neoplastic transformation in cervical tissues, and an increased risk of transmission of other STI, including human immunodeficiency virus (HIV), by as much as twofold [7] [8]. "
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    ABSTRACT: Vaginitis is one of the commonest reproductive tract infections in sexually active women. In the present study clinicoetiological characterization of infectious vaginitis amongst 380 women of reproductive age group (18-45 years) was done. Bacterial vaginosis (BV) was detected by Nugent's scoring, Candida infection by culture, and trichomoniasis (TV) by wet mount. One hundred and ten (28.9%) women presented with symptoms of vaginitis. The presenting symptoms were vaginal discharge 106 (96.4%), vulval itching/irritation 19 (17.3%), malodor 5 (4.5%), pain in abdomen 3 (2.7%), and dysuria 1 (0.9%). The commonest etiology detected was Candida in 33 (30%) cases, of which 18 (54.5%) were C. albicans and 15 (45.5%) non-albicans Candida (NAC) infections. The NAC isolates were C. glabrata (n = 10), C. tropicalis (n = 3), and C. krusei (n = 2). BV and TV were observed in 19 (17.3%) and 2 (1.8%) cases, respectively. A statistically significant association between Candida infection and presence of curdy-white discharge (p = 0.001) and vulval itching/irritation (p = 0.007) was noted. To conclude, we observed the etiological predominance of Candida infection, with considerable prevalence of NAC, indicating the need for microbiological investigation up to species level in cases of Candida infections, to ensure appropriate management.
    Full-text · Article · Sep 2015
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    • "Trichomoniasis, caused by the flagellated protozoan parasite Trichomonas vaginalis, is the most common curable sexually transmitted infection (STI) with about 276.4 million cases worldwide (WHO, 2012). Women may present with symptoms of malodorous vaginal discharge, dyspareunia, dysuria, lower abdominal pain, and vulvovaginal irritation, while men may clinically manifest symptoms of urethral discharge, irritation, and dysuria (Coleman et al., 2013). Untreated T. vaginalis infection in women may lead to endometritis, infertility, cervical erosion, premature rupture of membranes, preterm deliveries, and low-birth-weight infants (Petrin et al., 1998). "
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    ABSTRACT: A loop-mediated isothermal amplification (LAMP) assay targeting the 2-kbp repeated DNA species-specific sequence was developed for detection of Trichomonas vaginalis, the causative agent of trichomoniasis. The analytical sensitivity and specificity of the LAMP assay were evaluated using pooled genital swab and urine specimens, respectively, spiked with T. vaginalis trophozoites. Genital secretion and urine did not inhibit the detection of the parasite. The sensitivity of the LAMP was 10 to 1,000 times higher than the PCR performed. The detection limit of LAMP was 1 trichomonad for both spiked genital swab and urine specimens. Also, LAMP did not exhibit cross-reactivity with closely-related trichomonads, Trichomonas tenax and Pentatrichomonas hominis, and other enteric and urogenital microorganisms, Entamoeba histolytica, Candida albicans, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. This is the first report of a LAMP assay for the detection of T. vaginalis and has prospective application for rapid diagnosis and control of trichomoniasis.
    Full-text · Article · Jul 2014 · Diagnostic microbiology and infectious disease
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