2013, Number 04
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Ginecol Obstet Mex 2013; 81 (04)
Diagnosis of vaginitis-vaginosis by hibridization with DNA strands
García-Agudo L, de la Calle IJ, Román EM, Aznar MP, Rodríguez-Iglesias M
Language: Spanish
References: 36
Page: 195-200
PDF size: 239.80 Kb.
ABSTRACT
Background: Vaginal infections lie among the most common
causes women ask for medical advice. In order of frequency bacterial
vaginosis, vulvovaginal candidiasis, and trichomoniasis are
responsible for 90% of vaginitis/vaginosis.
Objective: To evaluate a DNA hybridization test for simultaneous
molecular detection of
Gardnerella vaginalis, Candida species and
Trichomonas vaginalis, as an alternative to conventional microbiological
methods.
Material and methods: Cohort, cross-sectional, and comparative
study of 1,003 vaginal samples from symptomatic women from our
health-care area. Two swabs were obtained from each woman,
one for routine microbiological diagnosis of vaginal infection (wet
mount, Gram stain, and mycological culture) and the other for the
DNA hybridization test (Affirm VPIII, Becton Dickinson). This method
detects clinically significant levels of
G. vaginalis (2x10
5 CFU/ml),
Candida spp. (1x10
4 cells) and
T. vaginalis (5x10
3 trichomonads).
Results: Out of the 1,003 women studied, 30.6% tested positive for
bacterial vaginosis, 23.3% for vulvovaginal candidiasis, and 0.5%
for trichomoniasis. The Affirm VPIII method turned out positive in
27.5%, 27.4% and 0.5% of cases, respectively. No statistically significant
differences were found between the molecular technique
and conventional methods for microbiological diagnosis of vaginitis/
vaginosis (p‹0.05).
Conclusion: The Affirm VPIII test correlated well with wet mount,
Gram stain and mycological culture. Although its cost is relatively
high, it is fast, reproducible, easy, and can be done in either clinical
laboratories or Gynecology offices, which permits prescribing
a specific early treatment.
REFERENCES
De la Calle I J, De la Calle MAJ. Vaginosis bacteriana. Med Clin (Barc) 2009;133:789-797.
Buitrón García R, Bonifaz A, Amancio Chassin O, Basurto Kuba E, Araiza J, y col. Correlación clínico-micológica de la candidiasis vulvovaginal. Ginecol Obstet Mex 2007;75:68-72.
Kamara P, Hylton-Kong T, Brathwaite A, Del Rosario GR, Kristensen S, et al. Vaginal infections in pregnant women in Jamaica: prevalence and risk factors. Int J STD AIDS 2000;11:516-520.
Brown HL, Fuller DD, Jasper LT, Davis TE, Wright JD. Clinical evaluation of Affirm VPIII in the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis. Infect Dis Obstet Gynecol 2004;12:17-21.
Sobel JD. Vaginal infections in adult women. Sexually transmitted diseases. Med Clin North Am 1990;74:1573-1602.
Donders GG, Vereecken A, Bosmans E, Dekeersmae A, Salembier G, et al. Definition of a type of vaginal flora that is distinct from bacterial vaginosis: aerobic vaginosis. Brit J Obstet Gynaecol 2002;109:34-43.
Cuadros J, Mazon A, Martínez R, González P, Gil-Setas A, et al. The aetiology of paediatric inflammatory vulvovaginitis. Eur J Pediatric 2004;162:105-107.
Verhelst R, Verstraelen H, Claeys G, Verschraegen G, van Simaey L, de Ganck C, de Backer E, Temmerman M, Vaneechoutte M. Comparison between Gram stain and culture for the characterization of vaginal microflora: Definition of a distinct grade that resembles grade I microflora and revised categorization of grade I microflora. BMC Microbiol 2005;5:61. Disponible en: http://www.biomedcentral.com/1471-2180/5/61
Schwiertz A, Tara D, Kerstin R, Rusch V. Throwing the dice for the diagnosis of vaginal complaints? Annl Clin Microbiol Antimicrob 2006;5:4. Disponible en: http://www.ann-clinmicrob. com/content/5/1/4
Sobel JD. Vulvovaginal candidiasis. Lancet 2007;369:1961-1971.
Montesano L, García-Martos P, Fernández M, Revuelta JA, Agudo E. Candidiasis vulvovaginal: análisis de 502 episodios. Rev Esp Microbiol Clin 1992;7:394-397.
García-Martos P, Hernández JM, Mira J, Galán F, Marín P. Saccharomyces cerevisiae vaginitis. Enferm Infecc Microbiol Clin 1996;14:453-454.
Ventolini G, Baggish MS. Recurrent vulvovaginal candidiasis. Clin Microbiol Newslett 2006;12:93-95.
Buitrón García R, Romero Cabello R, Cruz Talonia F, Bonifaz A, Zarama Márquez F. Estudio de especies de Candida noalbicans y su relación con candidiasis vulvovaginal recurrente. Ginecol Obstet Mex 2002;70:431-6.
Lossick JG, Kent HL. Trichomoniasis: trends in diagnosis and management. Am J Obstet Gynecol. 1991;165:1217-1222.
Petrin D, Delgaty K, Bhatt R, Garber G. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. 1998;11:300-317.
Karaca M, Bayram A, Kocoglu ME, Gocmen A, Eksi F. Comparison of clinical diagnosis and microbiological test results in vaginal infections. Clin Exp Obstet Gynecol 2005;32:172-174.
Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA 2004;291:1368-1379.
Fredricks DN, Fiedler TL, Marrazo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005;353:899-911.
Andrea SB, Chapin KC. Comparison of Aptima Trichomonas vaginalis transcription-mediated amplification assay and BD Affirm VPIII for detection of T. vaginalis in symptomatic women: Performance parameters and epidemiologic implications. J Clin Microbiol 2011;49:866-9.
Schoonmaker JN, Lunt BD, Lawellin DW, French JL, Hillier SL et al. A new proline aminopeptidase assay for diagnosis of bacterial vaginosis. Am J Obstet Gynecol 1991;165:737-742.
Krohn MA, Hillier SL, Eschenbach DA. Comparison of methods for diagnosing bacterial vaginosis among pregnant women. J Clin Microbiol. 1989;27:1266-1271.
Flores-Paz R, Rivera-Sánchez R, Ruix-Pérez NJ, Arriaga-Alba M. Utilidad del sistema Affirm VPIII y de la prueba L-Pap para el diagnóstico de vaginosis bacteriana. Enferm Infecc Microbiol Clin 2008;26:338-342.
Witt A, Petricevic L, Kaufmann U, Gregor H, Kiss H. DNA hydribization test: Rapid diagnostic tool for excluding bacterial vaginosis in pregnant women with symptoms suggestive of infection. J Clin Microbiol 2002;40:3057-3059.
Briselden AM, Hillier SL. Evaluation of Affirm VP Microbial Identification Test for Gardnerella vaginalis and Trichomonas vaginalis. J Clin Microbiol 1994;32:148-152.
Ferris DG, Hendrich J, Payne PM, Getts A, Rassekh R et al. Office laboratory diagnosis of vaginitis. Clinician-performed tests compared with a rapid nucleic acid hybridization test. J Fam Pract 1995;41:575-581.
Gazi H, Degerli K, Kurt O, Teker A, Uyar Y et al. Use of DNA hydrization test for diagnosing bacterial vaginosis in women with symptoms suggestive of infection. APMIS 2006;114:784-787.
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standarized method of Gram stain interpretation. J Clin Microbiol 1991;29:297- 301.
Balu RB, Savitz DA, Ananth CV, Hartmann KE, Miller WC et al. Bacterial vaginosis and vaginal fluid defensins during pregnancy. Am J Obstet Gynecol 2002;187:1267-1271.
Mendoza-González A, Sánchez-Vega JT, Sánchez-Peón I, Ruiz-Sánchez D, Tay-Zavala J. Frecuencia de vaginosis producida por Gardnerella vaginalis y su asociación con otros patógenos causantes de infección genital en la mujer. Ginecol Obstet Mex 2001;69:272-6.
Belmonte A, Nogueras MG, Ombrella AM, Ruiz Abad I, Nistal MA y col. Estudio microbiológico de vaginitis y vaginosis en mujeres sexualmente activas. Medicina (B Aires) 2002;62:103- 104.
Levi AW, Harigopal M, Hui P, Schofield K, Chhieng DC. Comparison of Affirm VPIII and Papanicolaou tests in the detection of infectious vaginitis. Am J Clin Pathol 2011;135:442-7.
Echeverría-Irigoyen MJ, Eraso E, Cano J, Gomáriz M, Guarro J, Quindós G. Saccharomyces cerevisiae vaginitis: Microbiology and in vitro antifungal susceptibility. Mycopathologia 2011;172:201-5.
DeMeo LR, Draper DL, McGregor JA, Moore DF, Peter CR, Kapernick PS, McCormack WM. Evaluation of a deoxyribonucleic acid probe for the detection of Trichomonas vaginalis in vaginal secretions. Am J Obstet Gynecol 1996;174:1339-42.
Kreiger JN, Tam MR, Stevens CE, Nielsen IO, Hale J et al. Diagnosis of trichomoniasis: Comparison of conventional wet-mount examination with cytologic studies, cultures and monoclonal antibody staining of direct specimens. JAMA 1988;259:1223-1227.
Brown HL, Fuller DA, Davis TE, Schwebke JR, Hillier SL. Evaluation of the Affirm Ambient Temperature Transport System for the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species from vaginal fluid specimens. J Clin Microbiol 2001;39:3197-3199.