Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 859
Filtrar
2.
Pediatr Rev ; 41(10): 522-537, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33004664

RESUMEN

Sexually transmitted infections (STIs) disproportionately affect young people, with more than half of the infections occurring in youth aged 15 to 25 years. (1)(2) This review, the second in a 2-part series on STIs, focuses on infections that may cause abnormal vaginal or penile discharge, including trichomonas, chlamydia, gonorrhea, and pelvic inflammatory disease (PID). Most infected persons, however, are asymptomatic. Nucleic acid amplification tests are the most sensitive and specific for the detection of chlamydia, gonorrhea, and trichomoniasis, and they can be performed on provider- or patient-collected swabs. Providers should have a low threshold for diagnosing and treating PID because untreated PID can have serious long-term complications for young women. Indications for hospitalization for PID include the presence of a tubo-ovarian abscess, severe illness with systemic symptoms, pregnancy, human immunodeficiency virus infection, and failure to respond to outpatient oral treatment (within 48-72 hours) or inability to tolerate the oral treatment.


Asunto(s)
Enfermedad Inflamatoria Pélvica/diagnóstico , Enfermedades de Transmisión Sexual/diagnóstico , Excreción Vaginal/microbiología , Adolescente , Candidiasis/complicaciones , Candidiasis/diagnóstico , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/diagnóstico , Femenino , Gonorrea/complicaciones , Gonorrea/diagnóstico , Humanos , Masculino , Enfermedad Inflamatoria Pélvica/etiología , Parejas Sexuales , Enfermedades de Transmisión Sexual/complicaciones , Vaginitis por Trichomonas/diagnóstico , Cervicitis Uterina/complicaciones , Vaginosis Bacteriana/complicaciones , Vaginosis Bacteriana/diagnóstico
3.
BMC Infect Dis ; 20(1): 642, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32873233

RESUMEN

BACKGROUND: Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV). METHODS: From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions. RESULTS: Among 310,545 female, 6067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p < 0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42-2.31). Co-infection with TV increased the risk of CIN 2-3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16-2.53). CONCLUSIONS: Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.


Asunto(s)
Neoplasia Intraepitelial Cervical/epidemiología , Coinfección/complicaciones , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecciones por Papillomavirus/complicaciones , Vaginitis por Trichomonas/complicaciones , Trichomonas vaginalis/aislamiento & purificación , Neoplasias del Cuello Uterino/epidemiología , Adulto , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/virología , China/epidemiología , Coinfección/diagnóstico , Colposcopía , Estudios Transversales , Citodiagnóstico , Detección Precoz del Cáncer/métodos , Femenino , Genotipo , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Factores de Riesgo , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/parasitología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología
4.
Sex Transm Infect ; 96(5): 342-347, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32241905

RESUMEN

OBJECTIVES: In 2016, WHO estimated 376 million new cases of the four main curable STIs: gonorrhoea, chlamydia, trichomoniasis and syphilis. Further, an estimated 290 million women are infected with human papillomavirus. STIs may lead to severe reproductive health sequelae. Low-income and middle-income countries carry the highest global burden of STIs. A large proportion of urogenital and the vast majority of extragenital non-viral STI cases are asymptomatic. Screening key populations and early and accurate diagnosis are important to provide correct treatment and to control the spread of STIs. This article paints a picture of the state of technology of STI point-of-care testing (POCT) and its implications for health system integration. METHODS: The material for the STI POCT landscape was gathered from publicly available information, published and unpublished reports and prospectuses, and interviews with developers and manufacturers. RESULTS: The development of STI POCT is moving rapidly, and there are much more tests in the pipeline than in 2014, when the first STI POCT landscape analysis was published on the website of WHO. Several of the available tests need to be evaluated independently both in the laboratory and, of particular importance, in different points of care. CONCLUSION: This article reiterates the importance of accurate, rapid and affordable POCT to reach universal health coverage. While highlighting the rapid technical advances in this area, we argue that insufficient attention is being paid to health systems capacity and conditions to ensure the swift and rapid integration of current and future STI POCT. Unless the complexity of health systems, including context, institutions, adoption systems and problem perception, are recognised and mapped, simplistic approaches to policy design and programme implementation will result in poor realisation of intended outcomes and impact.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Pruebas en el Punto de Atención/organización & administración , Enfermedades de Transmisión Sexual/diagnóstico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Infecciones por Chlamydia/transmisión , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Humanos , Ciencia de la Implementación , Masculino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/prevención & control , Infecciones por Mycoplasma/transmisión , Mycoplasma genitalium , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/prevención & control , Sífilis/transmisión , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/prevención & control , Vaginitis por Trichomonas/transmisión
5.
Obstet Gynecol ; 135(5): 1136-1144, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32282605

RESUMEN

OBJECTIVE: To identify factors associated with testing for and diagnosis of trichomoniasis in pregnancy and to describe patterns of treatment and tests of reinfection or persistence. METHODS: We conducted a retrospective cohort study of women who delivered from July 2016 to June 2018 at one institution. Testing for Trichomonas vaginalis infection was done by wet mount microscopy or by nucleic acid amplification testing for routine prenatal testing or symptomatic visits. Poisson regression was used to identify factors associated with testing for trichomoniasis and testing positive in pregnancy. Treatment and re-testing patterns also were assessed. RESULTS: Among 3,265 pregnant women, 2,489 (76%) were tested for T vaginalis infection. Of the total sample, 1,808 (55%) were tested by wet mount microscopy, 1,661 (51%) by nucleic acid amplification testing, and 980 (30%) by both modalities. The sensitivity for microscopy compared with nucleic acid amplification testing was 26%, with a specificity of 99%. Factors associated with increased likelihood of being tested included younger age (adjusted risk ratio [aRR] 0.99, 95% CI 0.99-1.00) and bacterial vaginosis (aRR 1.17, 95% CI 1.01-1.37). Prevalence of trichomoniasis was 15% among those tested by any modality (wet mount or nucleic acid amplification testing). Risk factors for trichomoniasis included younger age (aRR 0.97, P<.01), being of black race (aRR 2.62, P<.01), abnormal vaginal discharge (aRR 1.45, P<.01), and chlamydia during the current pregnancy (aRR 1.70, P<.01). Women diagnosed by microscopy had a shorter time to treatment compared with those diagnosed by nucleic acid amplification testing. Most (75%) women with positive infections had a test of reinfection; 29% of these were positive. Bacterial vaginosis was associated with decreased risk of a positive test of reinfection. CONCLUSION: Although testing for and treatment of trichomoniasis during pregnancy is not routinely recommended, the high burden of infection among some pregnant women demonstrates a need to further understand patterns of T vaginalis testing and infection. Opportunities exist for improving timely treatment of trichomoniasis and test of reinfection.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Diagnóstico Prenatal/métodos , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis , Excreción Vaginal/diagnóstico , Adulto , Femenino , Humanos , Microscopía , Técnicas de Amplificación de Ácido Nucleico , Distribución de Poisson , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/terapia , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y Especificidad , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/terapia , Excreción Vaginal/epidemiología , Excreción Vaginal/microbiología , Vaginosis Bacteriana/diagnóstico , Vaginosis Bacteriana/epidemiología , Adulto Joven
6.
Rev. chil. obstet. ginecol. (En línea) ; 85(2): 175-184, abr. 2020. tab
Artículo en Español | LILACS | ID: biblio-1115514

RESUMEN

OBJETIVO: revisar los diferentes métodos de diagnóstico de la tricomoniasis vaginal disponibles hasta el presente. MATERIALES Y MÉTODOS: se revisó la bibliografía latinoamericano e internacional a través de los sitios electrónicos de Pub-Med y Scielo. RESULTADOS: la Tricomonas vaginalis es considera como la enfermedad de transmisión sexual no viral, curable más frecuente y prevalente en el mundo. Se revisan los diferentes de métodos para diagnosticar la presencia de la tricomonas vaginalis en pacientes femeninos con síntomas y signos de la infección producida por el protozoario flagelado. CONCLUSIONES: se revisaron los diferentes métodos de diagnostico de la infección producida por la Tricomonas vaginalis en pacientes femeninas, desde los clásicos hasta los más actuales que emplean alta tecnología.


OBJECTIVE: to review the different diagnostic methods of Trichomonas vaginal available at the present time. MATERIAL AND METHOD: it was reviewed the Latin-American and international bibliography using the Pub-Med and Scielo web sites. RESULTS: Trichomonas vaginalis is considered the most common and prevalent sexual transmitted disease curable and non-viral worldwide. It was reviewed the different methods to diagnose the presence of Trichomonas vaginalis in female patients with symptoms and signs of infection produces by the flagellate protozoa. CONCLUSION: Different methods of diagnosis of the infection produced by Trichomonas vaginalis, since the classics to the most current methods that use high technology, were reviewed.


Asunto(s)
Humanos , Femenino , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis , Frotis Vaginal , Enfermedades de Transmisión Sexual/diagnóstico , Sensibilidad y Especificidad , Técnicas de Amplificación de Ácido Nucleico , Técnicas de Cultivo , Antígenos/análisis
7.
Mikrobiyol Bul ; 54(1): 135-143, 2020 Jan.
Artículo en Turco | MEDLINE | ID: mdl-32050884

RESUMEN

Sexually transmitted infections (STIs) are important as a public health problem all over the world. There are some difficulties in prevention and control programs of STIs due to clinical and laboratory diagnostic problems.The most common STIs are Chlamydia trachomatis infections, trichomoniasis and gonorrhea. The study aimed to investigate the direct microscopic examination, culture and polymerase chain reaction (PCR) tests in the diagnosis of Trichomonas vaginalis infection; to determine other microbiological agents that may cause vaginal discharge and to evaluate the various social variables in women with vaginal discharge admitted to the outpatient clinic of Obstetrics and Gynecology in Akdeniz University Hospital. Two hundred and fifteen patients were enrolled in the study. The socio-demographic features of the patients were recorded. Vaginal/endocervical swab specimens taken from patients were evaluated by microscopic examination. Swab specimens were inoculated into blood agar, MacConkey agar and chocolate agar for bacterial culture. Modified Trichosel broth with 5% horse blood (Becton Dickinson, USA) was used for Trichomonas spp. culture. The presence of C.trachomatis, Neisseria gonorrhoeae, and T.vaginalis in swab samples were investigated by multiplex PCR assay (BD Max CT/GC/TV, Becton Dickinson, USA). At least one pathogen was detected among 65 (30.3%) samples. T.vaginalis was detected by microscopic examination and PCR in four of 215 (1.9%) patients. Existence of yeast morphology was observed in 21 (9.8%) specimens by microscopic examination. Twenty four (11.2%) patients were diagnosed as bacterial vaginosis microscopically according to Nugent score system. Candida species grew in 32 (14.9%) and Streptococcus agalactiae grew in 2 (0.9%) of the specimens. C.trachomatis was detected in 2 (0.9%) samples and N.gonorrhoeae in 1 (0.5%) sample by PCR. In this study, 95.3% of the patients were married and 96.7% had only one sexual partner in the mean time. The rate of detection of pathogens were statistically higher in women who have had two or more pregnancies (p<0.05). In our study, T.vaginalis together with N.gonorrhoeae and C.trachomatis were investigated by PCR method in women with vaginal discharge. The use of multiplex PCR test allowed simultaneous investigation of multiple pathogens in the patient samples.


Asunto(s)
Infecciones por Chlamydia , Técnicas y Procedimientos Diagnósticos , Gonorrea , Tricomoniasis , Vaginitis por Trichomonas , Técnicas de Cultivo de Célula , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/genética , Técnicas y Procedimientos Diagnósticos/normas , Femenino , Gonorrea/diagnóstico , Humanos , Microscopía/normas , Reacción en Cadena de la Polimerasa Multiplex , Neisseria gonorrhoeae/genética , Embarazo , Tricomoniasis/diagnóstico , Tricomoniasis/parasitología , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/genética
9.
Int J STD AIDS ; 31(3): 221-229, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31996095
10.
Eur J Clin Microbiol Infect Dis ; 39(1): 39-44, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31502121

RESUMEN

The three main causes of vaginitis are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis (TV). Two multiplex assays are commercially available for detection of DNA from organisms associated with vaginitis: BD Affirm™ VPIII Microbial Identification Test (Affirm) and BD MAX™ Vaginal Panel (MAX VP). Here, the performance of MAX VP was compared to that of Affirm, which was considered the standard of care. Four vaginal swabs were collected from each subject with the following: BD Affirm™ VPIII Ambient Temperature Transport System (ATTS), BD MAX™ UVE Specimen Collection Kit, Hologic Aptima® Vaginal Swab Specimen Collection Kit, and BD ESwab™ collection and transport system (ESwab). Candida culture, Gram stain followed by Nugent scoring, and the Hologic Aptima® Trichomonas vaginalis assay were used for discordant analysis. Results were considered true positive if there were at least two tests positive for any vaginitis target. A total of 200 symptomatic women were evaluated in the study. The sensitivity and specificity of MAX VP for BV was 96.2% and 96.1%, respectively, compared to 96.2% and 81.6% for Affirm. The sensitivity and specificity of MAX VP for Candida spp. was 98.4% and 95.4%, respectively, compared to 69.4% and 100% for Affirm. MAX VP and Affirm showed 100% concordance for detection of TV. These results demonstrate improved accuracy of MAX VP compared to Affirm for the detection of BV and Candida spp. and no difference for detection of TV between the two tests.


Asunto(s)
Candida/aislamiento & purificación , Técnicas de Diagnóstico Molecular/normas , Juego de Reactivos para Diagnóstico/normas , Vaginitis/diagnóstico , Adolescente , Adulto , Anciano , Candidiasis Vulvovaginal/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular/métodos , Sensibilidad y Especificidad , Vaginitis por Trichomonas/diagnóstico , Vaginitis/microbiología , Vaginitis/parasitología , Adulto Joven
11.
Am J Obstet Gynecol ; 222(2): 114-122, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31513780

RESUMEN

Vaginitis is one of the most common causes of patient visits to gynecologists, primary care providers, and urgent care centers. However, many women leave without a clear diagnosis or experience recurrent symptoms despite treatment. The 3 most common etiologies of vaginitis are trichomonas, bacterial vaginosis, and vulvovaginal candidiasis, which account for an estimated 70% of cases. The remaining 30% may be related to other causes of vaginitis, including atrophic vaginitis, desquamative inflammatory vaginitis, and vaginal erosive disease. The purpose of this review is to describe the noncandidal causes of acute and recurrent vaginitis, with the goal of improving the likelihood of accurate diagnosis as well as efficient and effective therapy. We excluded candidal vaginitis from our review because there was a recently published review on this topic in the Journal. The clinical presentation and evaluation of patients with symptoms of vaginitis can be triaged into 1 of 2 diagnostic pathways: noninflammatory and inflammatory vaginitis. The most common noninflammatory cause is bacterial vaginosis. Features such as irritation, purulent discharge, and the presence of polymorphonuclear neutrophils are more suggestive of an inflammatory process. Trichomoniasis is the most common cause of inflammatory vaginitis. Other well-described forms of inflammatory vaginitis include atrophic vaginitis, desquamative inflammatory vaginitis, and erosive disease. We present a review of the pathogenesis, symptoms, examination findings, diagnostic testing, and treatment for each of these causes of noncandidal vaginitis.


Asunto(s)
Antiinfecciosos/uso terapéutico , Vaginitis Atrófica/diagnóstico , Candidiasis Vulvovaginal/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Vaginosis Bacteriana/diagnóstico , Administración Intravaginal , Administración Oral , Antiinflamatorios/uso terapéutico , Vaginitis Atrófica/terapia , Clindamicina/uso terapéutico , Deshidroepiandrosterona/uso terapéutico , Diagnóstico Diferencial , Terapia de Reemplazo de Estrógeno , Estrógenos/uso terapéutico , Femenino , Humanos , Hidrocortisona/uso terapéutico , Inflamación , Liquen Plano/diagnóstico , Liquen Plano/terapia , Metronidazol/análogos & derivados , Metronidazol/uso terapéutico , Penfigoide Benigno de la Membrana Mucosa/diagnóstico , Penfigoide Benigno de la Membrana Mucosa/terapia , Penfigoide Ampolloso/diagnóstico , Penfigoide Ampolloso/terapia , Pénfigo/diagnóstico , Pénfigo/terapia , Tamoxifeno/análogos & derivados , Tamoxifeno/uso terapéutico , Tinidazol/uso terapéutico , Vaginitis por Trichomonas/terapia , Vaginitis/diagnóstico , Vaginitis/terapia , Vaginosis Bacteriana/terapia
12.
Sex Transm Infect ; 96(1): 76-78, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30992326

RESUMEN

OBJECTIVES: Using mathematical modelling, we have previously shown that the prevalence of infection with Trichomonas vaginalis (TV) is likely to increase in the general population in Australia with the transition from Pap smear-based cervical screening to human papillomavirus (HPV) DNA testing. Here we use the existing model to estimate the level of supplemental testing required to maintain TV control. METHODS: A compartmental mathematical model describing the transmission of TV in the general heterosexual population in Australia was used to evaluate the impact of a range of screening scenarios on TV prevalence over time following the transition to HPV DNA testing for cervical screening. Scenarios considered were the inclusion of a TV test with the HPV test and the addition of TV testing to routine chlamydia testing conducted in primary care. RESULTS: Our modelling suggests that with sufficient coverage, inclusion of TV testing with routine chlamydia screening in general practice, TV prevalence can be reduced over time, but at the current reported coverage will gradually increase following the transition to HPV testing. Inclusion of TV testing with HPV testing in the cervical screening programme is preferable to no supplemental testing but is considerably less effective in controlling TV. CONCLUSIONS: These findings support the inclusion of TV testing with routine chlamydia testing of young people.


Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/aislamiento & purificación , Adulto , Australia/epidemiología , Femenino , Pruebas de ADN del Papillomavirus Humano , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Prueba de Papanicolaou , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Vaginitis por Trichomonas/epidemiología , Vaginitis por Trichomonas/parasitología , Trichomonas vaginalis/genética , Adulto Joven
13.
Lett Appl Microbiol ; 70(3): 196-202, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31808556

RESUMEN

Trichomonas vaginalis is one of the most common curable sexually transmitted pathogens infecting both men and women worldwide. Unlike traditional methods such as microscopy and culture, nucleic acid amplification tests rapidly detect this agent, assisting in treatment. Conventional polymerase chain reaction (PCR), the loop-mediated isothermal amplification (LAMP), and the Xpert TV assay were evaluated using 28 microscopy positive T. vaginalis samples and 125 microscopy negative samples from symptomatic females of reproductive age. The sensitivity of all tests was 100% and the specificity was 100%, 100%, and 99·2% for PCR, Xpert TV, and LAMP, respectively. The inter-rater reliability was excellent for PCR: Xpert TV (kappa-coefficient = 1) and good for LAMP assay: Xpert TV/PCR (kappa-coefficient = 0·98) and conventional PCR: LAMP (kappa-coefficient = 0·98). The study highlights the importance of PCR for screening T. vaginalis in women, particularly in laboratories where the Xpert-TV assay is not available or not affordable. The LAMP assay showed a lower positive predictive value which merits further evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Trichomonas vaginalis is a common sexually transmitted pathogen associated with considerable morbidity and risk of complications. Due to the limitations of traditional diagnostic modalities, three molecular assays were compared: conventional polymerase chain reaction (PCR), Xpert TV assay, and loop mediated isothermal amplification (LAMP) assay for detecting T. vaginalis in symptomatic females. All tests had a sensitivity of 100% and the inter-rater reliability was excellent for PCR: Xpert TV, and good for LAMP assay: Xpert TV/PCR. The translational impact of this study lies in the possible use of conventional PCR and LAMP in laboratories where the Xpert TV assay is not available or not affordable.


Asunto(s)
Técnicas de Amplificación de Ácido Nucleico/métodos , Reacción en Cadena de la Polimerasa/métodos , Enfermedades de Transmisión Sexual/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/genética , Adulto , Bioensayo/métodos , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Enfermedades de Transmisión Sexual/parasitología , Trichomonas vaginalis/aislamiento & purificación , Frotis Vaginal/métodos
14.
Eur J Clin Microbiol Infect Dis ; 39(2): 345-351, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31705339

RESUMEN

The purpose was to evaluate whether probiotics can increase the effectiveness of antimicrobial therapy. Ninety women with Trichomonas vaginalis (TV) in the presence BV were included in the study of regimens for therapy combination with metronidazole and vaginal probiotics. For 7 days, the probiotics group patients received metronidazole at 500 mg twice a day and 1 capsule of probiotic Gynophilus® vaginally twice a day; the placebo group patients in addition to metronidazole received a placebo instead of a probiotic. For the next 7 days, patients in both groups in order restore normal microflora were given the probiotics vaginally. Before the treatment, on the 4th, 8th, and 15th day of therapy complaints, pH and redox potential of the vaginal fluid were recorded, TV detection culturally, microflora of the vagina with the qPCR-RT and microscopically. Adding probiotics to traditional therapy of TV in the presence of BV increased the likelihood of cure from TV (88.6 and 42.9% in the probiotic and placebo groups, respectively) and from BV (63.6 and 11.9%, respectively). We have found that the addition of probiotics to antimicrobial therapy causes the decrease in the inflammatory response and significant changes in the vagina's physicochemical parameters (decreased of the pH values, increased of the redox potential) already on the fourth day of the therapy. The changes in the metronidazole's antimicrobial action implementation when a probiotic is added are the reason of increasing the TV therapy's effectiveness in the BV presence.


Asunto(s)
Antiprotozoarios/uso terapéutico , Coinfección , Metronidazol/uso terapéutico , Probióticos/administración & dosificación , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/parasitología , Trichomonas vaginalis/efectos de los fármacos , Vaginosis Bacteriana/microbiología , Administración Intravaginal , Adulto , Antiprotozoarios/farmacología , Terapia Combinada , Femenino , Humanos , Concentración de Iones de Hidrógeno , Metronidazol/farmacología , Resultado del Tratamiento , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis/citología , Vaginosis Bacteriana/diagnóstico , Adulto Joven
16.
Sex Health ; 16(6): 566-573, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31623703

RESUMEN

Australian Aboriginal communities experience a high burden of sexually transmissible infections (STIs). Since 2009, a comprehensive sexual health program has been implemented at nine Aboriginal Community Controlled Health Services in South Australia. This study assessed trends in STI testing and positivity using deidentified diagnostic data from this period (2008-16). METHODS: Testing data for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) from one urban, three regional and five remote Aboriginal health services were analysed using logistic regression. RESULTS: From 2008 to 2016, testing increased for CT (twofold), NG (threefold) and TV (sixfold). On average, 30% of testing occurred during an annual 6-week screen. Fewer males were tested (range 27-38% annually). Mean annual STI testing coverage was 28% for 16- to 30-year-old clients attending regional or remote services (2013-16). Positivity at first testing episode for all three infections declined during the study period. From 2013 to 2016, when testing was stable and changes in positivity were more likely to indicate changes in prevalence, there were significant reductions in CT positivity (adjusted odds ratio (aOR) 0.4; 95% confidence interval (CI) 0.2-0.5) and TV positivity (aOR 0.6, 95% CI 0.4-0.9), although declines were statistically significant for females only. There was no significant decrease in NG positivity (aOR 0.9; 95% CI 0.5-1.5). CONCLUSIONS: Since the sexual health program began, STI testing increased and STI positivity declined, but significant reductions observed in CT and TV positivity were confined to females. These findings suggest evidence of benefit from sustained, comprehensive sexual health programs in Aboriginal communities with a high STI prevalence, but highlight the need to increase STI testing among men in these communities.


Asunto(s)
Servicios de Salud del Indígena/estadística & datos numéricos , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Adolescente , Adulto , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Femenino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Humanos , Masculino , Neisseria gonorrhoeae , Factores de Riesgo , Enfermedades de Transmisión Sexual/epidemiología , Australia del Sur/epidemiología , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/epidemiología , Trichomonas vaginalis , Adulto Joven
17.
PLoS One ; 14(9): e0222439, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31513653

RESUMEN

Sexually transmitted infections (STIs) remain a worldwide problem and a severe threat to public health. The purpose of this study was to compare Aptima® Assays (Hologic®) and the Allplex™ STI Essential Assay (Seegene®) for the simultaneous detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium in clinical practice. The Aptima® assays (Hologic®) are based on a transcription-mediated amplification (TMA) method. The Allplex™ STI Essential assay (Seegene®) is based on a multiplex Real-Time PCR (RT-PCR) method. A total of 622 clinical samples from different anatomical sites were tested using both methods. A total of 88 (14.1%) and 66 (10.6%) positive samples were found for any of the TMA assays used and for the RT-PCR assay, respectively. Aptima® assays showed a slightly higher rate of positive results for all pathogens except for T. vaginalis, the results of which were similar to those obtained with Allplex™. The most commonly detected pathogen was C. trachomatis (37 samples; 5.9% using TMA assays) and the anatomical site with the highest prevalence of microorganisms was a non-urogenital site, the pharynx (27 positive samples; 4.3%). Using the Aptima® assays as reference method, the comparison showed that the average specificity of multiplex RT-PCR was 100.0% for the four pathogens. However an average sensitivity of 74.5% was observed, showing 95.2% (CI95%; 93.6-96.9) of overall concordance (κ = 0.80). In conclusion, the Aptima® assays show a higher sensitivity on a wide range of sample types compared to the Allplex™ assay.


Asunto(s)
Reacción en Cadena de la Polimerasa Multiplex/métodos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis , Femenino , Gonorrea/diagnóstico , Humanos , Masculino , Infecciones por Mycoplasma/diagnóstico , Mycoplasma genitalium , Neisseria gonorrhoeae , Prevalencia , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Sensibilidad y Especificidad , España , Vaginitis por Trichomonas/diagnóstico , Trichomonas vaginalis , Adulto Joven
18.
BMJ Open ; 9(8): e025013, 2019 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-31462459

RESUMEN

OBJECTIVES: Self-collected vaginal swabs can facilitate diagnosis of vaginal discharge (VD) in resource-limited settings, provided reliability of the method is established. The aim of this study was to evaluate the concordance between self-collected and physician-collected vaginal swabs for aetiological diagnosis of VD and to determine the prevalence of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonas vaginitis (TV). METHODS: A total of 550 females (median age: 32 years; range: 18-45 years) attending two sexually transmitted infection/reproductive tract infection (STI/RTI) clinics with VD from January 2015 to May 2016 were included in the study after obtaining written informed consent. Swabs were self-collected by patients after instructions and subsequently by a physician under speculum examination. Samples were processed for standard bedside tests, Gram staining, wet mount and culture (gold standard) according to the national guidelines. Concordance between the two methods was determined by the Cohen's kappa value. RESULTS: BV, VVC and TV were diagnosed in 79 (14.4%), 144 (26.2%) and 3 (0.5%) patients, respectively. VVC coexisted with BV in 58 (10.5%) patients. There was no coinfection of TV with BV or VVC. Candida albicans was isolated in 84 (58.3%) VVC cases. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-collected swabs for diagnosing BV was 91.1%, 100%, 100% and 98.5%, respectively, while for the C. albicans VVC and TV, sensitivity, specificity, PPV and NPV all were 100% as compared with physician-collected swabs. Highly concordant results were obtained between two methods by the Kappa values of 0.95 (BV), 0.99 (VVC) and 1.0 (TV). CONCLUSION: The comparative performance of self-collected and physician-collected vaginal swabs establishes self-collection of samples for BV, VVC and TV as a viable alternative tool in the management of STIs/RTIs, especially in peripheral and resource-constrained settings. This would be effective in implementing the diagnostic approaches for STIs/RTIs in community-based surveillance studies at national or regional level and therefore strengthening the National STI/RTI Control Programme.


Asunto(s)
Candidiasis Vulvovaginal/diagnóstico , Autocuidado , Vaginitis por Trichomonas/diagnóstico , Frotis Vaginal/métodos , Vaginosis Bacteriana/diagnóstico , Adolescente , Adulto , Factores de Edad , Candidiasis Vulvovaginal/epidemiología , Estudios Transversales , Países en Desarrollo , Femenino , Humanos , India/epidemiología , Persona de Mediana Edad , Prevalencia , Reproducibilidad de los Resultados , Vaginitis por Trichomonas/epidemiología , Vaginosis Bacteriana/epidemiología , Adulto Joven
20.
Med Microbiol Immunol ; 208(6): 773-780, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31183547

RESUMEN

Vaginal infections caused by bacteria, Candida and Trichomonas vaginalis, affect millions of women annually worldwide. Symptoms and signs have limited value in differential diagnosis of three causes of vaginitis. Current laboratory methods for differential diagnosis are either expensive or time consuming. Therefore, in this work, development of a method based on gold nanoparticles has been investigated for rapid diagnosis of vaginal infections. Specific antibodies against three main causes of vaginal infections were raised in rabbits. The antibodies were then purified and conjugated to gold nanoparticles and used in an agglutination test for detection of vaginal infections. Finally, sensitivity and specificity of this test for diagnosis of vaginal infections were estimated using culture method as gold standard. Purification of antibodies from sera was confirmed by electrophoresis. Construction of nanoparticles was proved by TEM and FT-IR methods. Conjugation of antibodies to gold nanoparticles was confirmed using XPS method. Sensitivity and specificity of gold nanoparticles for diagnosis of Candida species were 100%, for Gardnerella were 100% and 93%, and for T. vaginalis was 53.3% and 100%, respectively. Gold nanoparticle-based method is a simple, rapid, accurate, and cost-effective test for differential laboratory diagnosis of vaginal infections.


Asunto(s)
Pruebas de Aglutinación/métodos , Candidiasis Vulvovaginal/diagnóstico , Diagnóstico Diferencial , Pruebas Diagnósticas de Rutina/métodos , Infecciones por Bacterias Grampositivas/diagnóstico , Vaginitis por Trichomonas/diagnóstico , Anticuerpos Antibacterianos , Anticuerpos Antifúngicos , Anticuerpos Antiprotozoarios , Candida/aislamiento & purificación , Femenino , Gardnerella/aislamiento & purificación , Humanos , Nanopartículas del Metal , Sensibilidad y Especificidad , Trichomonas vaginalis/aislamiento & purificación
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA