Role played by antigen tests in the fast diagnosis of vulvovaginal candidiasis, gardnerella and trichomoniasis
Section: Originales
How to quote
Huertas Fernández MA, Mica Tartau AM, Caballero de Diego A, Simón Ruiz P. Papel de los test antigénicos en el diagnóstico rápido de vulvovaginitis por Cándida, Cardnerella y Trichomonas. Matronas Hoy 2023; 11(3):33-8.
Authors
1 Miguel Ángel Huertas Fernández, 2 Ana María Mirca Tartau, 2 Alicia Caballero de Diego, 2 Paula Simón Ruiz
Position
1 Jefe de Servicio de Ginecología y Obstetrica Hospital Universitario de Getafe. Madrid (España)2 MIR. Ginecología y Obstetricia Hospital Universitario de Getafe. Madrid (España)
Abstract
Introduction: bacterial vaginosis is responsible for 40%-50% of all vaginal infections, followed by candidiasis (20%-25%) and trichomoniasis (15%-20%). A late diagnosis is one of the reasons why it is difficult to control these infections, which is why the objective is to ensure an early detection of these illnesses, thus avoiding the patient’s suffering and expense.
Objective: appraisal in the gynecological ER of fast antigen tests when diagnosing vulvovaginitis caused by Candidiasis, Gardnerella and Trichomoniasis in women with abnormal flow and vulvovaginal symptoms, when compared to standard techniques used in microbiology laboratories.
Methodology: comparative observational study conducted on 42 women between 18 and 61 years of age with genital symptoms, as walk-in-patients of gynecological ERs.
Women were excluded who had severe medical conditions, a previous hysterectomy, pregnant women and those who had been treated with antibiotics over the last 10 days. Three vaginal samples and one endocervical sample were collected from each patient, one for an on-site study using a fast antigen test and the other two for laboratory testing as a smear, culture, gram appraisal following Nugent criteria and a PCR endocervical sample to detect trichomoniasis. The fast antigen test results were checked against laboratory testing results.
Results: the fast tests examined evidenced sensitivity and specificity above 90% in diagnosed infections of Candidiasis and Gardnerella; sensitivity indicated more variability in Trichomoniasis vaginitis, with lower values due to the small number of samples. To note is that all non-specific vaginitis symptoms with negative results, in all tests, belonged to post-menopausal patients.
Keywords:
bacterial vaginosis; vaginitis vulvovaginitis; infection; candidiasis; trichomoniasis; gardnerella; fast test; gynecological ER
Versión en Español
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Bibliography
- Pillay A. Media, stains, reagents and test procedures. En: Morse SA, Holmes KK, Ballard RC, Moreland AA (eds.). Atlas of sexually transmitted diseases and AIDS. 4th ed. Edinburgh: Saunders/Elsevier; 2010.
- World Health Organization (WHO). Covid 19 strategy. Geneva: WHO; 2020. [citado 1 nov 2023]. Disponible en: https://www.who.int/publications/i/item/covid-19-strategy-update---14-april-2020
- 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. [internet] 2001 Sep [citado 1 nov 2023]; 39(9):3197-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88318/.
- Unemo M. Diagnóstico de laboratorio de las infecciones de transmisión sexual, incluida la infección por el virus de la inmunodeficiencia humana [internet]. Ginebra: Organización Mundial de la Salud (OMS); 2014 [citado 1 nov 2023]. Disponible en: https://iris.paho.org/handle/10665.2/38597
- Cercenado E, Cantón R. Procedimientos en Microbiología Clínica. Recomendaciones de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIM). Madrid: SEIM; 2007.
- 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(1):17-21. [citado 1 nov 2023]. Disponible: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784585/
- Otero-Guerra L, Fernández-Blázquez A, Vázquez F. Diagnóstico rápido de las infecciones de transmisión sexual. Enferm Infecc Microbiol Clin. [internet] 2017 [citado 1 nov 2023]; 35(7):444-50. Disponible en: https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-diagnostico-rapido-infecciones-transmision-sexual-S0213005X17300241
- Peeling RW, Holmes KK, Mabey D, Ronald A. Rapid tests for sexually transmitted infections (STIs): the way forward. Sex Transm Infect. [internet] 2006 [citado 1 nov 2023]; 5(Suppl 5):v1-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17151023/
- Machado A, Cerca N. Influence of Biofilm Formation by Gardnerella vaginalis and Other Anaerobes on Bacterial Vaginosis. J. Infect. Dis. [nternet] 2015 [citado 1 nov 2023]; 212(12-15):1856-61. Disponible en: https://academic.oup.com/jid/article/212/12/1856/2911944
- Sociedad Española de Ginecología y Obstetricia (SEGO). Diagnóstico y tratamiento de las infecciones vulvovaginales. Prog Obstet Ginecol. [internet] 2018 [citado 1 nov 2023]. Disponible en: https://bibliotecavirtual.sego.es/uploads/app/1297/elements/file/file1677769502.pdf
- Gift TL, Pate MS, Hook EW, Kassler WJ. The rapid test paradox: when fewer cases detected lead to more cases treated: a decision analysis of tests for Chlamydia trachomatis. Sex Transm Dis. [internet] 1999 [citado 1 nov 2023]; 26(4):232-40. Disponible en: https://journals.lww.com/stdjournal/fulltext/1999/04000/the_rapid_test_paradox__when_fewer_cases_detected.10.aspx
