P78 Detection of Trichomonas Vaginalis UsingTranscription Mediated Amplification Analyte SPECIFIC Reagents On Various Types of Vaginal Swabs Which Were Self Collected

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Max Chernesky, PhD, Research Laboratory, St. Joseph's Healthcare/McMaster University, Hamilton, ON, Canada

Background:  Trichomonas vaginalis [TV] may cause adverse outcomes in pregnancy and better laboratory tests are needed. 

Objectives:  To determine the prevalence of TV by testing self-collected vaginal swabs [VS] by wet mount [WM] and transcription mediated amplification [TMA] tests using Gen-Probe analyte specific reagents [ASR].

Methods:  Group A consisted of 247 women attending a street youth clinic who self-collected 2 VS. The first dacron swab was collected into an M40 tube [Copan] for wet mount [WM] examination within 24 hours. The second swab was placed into a specimen transport medium [STM] tube [Gen-Probe] for TV ASR. Group B consisted of 289 young women who self-collected 2 VS.  The first swab was a dacron APTIMA swab [AS] transported in STM and the other was a flocked swab [FS] transported in STM.  Patients were considered infected if both of the comparator swabs were positive or if a single positive was confirmed by a second research use only [RUO] TMA test directed against alternate targets from a different rRNA region [ALT TMA].

Results:  The TV prevalence was 18.2% [45/247] in Group A and 13.5% [39/289] in Group B.  The percent sensitivity and specificity in Group A were: ASR-TMA 93.3% [42/45] and 97.5% [197/202] compared to WM which was 20.0% [9/45] and 100% [201/201]: in Group B the values were 92.3% [36/39] and 98.8% [247/250] for AS and 92.3% [36/39] and 99.2% [248/250] for FS.

Conclusions:  This TV-TMA test using ASR was easy to perform, yielding clear results with self-collected VS using different swab types.  A run of 98 samples was processed in approximately 6 hours. The sensitivity of WM makes it unacceptable.

Implications for Programs, Policy, and/or Research:  TV-TMA testing can be performed on self collected VS and should enable more accurate identification and treatment of infections.

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