TP 39 Rapid Trichomonas Vaginalis (TV) Testing for Adolescents with Suspected Sexually Transmitted Infections (STIs) in the Emergency Department (ED)

Tuesday, June 10, 2014
Exhibit Hall
Heather Territo, MD, Department of Pediatrics, Division of Emergency Medicine, Women and Children's Hospital Buffalo, Buffalo, NY, Scott Bouton, MD, Department of Emergency Medicine, Women and Children‘s Hospital of Buffalo, Buffalo, NY, Brian Wrotniak, P.T., Ph.D, Department of Pediatrics, University at Buffalo, Buffalo, NY and Gale Burstein, MD, MPH, Division of General Pediatrics, SUNY at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY


TV diagnosis is often based on microscopy exam of vaginal secretions with poor sensitivity. The OSOM Trichomonas Rapid Test (TRT; Sekisui Diagnostics) is a CLIA-waived, rapid test with sensitivity >83% and results in 10 minutes. The study purpose was to determine if adding TV testing to all routine ED STI evaluations increased TV identification and treatment.


Setting: Western New York State urban, children’s hospital ED

Population: 13 – 20 year old females presenting to ED for STI testing

Time periods: Study Time 1 (T1): 4/11-9/11(prior to routine TV ED STI testing);

Study Time 2 (T2): 11/11-10/12 (after routine TV ED STI testing implemented).

Methods: We performed a retrospective review during T1 of consecutive medical records of eligible patients.

We conducted a prospective study during T2 of enrolled females for STIs. TRTs and TV nucleic acid amplification tests (NAAT; Aptima, GenProbe) were ordered for enrolled patients.

Chi-square tests and logistic regression were used to assess statistical significance.


During T1, 234 female ED patients met study inclusion criteria, 13% (31/234) were TV tested with 1.3% (3/234) testing positive. During T2, 213 females were enrolled; 99.5% (212/213) were TV tested; 13.6% (29/213) tested TRT positive (p<.001) and 17.6% (33/188) tested TV NAAT positive (p<.001). TV treatment was given to 7% (17/234) of patients during T1 compared to 24% (52/213) during T2 (p<.001).

TRT and NAAT TV testing were concordat in 94.6%(178/188) of patients.  Of these 188 tests, thirty percent  (10/33) of positive TV NAATs were TRT negative.

Using logistic regression, we found no statistical significant trichomonas clinical predictors.

During T2, 26 males were enrolled;  77% (20/26) were TV tested; 8% (2/26) tested positive. 

Conclusions:  Incorporating TRTs and TV NAATs into routine adolescent STI testing significantly increased adolescent TV diagnosis and treatment and are important tools for STI screening in urban EDs.