Diagnosis of Trichomonas vaginalis infection:: The sensitivities and specificities of microscopy, culture and PCR assay
Diagnosis of Trichomonas vaginalis infection:: The sensitivities and specificities of microscopy, culture and PCR assay
复制标题
DOI：
10.1016/j.ejogrb.2005.07.033
复制
发表时间：
2006-05-01
影响因子：
2.6
通讯作者：
Zec, Ivana F. Kranjcic
中科院分区：
文献类型：
--
作者：
Radonjic, Ivana V.;Dzamic, Aleksandar M.;Zec, Ivana F. Kranjcic
目的：本研究的目的是比较湿封片法、姬姆萨染色法、吖啶橙子荧光染色法、培养法和聚合酶链反应（PCR）法，以确定哪种方法或方法组合在滴虫病的实验室诊断中最有效。在200例妇科疾病患者中，27例（13.5%）通过任何一种方法检测到阴道毛滴虫感染。在患有滴虫的女性中，只有9例出现典型的临床表现。结果：诊断感染的湿封片14例（7.0%）妇女，姬姆萨染色11例（5.5%），吖啶橙子染色16例（8.0%）妇女。在21例（10.5%）妇女中，通过Diamond培养基培养确诊，22例（11.0%）通过PCR确诊。阴道湿片是目前性病门诊普遍采用的诊断滴虫病的首选方法，但敏感性较差（66.67%）。姬姆萨染色敏感性低，仅为52.38%。吖啶橙子染色的敏感性和特异性分别为71.43%和99.44%。PCR的敏感性和特异性（80.95%和97.21%）均未超过培养法。结论：考虑到滴虫病可以有不典型甚至无症状的病程，为了准确诊断该病，微生物调查是必要的。不同方法的比较表明，至少有两种技术，如培养和吖啶橙子染色，有可能更好地诊断T迷走细胞感染。PCR检测感染已被证明是高度特异性和敏感性，但其可用性和成本效益的问题。PCR可作为培养法诊断滴虫病的一种替代方法。(C)2005爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: The aim of this study was to compare wet mount-, Giemsa stain-, acridine orange fluorescent stain-, cultivation- and polymerase chain reaction (PCR)-based approaches to establish which method or combination of methods was most effective in the laboratory diagnosis of trichomoniasis.Study design: Out of 200 investigated patients with various gynecological complaints, Trichomonas vaginalis infection was detected in 27 (13.5%) by any of methods investigated. Among women with trichomonads, a typical clinical finding was presented in only nine. For analysis of sensitivity and specificity of the methods used, the receiver operating characteristic (ROC) curve concept with culture as a gold standard was applied.Results: Infection was diagnosed by wet mount in 14 (7.0%) women, by Giemsa stain in 11 (5.5%) and by acridine orange stain in 16 (8.0%) women. In 21 (10.5%) women, it was diagnosed by culture in Diamond's medium, and in 22 (11.0%) by PCR. For the initial diagnosis of trichomoniasis, wet preparation is the test that is widely available in most STD clinics, but its sensitivity is poor (66.67%). Giemsa stain shows a low sensitivity of 52.38%. Acridine orange shows reasonable sensitivity and specificity of 71.43% and 99.44%, respectively. The sensitivity and specificity of PCR (80.95% and 97.21%) did not exceed that of culture.Conclusion: With regard to the fact that trichomoniasis can have an atypical or even asymptomatic course, in order to accurately diagnose this disease, microbiological investigation is necessary. Comparison of different methods showed that at least two techniques, such as culture and acridine orange staining, have the potential for better diagnosis of T vaginalis infection. PCR detection of infection has been demonstrated to be highly specific and sensitive, but its availability and cost effectiveness are in question. PCR could provide an alternative for laboratory diagnosis of trichomoniasis by culture. (C) 2005 Elsevier Ireland Ltd. All rights reserved.