A profile of the cobas® TV/ MG test for the detection of Trichomonas vaginalis and Mycoplasma genitalium

ABSTRACT

Introduction: Trichomonas vaginalis and Mycoplasma genitalium are highly prevalent sexually transmitted pathogens that may be asymptomatic or may cause cervicitis and pelvic inflammatory disease in women and urethritis in men. Our limited understanding of the epidemiology of these infections has been hampered by a lack of diagnostic capacity, but the new cobas® TV/MG assay runs on the cobas® 6800/8800 platform offers a solution to this gap in our current diagnostic capacity.

Areas covered: This article will describe what we know about the epidemiology and impact of untreated infections with these organisms as well as current recommendations for testing. The features and performance of the cobas 6800/8800 and the TV/MG assay will be described based on the emerging data related to this assay.

Expert commentary: Molecular diagnostics for trichomonas and mycoplasma that can be performed on a high-throughput system with the flexibility to order only those tests required are needed in order to reduce the burden of disease and of consequences of undiagnosed infections caused by these pathogens. As a result of the complexities in the needs for testing in different populations, sample-specific flexibility in test ordering is an absolute need in the molecular laboratory.     

Persistent and recurrent Trichomonas vaginalis infections: epidemiology,treatment and management considerations

Trichomonas vaginalis (TV) is a common sexually transmitted infection that can cause vaginitis, cervicitis and urethritis. Persistent and recurrent TV infections are frequent in women, potentially due to the lack of routine screening recommendations for this pathogen, the chronic nature of some infections, and drug resistance. Metronidazole and tinidazole are two oral drugs that are effective against trichomoniasis. There are few alternative treatment options for persons with a metronidazole allergy or treatment failure. Most TV isolates from women with treatment failures that have been analyzed for susceptibility testing in the United States have exhibited low-level metronidazole resistance, supporting the initial use of tinidazole for patients who fail metronidazole therapy. Several non-nitroimidazole drugs and other agents have demonstrated acceptable in vitro activity or cure rates in case reports for metronidazole-resistant trichomoniasis; however, clinical trials are imperative to evaluate their efficacy as alternative therapeutic regimens for this highly prevalent infection.     

Trichomoniasis and its treatment

Trichomonas vaginalis has long been recognized as a cause of infectious vaginitis in women. More recently, studies have demonstrated a significant burden of disease in men with urethritis or men at high risk for sexually transmitted diseases. There is increasing interest in this pathogen as more data accumulates linking it to HIV transmission and perinatal morbidity. New diagnostic methods have emerged that may increase sensitivity of diagnosis or improve point-of-care access to testing. Nitroimidazoles remain the mainstay of therapy. Metronidazole and tinidazole are highly effective as single-dose therapy. Unfortunately, despite the link between T. vaginalis infection and perinatal morbidity, nitroimidazole therapy during pregnancy remains controversial. Although metronidazole resistance is currently uncommon, pharmacological features and nitroimidazole resistance patterns suggest that tinidazole may be more effective in treating patients with metronidazole treatment failure. Alternatives to nitroimidazole therapy are few, and most have limited efficacy and significant toxicity.     

深圳市四种性传播疾病病原体检出情况分析

[目的] 总结和分析了5年来深圳市性传播疾病(STD)的病原学状况。[方法] 收集了30413例可疑STD患者的资料，对四种最主要的STD病原体—淋球菌(NG)、沙眼衣原体(CT)、解脲支原体(UU)、人乳头状瘤病毒(HPV)进行详细的统计分析。[结果] 近5年来CT、UU、HPV阳性率持续上升，NG略有下降。NG、CT、UU、HPV阳性率分别为16．38％、22．10％、38．14％、36．10％。[结论] STD已构成区域流行，其原因可能与混合感染和治疗不彻底有关，应引起全社会的高度重视。     

1997-2006年江西省丰城市性病流行病学分析

目的 了解江西省丰城市性病流行特征与变化趋势,探讨防制对策与措施.方法 采用描述流行病学方法,对丰城市37个医疗机构1997-2006年上报的性病疫情资料进行分析.结果 1997-2006年全市共报告性病7种共计6782例.自2000年,全市性病报病数和报告发病率均呈下降趋势,而尖锐湿疣(CA)、非淋菌性尿道炎(NGU)、梅毒(Syphilis)、艾滋病/艾滋病病毒(AIDS/HIV)感染者报病数增加.性病构成谱由20世纪90年代淋病(GU)为主转变为21世纪以CA、NGU和GU三者并行的格局.近几年,HIV感染者报告数迅速上升.结论 丰城市性病疫情仍处低流行状态,但HIV/AIDS疫情流行速度明显加快.疫情正由高危人群向一般人群蔓延,并造成家庭内传播.应采取加强监测、开展健康教育和行为干预等措施,遏制艾滋病传播和蔓延的趋势.     

Getting it Right: The Impact of Point-of-Care Testing for Gonorrhea and Chlamydia in the Urgent Care Setting

Sexually transmitted infections (STIs), including Neisseria gonorrhea and Chlamydia trachomatis, have been at the forefront of public health and world health initiatives because of increasing prevalence, antimicrobial resistance trends, and immense economic health care burdens. Current STI laboratory-based testing impedes timely and accurate treatment in urgent care clinics (UCCs) and emergent care settings; the typical 3- to 5-day turnaround for testing results is not efficient in these settings. Of significance, UCCs and emergency settings often serve as the only point of contact for many exposed or affected individuals, further complicating appropriate treatment and follow-up care. This quality improvement project was conducted at a high-volume, suburban UCC to evaluate the implementation of nucleic acid amplification test (NAAT) point-of-care (POC) STI screening for gonorrhea and chlamydia. Analysis included comparison of appropriate STI treatment based on laboratory results among 100 patients preintervention and 100 patients postintervention, financial feasibility of the POC testing intervention, and staff satisfaction measurement. Results show that STI treatment appropriateness dramatically improved with NAAT; the innovation exceeded cost neutrality by creating revenue through appropriate billing and coding, and clinical staff were highly satisfied using the new testing protocol. The results of this study support the use of POC testing using NAAT for the diagnosis of urogenital gonorrhea and chlamydia infections in urgent and emergent care settings and highlight implications for adoption, sustainability, and expansion into other clinic settings.     

2004-2009年浙江省永嘉县性传播疾病疫情特征分析

目的 对浙江省永嘉县2004-2009年性传播疾病疫情特征进行分析,探讨性病防治工作策略.方法 利用传染病监测系统导出永嘉县2004年1月1日至2009年12月31日性病资料,用Excel软件整理数据,用SPSS软件统计分析.结果 6年来性病发病率呈上升趋势,以梅毒、尖锐湿疣、淋病等为主;婚外传染为主要传播途径;职业以...     

2005年北京市大兴区性病流行病学分析

目的 了解大兴区性病发病趋势和流行特点,为制定防治策略提供科学依据.方法 对全区的性病疫情年(季)报表汇总分析.结果 2005年大兴区累计报告非淋菌性尿道炎(NGU)、淋病、尖锐湿疣、梅毒、生殖器疱疹等5种性病443例,较2004年下降10.87%.疾病流行谱发生变化,尖锐湿疣位居首位;男女性病病种的构成不完全相同,男性以淋病最多,女性以梅毒最多;20-39岁性活跃人群的性病报告病例数最多,占病例总数的70.65%.结论 2005年大兴区的性病报告数较2004年有所下降,但部分病种仍呈现上升趋势,尤其是生殖器溃疡性性病,应引起重视.     

The relationships among sexually transmitted infection, depression, and lifetime violence in a sample of predominantly African American women

This study was a secondary analysis of the relationships among lifetime experiences of violence, depressive symptoms, substance use, safer sex behaviors use, and past-year sexually transmitted infection (STI) treatment among a sample of 445 low income, primarily African American women (257 HIV-, 188 HIV+) reporting a male intimate partner within the past year. Twenty-one percent of HIV- and 33% of HIV+ women reported past-year STI treatment. Violence victimization increased women's odds of past-year STI treatment, controlling for HIV status and age. Depressive symptoms increased, and use of safer sex behaviors decreased, women's odds of past-year STI treatment. Results suggest that positive assessment for violence and/or depression indicates need for STI screening.     

Critical Analysis of a New Antihistaminic—Antipruritic in Allergy

A 17 year old girl with bone pain had a history suggestive of renal colic. Radiograms showed extensive bony changes, scattered calcifications within the kidneys, and a mass displacing the esophagus. Laboratory studies confirmed the radiographic diagnosis of parathyroid adenoma.     

女性解脲脲原体感染与其男性伴侣解脲脲原体感染的关系

目的探讨女性解脲脲原体(Ureaplasma urealyticum,Uu)感染与其男性伴侣Uu感染的关系,为临床诊治Uu感染提供依据。方法对2010年2月至2011年3月就诊并排除其他病原体感染的有症状且Uu阳性女性334例,无症状但Uu阳性女性61例和同期男性伴侣395例,分别取宫颈管或阴道、尿道分泌物进行Uu实时荧光定量-聚合酶链反应(real-time fluorescence quantitative-Polymerase Chain Reaction,FQ-PCR)基因检测和PCR反向斑点杂交(PCR-RDB)基因分群检测。结果 395例男性伴侣中,203例(51.39%)经FQ-PCR检测为Uu阳性,其中,有症状和无症状女性的男性伴侣Uu阳性率分别为56.3%(188/334)和24.6%(15/61),差异有统计学意义(χ2=19.50,P0.01)。基因分群显示,有症状女性感染者生物1群、生物2群和混合群各占一定比例,但以生物1群占优势,而无症状女性感染者绝大部分以生物1群为主,占86.9%(53/61);有症状女性的男性伴侣中,有尿道炎症状者绝大部分(98.7%,147/149)为生物2群和混合群感染,无尿道炎症状者则绝大部分(94.9%,37/39)为生物1群感染;而无症状女性的男性伴侣均无尿道炎症状,感染主要以生物1群为主,占80.0%(12/15)。进一步分析发现,女性感染生物1群时其男性伴侣发生感染的比例较低,而女性感染生物2群和混合群时,其男性伴侣感染同类基因群的比例则高达98.6%(71/72)和73.0%(84/115)。结论无论女性感染生物1群还是生物2群,其男性伴侣感染的主要是生物2群。因此,在女性Uu感染者及其男性伴侣中进行Uu基因分群分析,不但可指导临床制定有针对性的治疗方案,而且对监测Uu的基因变化、追踪传染源、分析流行趋势有重要意义。     

性传播疾病性慢性前列腺炎423例病原学检测

目的 :为研究性传播疾病 (STD)引起的慢性前列腺炎的病原学特点。方法 :对STD性慢性前列腺炎患者 42 3例进行了病原体检测 ,结果显示 :单一病原体感染 2 38例 (5 6 .2 6 % ) ,其中 ,CT阳性 115例 (2 7.19) ,UU阳性 71例(16 .78% ) ,NG阳性 5 2例 (12 .2 9% ) ,混合病原体感染 1     

城市周边插花地带暗娼STD感染及就医行为调查分析

目的了解城市周边插花地带暗娼性传播疾病（STD）感染及就医情况,为实施有效的艾滋病（AIDS）行为干预措施提供科学依据。方法对南昌市青云谱区娱乐场所201名暗娼进行匿名问卷调查。结果中、低档次娱乐场所的暗娼在STD感染项目情况和就医检查频率上有显著性差异（P〈0.05）,59.5%的暗娼出现过性病症状,65.7%选择到正规医疗机构进行性病诊疗。结论STD感染率高且部分就医不规范,急需进行有效干预,减少性病和艾滋病的传播。     

Turn-of-the-Century Nursing Perspectives on Venereal Disease

In the early 1900s, nurses, feminists, and social reformers focused on venereal disease as a symbol of women's powerlessness. Authors in popular literature and nursing journals debated the ethics of the "medical secret," whereby physicians collaborated with their male patients to keep wives uninformed of the risk of infection. The nurses Lavinia Dock and Emma Goldman used the topic of venereal disease as a springboard to discuss their contrasting feminist ideologies. Their writings provide a context for current debates about sexual partner notification for HIV and nurses' role in political activism.     

某大型综合医院2014—2018年性病患者临床资料分析

目的 分析陕西省人民医院性病患者的分布情况,探讨性病在综合医院中的现状及流行病学特征,为调整现有性病防治方案提供新思路.方法 回顾性分析2014年1月至2018年12月某综合医院确诊的梅毒、尖锐湿疣、淋病、生殖器疱疹、生殖道沙眼衣原体感染的5类性病患者的临床资料.结果 共确诊7704例性病患者,其中前三位的分别为梅毒5...