NEW ORLEANS -- Polymerase chain reaction tests proved nearly as accurate as culture in diagnosing vaginal trichomoniasis in a metaanalysis of 35 studies, but less expensive tests may suffice in some patients, Dr. Sangnya Patel said at the annual meeting of the Southern Society of General Internal Medicine.
The metaanalysis covered 9,882 patients in the studies who underwent testing for trichomoniasis. The standard was culture, with sensitivities of 95%-96% in a comparison of three culture media and 100% specificity with each.
Many laboratories do not offer culture for trichomoniasis, making alternative tests desirable, Dr. Patel said in an interview.
The study found that PCR tests were 95% sensitive and 98% specific for trichomoniasis, compared with an 82% sensitivity and a 73% specificity for enzyme-linked immunosorbent assay (ELISA), and an 85% sensitivity and a 99% specificity for direct fluorescence antibody tests, reported Dr. Patel of East Carolina University, Greenville, N.C.
The choice of test depends a lot on patient characteristics, she added. A positive Pap test in a young woman with multiple sexual partners may be sufficient to presume diagnosis and proceed with treatment for vaginal trichomoniasis. Overall, however, Pap smears are only 57% sensitive for trichomoniasis, Dr. Patel added.
Wet mounts that contain trichomonas clinch the diagnosis, but wet mounts miss 30%-50% of true infections.
After a positive Pap but a negative wet mount, order a culture if it's available, she advised. If not, consider PCR testing, the investigator recommended.
A PCR test costs about $64, compared with $8 for culture, but it tells you what you need to know.
COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group
Contact
Home
A
Candidiasis