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Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women.
Clin Infect Dis. 2007 Jul 15; 45(2):194-8.CI

Abstract

BACKGROUND

Diagnosis of Trichomonas vaginalis (TV) infection is limited by imperfect testing methods. Newer tests, such as rapid antigen and nucleic acid amplification tests, are often compared with culture, which is not widely used but is more sensitive than wet mount. We assessed the sensitivity and specificity of 4 tests for the identification of TV using 3 statistical approaches.

METHODS

Sexually active adolescent women aged 14-21 years (n=330) were recruited from a teen health center and emergency department. Vaginal swabs were tested for TV using wet mount, culture (InPouch TV; Biomed Diagnostics), rapid antigen testing (OSOM TV; Genzyme Diagnostics), and transcription-mediated amplification testing (TMA; APTIMA TV analyte specific reagents; Gen-Probe).

RESULTS

TV was detected in 61 participants (18.5%). Compared with a composite reference standard (i.e., any TV test with positive results), the sensitivities of wet mount, culture, rapid antigen testing, and TMA were 50.8%, 75.4%, 82%, and 98.4%, respectively. Using latent class analysis, the sensitivity of wet mount (56%) was significantly lower than that of other tests, and the sensitivities of culture and rapid antigen testing were similar (83% and 90%, respectively); specificity was 100% for each of these 3 methods. TMA had a sensitivity of 98.2% and a specificity of 98%. Tests performed equally well regardless of whether the participant had bleeding or other infections. The sensitivities of the rapid antigen test and TMA were comparable (92.5% and 97.5%, respectively) in women who had vaginal symptoms.

CONCLUSIONS

Wet mount alone is insufficient for the reliable diagnosis of TV infection in women. TMA and rapid antigen tests are highly sensitive and specific, and both are superior to wet mount. Rapid antigen testing is equivalent to culture, and it compares favorably with the sensitivity of TMA for the detection of TV.

Authors+Show Affiliations

Division of Adoeslecent Medicine, Cincinnati Children's Hospital Medical Center, and University of Cincinnati College of Medicine, Cincinnati, OH 45229-3039, USA. jill.huppert@cchmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17578778

Citation

Huppert, Jill S., et al. "Rapid Antigen Testing Compares Favorably With Transcription-mediated Amplification Assay for the Detection of Trichomonas Vaginalis in Young Women." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 45, no. 2, 2007, pp. 194-8.
Huppert JS, Mortensen JE, Reed JL, et al. Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women. Clin Infect Dis. 2007;45(2):194-8.
Huppert, J. S., Mortensen, J. E., Reed, J. L., Kahn, J. A., Rich, K. D., Miller, W. C., & Hobbs, M. M. (2007). Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 45(2), 194-8.
Huppert JS, et al. Rapid Antigen Testing Compares Favorably With Transcription-mediated Amplification Assay for the Detection of Trichomonas Vaginalis in Young Women. Clin Infect Dis. 2007 Jul 15;45(2):194-8. PubMed PMID: 17578778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women. AU - Huppert,Jill S, AU - Mortensen,Joel E, AU - Reed,Jennifer L, AU - Kahn,Jessica A, AU - Rich,Kimberly D, AU - Miller,William C, AU - Hobbs,Marcia M, Y1 - 2007/06/06/ PY - 2007/02/27/received PY - 2007/04/06/accepted PY - 2007/6/21/pubmed PY - 2007/7/10/medline PY - 2007/6/21/entrez SP - 194 EP - 8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 45 IS - 2 N2 - BACKGROUND: Diagnosis of Trichomonas vaginalis (TV) infection is limited by imperfect testing methods. Newer tests, such as rapid antigen and nucleic acid amplification tests, are often compared with culture, which is not widely used but is more sensitive than wet mount. We assessed the sensitivity and specificity of 4 tests for the identification of TV using 3 statistical approaches. METHODS: Sexually active adolescent women aged 14-21 years (n=330) were recruited from a teen health center and emergency department. Vaginal swabs were tested for TV using wet mount, culture (InPouch TV; Biomed Diagnostics), rapid antigen testing (OSOM TV; Genzyme Diagnostics), and transcription-mediated amplification testing (TMA; APTIMA TV analyte specific reagents; Gen-Probe). RESULTS: TV was detected in 61 participants (18.5%). Compared with a composite reference standard (i.e., any TV test with positive results), the sensitivities of wet mount, culture, rapid antigen testing, and TMA were 50.8%, 75.4%, 82%, and 98.4%, respectively. Using latent class analysis, the sensitivity of wet mount (56%) was significantly lower than that of other tests, and the sensitivities of culture and rapid antigen testing were similar (83% and 90%, respectively); specificity was 100% for each of these 3 methods. TMA had a sensitivity of 98.2% and a specificity of 98%. Tests performed equally well regardless of whether the participant had bleeding or other infections. The sensitivities of the rapid antigen test and TMA were comparable (92.5% and 97.5%, respectively) in women who had vaginal symptoms. CONCLUSIONS: Wet mount alone is insufficient for the reliable diagnosis of TV infection in women. TMA and rapid antigen tests are highly sensitive and specific, and both are superior to wet mount. Rapid antigen testing is equivalent to culture, and it compares favorably with the sensitivity of TMA for the detection of TV. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/17578778/Rapid_antigen_testing_compares_favorably_with_transcription_mediated_amplification_assay_for_the_detection_of_Trichomonas_vaginalis_in_young_women_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/518851 DB - PRIME DP - Unbound Medicine ER -