Affirm VPIII, Papanicolaou 도말 검사 및 Gram 염색에서의 Trichomonas vaginalis, Gardnerella vaginalis 및 Candida spp. 검출
Detection of Trichomonas vaginalis, Gardnerella vaginalis, and Candida Species in Affirm VPIII, Papanicolaou Smear Test and Gram Stain
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배경: 감염성 질염은 주로 3종류의 원인균(Trichomonas vaginalis, Candida spp., Gardnerella vaginalis)에 의해 발생한다. 본 연구의 목적은 3종류의 주요 원인균 검출과 동정을 위하여, DNA 교잡 기술을 사용한 Affirm VPIII 검사를Papanicolaou (Pap) 도말 검사 및 Gram 염색과 비교하는 것이다. 방법: 질염 증상이 있거나 산부인과를 방문하여 질 검사를 받은 300명의 여성으로부터 채취한 질 분비물을 대상으로하였다. Affirm VPIII 검사, Pap 도말 검사 및 Gram 염색을 시행하여 T. vaginalis, G. vaginalis 및 Candida spp. 유무를 검사하였다. 결과: Affirm VPIII 검사에서는 T. vaginalis가 1명(0.3%), G. vaginalis는 99명(33.0%), Candida spp.는 18명(6.0%)에서 검출되었다. Pap 도말 검사와 Gram 염색에서는 T. vaginalis가 2명(0.7%)과 0명, G. vaginalis는 49명(16.3%)과 107명(35.7%),Candida spp.는 5명(1.7%)과 29명(9.7%)에서 각각 검출되었다. 3종류의 검사간 검출률은 모두 통계적으로 유의한 차이를보였다(P＜0.05). 결론: 3종류의 주요 원인균 검출과 동정을 위한 본 연구에서 Affirm VPIII 검사가 Pap 도말 검사에 비해 민감도가 높고Gram 염색보다는 특이도가 높았다. 또한 Affirm VPIII 검사는 신속 간편하고 판독이 용이하였다.
Abstract
Background: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. Methods: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. Results: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (P＜0.05). Conclusion: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
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