Prevalence of Trichomonas vaginalis in Women Visiting 2 Obstetrics and Gynecology Clinics in Daegu, South Korea
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초록
This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.
Abstract
This study explored epidemiological trends in trichomoniasis in Daegu, South Korea. Wet mount microscopy, PCR, and multiplex PCR were used to test for Trichomonas vaginalis in vaginal swab samples obtained from 621 women visiting 2 clinics in Daegu. Of the 621 women tested, microscopy detected T. vaginalis in 4 (0.6%) patients, PCR detected T. vaginalis in 19 (3.0%) patients, and multiplex PCR detected T. vaginalis in 12 (1.9%) patients. Testing via PCR demonstrated high sensitivity and high negative predictive value for T. vaginalis. Among the 19 women who tested positive for T. vaginalis according to PCR, 94.7% (18/19) reported vaginal signs and symptoms. Notably, more than 50% of T. vaginalis infections occurred in females younger than 30 years old, and 58% were unmarried. Multiplex PCR, which simultaneously detects pathogens from various sexually transmitted infections, revealed that 91.7% (11/12) of patients were infected with 2 or more pathogens. Mycoplasma hominis was the most prevalent co-infection pathogen with T. vaginalis, followed by Ureaplasma urealyticum and Chlamydia trachomatis. Our results indicate that PCR and multiplex PCR are the most sensitive tools for T. vaginalis diagnosis, rather than microscopy which has been routinely used to detect T. vaginalis infections in South Korea. Therefore, clinicians should take note of the high prevalence of T. vaginalis infections among adolescent and young women in order to prevent persistent infection and transmission of this disease.
참고문헌 (30)
- Gerbase AC, "Global prevalence and incidence estimates of selected curable STDs", Sex Transm Infect, 74(suppl 1), pp.S12~S16 (1998)
- World Health Organization, "Global incidence and prevalence of selected curable sexually transmitted infections-2008" (2008), WHO
- Ginocchio C, "Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay", J Clin Microbiol, 50, pp.2601~2608 (2012)
- Fichorova RN, "Impact of T. vaginalis infection on innate immune responses and reproductive outcome", J Reprod Immunol, 83, pp.185~189 (2009)
- Cotch M, "Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group", Sex Transm Dis, 24, pp.353~360 (1997)
- Kigozi GG, "Treatment of Trichomonas in pregnancy and adverse outcomes of pregnancy: a subanalysis of a randomized trial in Rakai, Uganda", Am J Obstet Gynecol, 189, pp.1398~1400 (2003)
- Moodley P, "Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus", Clin Infect Dis, 34, pp.519~522 (2002)
- Rendón-Maldonado J, "Trichomonas vaginalis: in vitro attachment and internalization of HIV-1 and HIV-1-infected lymphocytes", J Eukaryot Microbiol, 50, pp.43~48 (2003)
- Guenthner PC, "Trichomonas vaginalis-induced epithelial monolayer disruption and human immunodeficiency virus type 1 (HIV-1) replication: implications for the sexual transmission of HIV-1", Infect Immun, 73, pp.4155~4160 (2005)
- Kissinger P, "Trichomonas vaginalis treatment reduces vaginal HIV-1 shedding", Sex Transm Dis, 36, pp.11~16 (2009)
- Workowski KA, "Sexually transmitted diseases treatment guidelines, 2010", MMWR Recomm Rep, 59, pp.1~110 (2010)
- Radonjic IV, "Diagnosis of Trichomonas vaginalis infection: the sensitivities and specificities of microscopy, culture and PCR assay", Eur J Obstet Gynecol Reprod Biol, 126, pp.116~120 (2006)
- Caliendo A, "Real-time PCR improves detection of Trichomonas vaginalis infection compared with culture using self-collected vaginal swabs", Infect Dis Obstet Gynecol, 13, pp.145~150 (2005)
- Huppert JS, "Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women", Clin Infect Dis, 45, pp.194~198 (2007)
- Lawing LF, "Detection of trichomonosis in vaginal and urine specimens from women by culture and PCR", J Clin Microbiol, 38, pp.3585~3588 (2000)
- Schirm J, "Trichomonas vaginalis detection using real-time TaqMan PCR", J Microbiol Methods, 68, pp.243~247 (2007)
- Kim Y, "Prevalence of sexually transmitted infections among healthy Korean women: implications of multiplex PCR pathogen detection on antibiotic therapy", J Infect Chemother, 20, pp.74~76 (2014)
- Van Der Pol B, "Detection of Trichomonas vaginalis DNA by use of self-obtained vaginal swabs with the BD ProbeTec Qx assay on the BD Viper system", J Clin Microbiol, 52, pp.885~889 (2014)
- van der Schee C, "Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimens compared to diagnosis by wet mount microscopy, culture, and fluorescent staining", J Clin Microbiol, 37, pp.4127~4130 (1999)
- Wendel KA, "Trichomonas vaginalis polymerase chain reaction compared with standard diagnostic and therapeutic protocols for detection and treatment of vaginal trichomoniasis", Clin Infect Dis, 35, pp.576~580 (2002)
- 류재숙, "Trichomonas vaginalis and trichomoniasis in the Republic of Korea", The Korean Journal of Parasitology, 44(2), pp.101~116 (2006), 대한기생충학ㆍ열대의학회
- 김재경, "Epidemiological Trends of Sexually Transmitted Infections Among Women in Cheonan, South Korea, 2006-2012", Journal of Microbiology and Biotechnology, 23(10), pp.1484~1490 (2013), 한국미생물·생명공학회[DOI]
- Meites E, "Trichomonas vaginalis in selected US sexually transmitted disease clinics: testing, screening, and prevalence", Sex Transm Dis, 40, pp.865~869 (2013)
- Sutton M, "The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001–2004", Clin Infect Dis, 45, pp.1319~1326 (2007)
- Kosters K, "Real-time LightCycler PCR for detection and discrimination of Bordetella pertussis and Bordetella parapertussis", J Clin Microbiol, 40, pp.1719~1722 (2002)
- McIver CJ, "Multiplex PCR testing detection of higher-than-expected rates of cervical Mycoplasma, Ureaplasma, and Trichomonas and viral agent infections in sexually active australian women", J Clin Microbiol, 47, pp.1358~1363 (2009)
- Brotman RM, "Bacterial vaginosis assessed by gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection", J Infect Dis, 202, pp.1907~1915 (2010)
- Samra Z, "Direct simultaneous detection of 6 sexually transmitted pathogens from clinical specimens by multiplex polymerase chain reaction and auto-capillary electrophoresis", Diagn Microbiol Infect Dis, 70, pp.17~21 (2011)
- White MJ, "Is the presence of Trichomonas vaginalis a reliable predictor of coinfection with Chlamydia trachomatis and", or Neisseria gonorrhoeae in female ED patients?, 2005, pp.23, 127~130
- Jun-Hyeok Seo, "Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea", The Korean Journal of Parasitology, 52(5), pp.551~555 (2014), 대한기생충학ㆍ열대의학회[DOI]