Lord Emily, Newnham Tana, Dorrell Lucy, Jesuthasan Gerald, Clarke Lorraine, Jeffery Katie, Sherrard Jackie
1 Department of Sexual Health, Oxford University Hospitals NHS Foundation Trust, UK.
2 Department of Microbiology, Oxford University Hospitals NHS Trust, UK.
Int J STD AIDS. 2017 Mar;28(4):357-361. doi: 10.1177/0956462416649888. Epub 2016 Jul 10.
Trichomonas vaginalis (TV) rates in women are increasing and many are asymptomatic. Nucleic acid amplification tests (NAATs) are becoming the 'gold standard' for diagnosis. We aimed to establish our asymptomatic TV rates by testing all women attending Oxfordshire's Sexual Health service, regardless of symptoms, using the BD ProbeTec™ TV Q NAATs (BDQ). During BDQ's verification process, the sensitivity and specificity were calculated using results of 220 endocervical samples from symptomatic women, compared with culture. BDQ was subsequently implemented and prospectively evaluated over 6 months in female attendees. Wet mount microscopy was also performed in symptomatics. Demographic and clinical characteristics of those diagnosed were analysed. From 220 samples tested by BDQ and culture: 5 were positive on both and one solely using BDQ, giving a sensitivity and specificity of 100% and 99.53%, respectively. In the prospective cohort, of 5775 BDQ tests, 33 (0.57%) were positive. 11/33 (33%) patients were asymptomatic. All patients diagnosed had risk factors: age >25 years (85%), residence in a deprived area (79%) and black ethnicity (21%). Despite BDQ being highly sensitive and specific, with our low TV prevalence universal screening may not be justified. Targeted screening using local demographic data merits further investigation.
女性阴道毛滴虫（TV）感染率呈上升趋势，且许多感染者无症状。核酸扩增检测（NAATs）正成为诊断的“金标准”。我们旨在通过使用BD ProbeTec™ TV Q核酸扩增检测（BDQ）对牛津郡性健康服务机构的所有女性进行检测，无论其有无症状，来确定无症状TV感染率。在BDQ的验证过程中，将220例有症状女性的宫颈管样本检测结果与培养结果进行比较，计算其敏感性和特异性。随后对BDQ进行实施，并在6个月内对女性就诊者进行前瞻性评估。对有症状者也进行了湿片显微镜检查。分析了确诊者的人口统计学和临床特征。在通过BDQ和培养检测的220份样本中：5份两者均为阳性，1份仅BDQ检测为阳性，敏感性和特异性分别为100%和99.53%。在前瞻性队列中，5775次BDQ检测中有33次（0.57%）呈阳性。11/33（33%）的患者无症状。所有确诊患者均有危险因素：年龄>25岁（85%）、居住在贫困地区（79%）和黑人种族（21%）。尽管BDQ具有高度敏感性和特异性，但鉴于我们这里TV感染率较低，普遍筛查可能不合理。利用当地人口统计学数据进行针对性筛查值得进一步研究。
