1Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.
2Department of Medical Microbiology and Infection Prevention, VU University Medical Center, Amsterdam, the Netherlands.
J Med Microbiol. 2018 Sep;67(9):1265-1270. doi: 10.1099/jmm.0.000792. Epub 2018 Jul 9.
Bacterial vaginosis (BV) is a common clinical condition characterized by odorous vaginal discharge, vaginal itching and/or burning. BV can occur when vaginal lactobacilli are depleted and replaced by diverse anaerobic bacteria. We evaluated a commercial multiplex PCR (ATRiDA) for the diagnosis of BV.
Cervicovaginal samples were included from women reporting urogenital symptoms and from women notified for sexually transmitted infections (STI) - who were not (necessarily) symptomatic. Clinical BV diagnoses were obtained from electronic patient files. The ATRiDA test measures the loads of Gardnerella vaginalis, Atopobium vaginae and Lactobacillus species in relation to overall bacterial load. The ATRiDA test outcome was compared to the clinical BV diagnosis and to vaginal microbiota composition, determined by 16SrRNA gene sequencing.
We included samples from 185 women reporting urogenital symptoms, of whom 81 had BV and 93 women who were notified for an STI, of whom 16 had BV. Overall, compared to the clinical BV diagnosis, the ATRiDA test demonstrated high sensitivity (96.9 %) and moderate specificity (70.2 %). The negative predictive value was high (>97.3). The positive predictive value differed by study group and was highest in women reporting urogenital symptoms (78.2 %). Sequencing showed that 54 % of women who had an ATRiDA BV-positive test outcome, but who were not clinically diagnosed with BV, had diverse anaerobic vaginal microbiota (asymptomatic vaginal dysbiosis).
The ATRiDA test is a sensitive method for the detection of BV but, given the high occurrence of asymptomatic vaginal dysbiosis, a positive test outcome should be interpreted together with clinical symptoms.
细菌性阴道病（BV）是一种常见的临床病症，其特征为有臭味的阴道分泌物、阴道瘙痒和/或烧灼感。当阴道乳杆菌减少并被多种厌氧菌取代时，就会发生 BV。我们评估了一种用于诊断 BV 的商业多重 PCR（ATRiDA）。
纳入有泌尿生殖系统症状的女性和因性传播感染（STI）而被通知的女性（不一定有症状）的宫颈阴道样本。临床 BV 诊断是从电子病历中获得的。ATRiDA 测试测量与总细菌负荷相关的阴道加德纳菌、阴道阿托波氏菌和乳杆菌的负荷。将 ATRiDA 测试结果与临床 BV 诊断和阴道微生物组组成进行比较，通过 16SrRNA 基因测序确定。
我们纳入了 185 名报告泌尿生殖系统症状的女性的样本，其中 81 名患有 BV，93 名因 STI 而被通知的女性中，有 16 名患有 BV。总体而言，与临床 BV 诊断相比，ATRiDA 测试表现出高灵敏度（96.9％）和中等特异性（70.2％）。阴性预测值很高（>97.3）。阳性预测值因研究组而异，在报告泌尿生殖系统症状的女性中最高（78.2％）。测序显示，54％的 ATRiDA BV 阳性测试结果但未被临床诊断为 BV 的女性存在多种厌氧阴道微生物群（无症状阴道菌群失调）。
ATRiDA 测试是一种检测 BV 的敏感方法，但鉴于无症状阴道菌群失调的高发生率，阳性测试结果应与临床症状一起解读。
