[Contribution of qPCR to the diagnosis of cervico-vaginal infections at the Hôpital Principal de Dakar, Senegal].

OBJECTIVE

To determine the etiology of cervico-vaginal infections by cytobacteriology and the efficacy of qPCR for the diagnosis of sensitive strains such as and

METHODOLOGY

This prospective cross-sectional study was performed between January and September 2021 in 346 women who were examined for cervico-vaginal infection at the Hôpital Principal de Dakar (HPD). Cytobacteriological (direct examination, agar culture) and molecular analyses were performed.

RESULTS

Vaginal flora imbalances predominated, with a rate of 72.3%. The proportion of type IV vaginal flora was 46.5%. Of the 199 germs isolated, (25.1%), (17.6%), (7.8%), (6.6%) and nonalbicans (5.5%) were the main pathogens responsible for cervico-vaginal infections in patients. Among women tested for mycoplasma, was identified in 43.3% of patients. Among those tested for the proportion of infected women was low (4%). The prevalence of was higher in pregnant women (38.3%) than in nonpregnant women (19.2%). strains showed high resistance to certain beta-lactam antibiotics (pristinamycin 100%, gentamycin 100%, ampicillin 92.5% and cefalotin 85.2%) and to a glycopeptide antibiotic (vancomycin 100%). The strain had good sensitivity to antibiotics except gentamycin (100%) and kanamycin (100%). The enterobacteria tested were all sensitive to phenicols, carbapenems, cephalosporins and aminoglycosides. However, showed high resistance to tetracycline. The different methods showed low prevalences of and so comparisons Test RapidChlamydia/qPCR for and culture/qPCR for N. were not possible. For on the other hand, qPCR was more advantageous than culture. The χ test showed a significant difference (Yates χ = 33.77 and p = 1) for the diagnosis of qPCR had a sensitivity of 40.7%, a specificity of 94%, and positive and negative predictive values of 36.7% and 94.9% respectively, as well as a kappa = 0.33.

CONCLUSION

The methods applied enabled us to identify the pathogens that cause cervicovaginal infections. The results suggest that qPCR may be an alternative, at least for the diagnosis of However, culture remains indispensable for studying antibiotic sensitivity. In order to improve patient care, molecular techniques need to be integrated into the HPD testing toolbox. To broaden the repertoire of pathogens to be diagnosed by qPCR, targeted comparison studies will be needed to increase the probability of encountering infected individuals.