阴道毛滴虫：在印度南部农村维洛尔实施内部 PCR 时引物的比较。
Trichomonas vaginalis: comparison of primers for implementation as an in-house PCR in rural Vellore, South India.
机构信息
Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Rural Unit for Health and Social Affairs (RUHSA), Christian Medical College, Vellore, Tamil Nadu, India.
出版信息
BMC Infect Dis. 2024 Sep 27;24(1):1039. doi: 10.1186/s12879-024-09619-z.
BACKGROUND
Trichomonas vaginalis (TV) accounts for the highest burden of curable, non-viral sexually transmitted infections worldwide. Prevalence in India ranges from 0.4 to 27.4% in women and 0.0-5.6% in men. In 2015, the prevalence of TV among pregnant women of rural Vellore was 3.11% using Sekisui OSOM Trichomonas test and culture methods. Molecular methods are the most sensitive, rapid diagnostic tool for Sexually Transmitted Infection's (STI) albeit cost hinders implementation of commercial platforms. To determine a sensitive, sustainable molecular method, we compared three targets (Adhesin AP65, cytoskeleton Beta-tubulin BTUB 9/2 and TVK 3/7) with the highest published diagnostic accuracy against microscopy, culture and Real Time PCR (RT- PCR).
MATERIALS & METHODS: Six-hundred adult, sexually active women attending the Obstetrics-Gynaecology rural out-patient clinic the Rural Unit for Health and Social Affairs (RUHSA) from July 2020 - February 2021 were enrolled. A vaginal lateral and posterior fornix specimen was inoculated, onsite, into Biomed InPouch TV culture and smeared onto a slide for fluorescence microscopy using Acridine orange. A flocked nylon swab specimen for PCR was used to determine the sensitivities of the Adhesin AP65, cytoskeleton Beta-tubulin BTUB 9/2 and TVK 3/7 gene targets. Seegene Allplex™ STI Essential Assay, S.Korea was used to confirm TV positives.
RESULTS
Nine specimens (9/600, 1.5%) were positive for TV. There was a 100% correlation between Biomed InPouch TV culture, PCR with TVK 3/7 and RT-PCR while a correlation of 66.6% with BTUB 9/2 and AP65 gene targets. Clinically, 77.7% (n = 7) presented with white-greenish discharge per vagina, 11% (n = 1) with infertility, 22.2% (n = 2) were asymptomatic. Eight of nine patients (88.9%) had co-infections with other bacterial STIs. Prevalence of TV coinfection with Neisseria gonorrhoea was 1.1%.
CONCLUSION
Current hospital-based prevalence of TV in rural Vellore was 1.5%. Repetitive DNA target TVK 3/7 was more sensitive than AP65 and BTUB 9/2 primers.
背景
阴道毛滴虫（TV）是全球可治愈的非病毒性性传播感染中负担最重的一种。在印度，女性中的患病率为 0.4%至 27.4%，男性中为 0.0%至 5.6%。2015 年，在农村 Vellore 的孕妇中，使用 Sekisui OSOM 阴道毛滴虫检测和培养方法，TV 的患病率为 3.11%。分子方法是最敏感、快速的性传播感染（STI）诊断工具，尽管成本阻碍了商业平台的实施。为了确定一种敏感、可持续的分子方法，我们比较了三种靶标（黏附素 AP65、细胞骨架β-微管蛋白 BTUB 9/2 和 TVK 3/7）与针对显微镜、培养和实时 PCR（RT-PCR）的最高已发表诊断准确性。
材料与方法
2020 年 7 月至 2021 年 2 月，共有 600 名在农村妇产科门诊就诊的成年、有性生活的妇女参与了这项研究。从阴道侧壁和后穹隆采集阴道外侧和后穹隆标本，现场接种 Biomed InPouch TV 培养物，并在玻片上用吖啶橙进行荧光显微镜检查。使用尼龙植绒拭子标本进行 PCR，以确定黏附素 AP65、细胞骨架β-微管蛋白 BTUB 9/2 和 TVK 3/7 基因靶标的敏感性。使用韩国的 Seegene Allplex™ STI 基本检测法来确认 TV 阳性。
结果
9 份标本（9/600，1.5%）为 TV 阳性。Biomed InPouch TV 培养物、PCR 与 TVK 3/7 以及 RT-PCR 之间存在 100%的相关性，而与 BTUB 9/2 和 AP65 基因靶标之间的相关性为 66.6%。临床上，77.7%（n=7）的患者阴道有白色-绿色分泌物，11%（n=1）有不孕，22.2%（n=2）无症状。9 例患者中有 8 例（88.9%）合并其他细菌性 STI 感染。TV 与淋病奈瑟菌的合并感染率为 1.1%。
结论
目前农村 Vellore 的 TV 医院患病率为 1.5%。重复 DNA 靶标 TVK 3/7 比 AP65 和 BTUB 9/2 引物更敏感。
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