Urethral Trichomonas vaginalis infection and HIV-1 transmission.
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The acridine orange test for detection of Trichomonas vaginalis in smears has been adapted for delayed examination of specimens. Mailed-in slides stained by acridine orange were compared with on-site wet mounts; the acridine orange test detected 96% of all positives, whereas only 76% were detected by wet mounts. In a similar comparison with Papanicolaou smears, the acridine orange test detected 89% as compared with 67% detected by Papanicolaou smears.
BACKGROUND: Substance abuse treatment centers provide an opportunity to offer sexually transmitted infection (STI) screening to a high-risk and hard-to-reach population. GOAL: The goal was to assess STI prevalence, risk factors, and acceptability of STI screening among females at substance abuse treatment centers with use of urine testing by ligase chain reaction and self-collected swab specimens. STUDY DESIGN: Adult, female inpatients were offered free testing and treatment for chlamydia infection, gonorrhea, and trichomonas infection. Interviews were conducted to collect risk behavior data. RESULTS: Eighty-six percent of inpatients (180/209) accepted testing. Twenty-three percent (41/177) had an STI. Of those with an STI, 90% (37/41) had trichomonas infection. All 41 infected patients received treatment. Drug use before sex, exchange of sex for money/drugs, and any gynecological complaint were significantly associated with infection. Most women were uninsured (76%). Only 45% had undergone a medical examination in the past year. CONCLUSION: STI screening is highly acceptable among women in substance abuse treatment centers. Substance users are at high risk for STIs and may not otherwise receive medical care.
Trichomonas vaginalis infection is the most prevalent nonviral sexually transmitted disease (STD) in the world. A PCR test using vaginal swab samples for the detection of T. vaginalis was developed to add T. vaginalis infection to the growing list of STDs that can be detected by DNA amplification techniques. A primer set, BTUB 9/2, was designed to target a well-conserved region in the beta-tubulin genes of T. vaginalis. All strains (15 of 15) of T. vaginalis tested were successfully detected by PCR giving a single predicted product of 112 bp in gel electrophoresis. No such targeted product was amplified with DNA from Trichomonas tenax, Trichomonas gallinae, Chlamydia trachomatis, Neisseria gonorrhoeae, Giardia lamblia, Chilomastix sulcatus, Dientamoeba fragilis, and Entamoeba histolytica. An optimal analytical sensitivity of one T. vaginalis organism per PCR was achieved. Culture, performed with the Inpouch TV culture system, was examined daily with a light microscope to identify T. vaginalis. Twenty-three of 350 (6.6%) vaginal swab samples from women attending an army medical clinic were culture positive for T. vaginalis. Of these culture positive specimens, PCR detected 22 of 23 (96%) with primer set BTUB 9/2, and wet preparation detected only 12 of 23 (52%). Seventeen specimens were BTUB 9/2-PCR positive and culture negative. Ten of these discordant specimens were determined to be as true positive by PCR using primer sets TVA 5-1/6 and/or AP65 A/B, which target different regions in the T. vaginalis genome, and seven were determined to be false positive. The sensitivity of BTUB 9/2-PCR was 97% and the specificity was 98%. The sensitivities of culture and wet preparation were 70 and 36%, respectively. The diagnosis of T. vaginalis infection by PCR is a sensitive and specific method that could be incorporated into a joint strategy for the screening of multiple STDs by using molecular amplification methods.
A patient is described who developed signs and symptoms of ankylosing spondylitis after prostatitis due to Trichomonas vaginalis. Chronic prostatitis of unknown cause had previously been reported as being common in patients with ankylosing spondylitis. The observations in this case raise the possibility that T. vaginalis might play a role in the prostatitis and pathogenesis of ankylosing spondylitis in some patients.
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Concurrent estimation by high pressure liquid chromatography (HPLC) of the concentrations of metronidazole in plasma and vaginal content in 12 patients with infections due to Trichomonas vaginalis who did not respond to normal and high-dose treatment has shown that the two levels are closely related to each other and to the dose. Individual idiosyncrasies in absorption of drug from the gut lumen or in its transfer into the vaginal content are unlikely to be the cause of treatment failure.
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Aim of the study was to research familial occurrence of Trichomonas tenax and relationship between infection with the protozoan and both a state of parodontium and hygiene of oral cavity. The study involved 10 families (22 individuals). Trichomonas tenax was found in 16 patients. Simultaneously isolates of protozoans were examined with the methods of molecular biology. The study showed the dependence of infection with Trichomonas tenax on both bad hygiene of oral cavity and occurrence of pathological lesions in the paradontium.
This study evaluated the positive predictive values of factors associated with Gardnerella vaginalis, Candida albicans, and Trichomonas vaginalis for diagnosing vaginitis in a community-based population. One hundred ninety-six women with and without vaginal complaints were evaluated for historical factors, physical examination findings, and office laboratory results that were potentially associated with each of the three vaginal organisms. Extensive microbiological tests were performed to detect pathogenic organisms in the vagina and cervix. Gardnerella vaginalis was associated with findings of clue cells, gray or creamy vaginal discharge, amine ordor on application of potassium hydroxide solution to the discharge, pH greater than 5, and a history of more than six sexual partners. Candida albicans was associated with the presence of pseudohyphae or budding yeast on microscopic examination and the lack of clue cells. Current use of oral contraceptives and the recent use of antibiotics were not predictive of a Candida albicans infection. Trichomonas vaginalis was more common in patients presenting with symptoms, but otherwise was not predicted by the factors tested.
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OBJECTIVE: Trichomoniasis, caused by Trichomonas vaginalis, is a prevalent sexually transmitted infection associated with increased risk of HIV infection. An animal model of T. vaginalis infection would enable scientists to further investigate trichomoniasis. STUDY DESIGN: Seven macaques (4 test vs. 3 control) were enrolled in a 2-week pilot study. Eight additional animals participated in a 2-arm (T. vaginalis vs. sham inoculated) crossover study lasting 5 weeks before treatment. In all, 12 Macaca nemestrina monkeys were challenged with a single intravaginal inoculation of 6.6 to 7.1 x 10(5) trichomonads (ATCC 50148). Vaginal culture (InPouch TV), colposcopy, microbiology, pH, and cervical cytokines were assessed at baseline, day 2, and weekly thereafter. RESULTS: Ten of 12 challenged animals tested positive for trichomoniasis for 2 weeks or longer. One animal tested positive on days 2 and 7 but negative thereafter. Only one animal was not infected. Oral metronidazole treatment (35 mg/kg per day for 3 days) resolved infection in all animals. Trichomoniasis infection did not lead to shifts in vaginal microbiology or pH. CONCLUSIONS: A single T. vaginalis inoculation results in persistent infection in the pigtailed macaque.
We performed a prospective randomized study to compare the potential genotoxic effects of metronidazole and nalidixic acid which they are used in the treatment of Trichomonas vaginalis infection. 20 patients with Trichomonas vaginalis infections participated in this study. 14 patients with vaginal trichomoniasis were treated with therapeutic doses of metronidazole 250 mg 3 times/d and six patients were treated with nalidixic acid 400 mg twice a day for 10 d. The genotoxic potential of a variety of mutagenic and carcinogenic agents can be evaluated by sister-chromatid exchange (SCE) test as a rapid cytogenetic test. An increased number of exchanges in lymphocytes reflects the influence of mutagens. No significant difference was observed in the SCE frequency of metronidazole treated patient however, a statistically significant increase (P<0.05) after nalidixic acid treatment could be described. We conclude that in spite of wide use of nalidixic acid for Trichomonas vaginalis infection, because of its potential genotoxic effect its usage must be individualized especially for pregnant women and small babies.
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An immunochromatographic strip test, Xenostrip-Tv, was compared to wet mount and PCR for the diagnosis of Trichomonas vaginalis infection in women. Of 428 specimens tested, 54 (12.6%) were positive by an "expanded gold standard," defined as either a positive wet mount and PCR test with primers TVK3 and TVK7 and/or a positive PCR test confirmed by a second PCR assay with primers TVA5-1 and TVA6; 26 (6%) were positive by wet mount, and 36 (8.4%) were positive by Xenostrip-Tv test. Since the Xenostrip-Tv test is rapid and easy to perform and proved to be more sensitive than wet mount, it should be considered as an alternative to wet mount for point-of-care diagnosis of trichomoniasis, especially in settings where microscopy is impractical.