Comparison of Diagnostic Methods for Detection of Trichomonas vaginalis in Prediagnosed Vaginitis Cases and Its Association with Various Pathogens

Abstract

Parasitological diagnostic methods such as direct microscopy, staining examination and culturemethodsare frequently used in the diagnosis ofTrichomonasvaginalis(T. vaginalis).Though, nowadays, new diagnostic methods, especially DNA-based methods, are developing, enabling the simultaneous recognition of different pathogens.In our study,weevaluatedwhetherthe choice of multiplex polymerase chain reaction (PCR), in whichT. vaginalisand different pathogens can be detected,is be an alternativeto classical methods and to evaluate the possible coexistence of pathogens. In our study, swab samples taken during routine examination of 100 female patients who presented to Manisa Celal Bayar University and Manisa City Hospital Outpatient Clinics Obstetrics and Gynecology were evaluated.The presence ofT. vaginaliswas investigated in these samples by direct microscopy, Giemsa stain and culture.BesidesT. vaginalis, other possible agents were also investigated by real-time multiplex PCR method. At least one agent was detected in 85 (85%) of the 100 patient samples included in our study.T. vaginalis positivity was detected in 6 (6%)of thesamples by parasitological diagnosis methods and in 10 (10%)of thesamples by multiplex PCR.Additionally,with real-time multiplex PCR,Chlamydia trachomatisin 4 (4%),Neisseria gonorrhoeaein 3 (3%),Ureaplasma urealyticum/parvumin 68 (68%),Gardnerella vaginalisin 68 (68%) andHerpes simplex virus1/2 in 1 (1%) of thesamplepositivity was found.Mycoplasma genitalium, another agent examinedbymultiplex PCR, was not found positive inany sample.The Kappa value of theculture thatis a parasitological test and multiplex PCR forT. vaginalisshowed moderate agreement with 59.5%. It has been concluded that usingreal-time multiplex PCR method, which hashigh specificity and sensitivity, in addition to microscopy and culture methods in the diagnosis ofT. vaginalis, could contribute to the correct and effective treatment by detecting multiple infections.