PCR Detection ofHaemophilus ducreyi, Treponema pallidum, andMycoplasma genitalium

Abstract

This chapter outlines the need for, and application of, molecular tests for Haemophilus ducreyi, Treponema pallidum, and Mycoplasma genitalium, three sexually transmitted diseases (STDs) pathogens for which commercial molecular tests are not currently available. H. ducreyi and T. pallidum are the causative agents of chancroid and syphilis, respectively, which along with herpes simplex virus (HSV) are responsible for the majority of genital ulcer disease (GUD) cases worldwide. The first PCR assays specific for M. genitalium were simultaneously developed in two laboratories and provided a means of detecting M. genitalium in patient specimens. The authors await further application of these quantitative PCR assays to assess other aspects of M. genitalium infection such as the association of M. genitalium burden in cervical, urine, and vaginal specimens and their association with signs and symptoms of infection at these sites. Unlike most PCRs, TMA assays target rRNA, which is present in multiple copies per cell, thus potentially increasing both the analytical and the clinical sensitivity of M. genitalium detection. Similarly, PCR and TMA assays for M. genitalium have allowed studies defining the association of this emerging pathogen with reproductive tract disease in both men and women. Undoubtedly other, previously uncultivated organisms colonizing the reproductive tract will be detected in the future. Their identification and the subsequent development of specific PCR assays and treatment regimens will expand one's knowledge of reproductive tract pathogens.