Wet Mount Microscopy Research Articles

Comparison of APTIMA Trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women

We evaluated the performance characteristics of APTIMA Trichomonas vaginalis (ATV) transcription-mediated amplification (TMA) for diagnosis of T vaginalis (TV) infection from female vaginal swab, endocervical swab, and urine specimens and from male urethral swab and urine specimens. Performance of ATV TMA was compared with wet mount microscopy, culture, and polymerase chain reaction (PCR). In all, 296 female and 298 male subjects who attended the Jefferson County Health Department sexually transmitted diseases clinic were enrolled in the study and provided specimens for each test. Results were analyzed using 3 interpretative algorithms. For women, vaginal swab ATV TMA was significantly more sensitive than wet mount or culture. In male subjects, urethral swab ATV TMA was significantly more sensitive than culture or PCR. ATV TMA provides a sensitive, commercially available nucleic acid amplification test for improved diagnosis of TV in male and female patients.

Sexually Transmitted Infections and Risk Factors for Gonorrhea and Chlamydia in Female Sex Workers in Soc Trang, Vietnam

To determine the prevalence of selected STIs and correlates of chlamydia (CT) and gonorrhea (GC) infection among (FSWs) in Soc Trang province, Vietnam. Four hundred and six FSWs in Soc Trang province participated in a cross-sectional study between May and August, 2003. The study subjects were interviewed to obtain information about socio-demographic and behavioral characteristics and gynecologic and STI history, using a standardized interview. They underwent a physical examination during which cervical swabs were collected for GC and CT testing by polymerase chain reaction (PCR). Vaginal wet mount microscopy was performed to detect candidiasis and trichomoniasis (TV), and blood was drawn for testing for syphilis using rapid plasma reagin (RPR)+ Treponema pallidum hemagglutination assay (TPHA). Univariate and multivariate analyses were used to assess the associations of GC, CT, and GC/CT with selected variables. Prevalences were 14.9% for GC, 48.4% for CT, 54.9% for GC/CT, 3.8% for syphilis, 8.9% for trichomoniasis, and 12.2% for candidiasis. Increased risk for CT was associated with sex work for more than 6 months (aOR = 2.40, 95% CI: 0.99-5.82), receiving $4 US or less per sexual transaction (aOR = 1.91, 95% CI 1.13-3.23), and ever having terminated a pregnancy (aOR = 1.68, 95% CI 1.00-2.82). Reduced likelihood of CT was associated with older age (aOR = 0.96, 95% CI: 0.93-1.00) and ever having douched in the past month (aOR = 0.60, 95% CI 0.36-1.00). Only ever douching in the past month was associated with decreased risk for GC (aOR = 0.47, 95% CI 0.25-0.87). Higher likelihood of GC/CT was associated with having more than 4 clients per month (OR = 2.35, 95% CI 1.02-5.41) and receiving $4 US or less per sexual transaction (aOR = 1.74, 95% CI 1.04-2.93). The prevalence of GC/CT is high amongst FSWs in Soc Trang. Therefore, periodic presumptive treatment (PPT) for cervicitis, together with World Health Organization-recommended periodic syndromic sexually transmitted disease management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program for FSWs should be strengthened, with special consideration of the correlates observed in this study.

Individualized decreasing-dose maintenance fluconazole regimen for recurrent vulvovaginal candidiasis (ReCiDiF trial)

Although many women with recurrent vulvovaginal candidiasis initially benefit from prophylactic intermittent treatment with antimycotics, most of them experience relapse after cessation of therapy, and often they return to the pretreatment recurrence rate. The purpose of this study was to demonstrate the efficacy and safety of an individualized, degressive, prophylactic regimen in 136 women with recurrent vulvovaginal candidiasis. After an induction dose of 600 mg fluconazole during the first week, 117 women started maintenance therapy: 200 mg fluconazole weekly for 2 months, followed by 200 mg biweekly for 4 months, and 200 mg monthly for 6 months, according to their individual response to therapy. All women were tested for recurrences monthly with wet mount microscopy and vaginal culture during the first 6 months and bimonthly during the next 6 months. Patients were allowed to move on to the next level of maintenance therapy only if they were symptom free and microscopy and culture negative. Of the women who were cured successfully after the induction phase, 101 women (90%) were disease-free after 6 months of maintenance therapy with this degressive regimen, and 80 women (77%) were disease-free after 1 year. The weekly incidence of the first clinical relapse was 0.5% during any period of the maintenance phase, and the rate of all new relapses, which included evidence of mycologic or microscopic colonization, was 1% per week. Women who experienced several relapses (poor responders) had experienced more relapses before entering the study compared with the optimal responders (odds ratio, 4.9; 95% CI,1.8-13.7; P = .002), experienced the disease for a longer period of time (6.5 vs 3.7 years; P = .06), and harbored significantly more Candida non-albicans during maintenance therapy (P = .001). No serious side-effects were noted. Individualized, degressive, prophylactic maintenance therapy with oral fluconazole is an efficient treatment regimen to prevent clinical relapses in women with recurrent vulvovaginal candidiasis.

Cervical fluid cytokines in pregnant women: Relation to vaginal wet mount findings and polymorphonuclear leukocyte counts

Objective The purpose of the study was to measure and compare concentrations of IFN-γ, IL-8, IL-10 and IL-12 in cervical fluids of pregnant women with normal and pathologic microscopic findings of vaginal wet mount. Study design Vaginal samples were obtained from 100 pregnant women (22–32 weeks of gestation) without signs and symptoms of preterm labour (PTL), selected on the basis of the microscopic examination of vaginal wet mounts. Cytokine (IFN-γ, IL-8, IL-10 and IL-12) concentrations were measured in cervical fluids by an enzyme-linked immunosorbent assay. Results The cytokines were found in cervical fluids of the majority of pregnant women, with IFN-γ and IL-8 detected in all samples. Concentrations of IL-8 were significantly higher in pregnant women with pathologic findings on vaginal wet mount, including elevated polymorphonuclear (PMN) cell counts. Conclusion A significant correlation between microscopic findings and cervical fluid IL-8 concentrations may make vaginal wet mount microscopy a useful tool for identification of patients with cervicovaginal inflammation, which is considered a risk factor for spontaneous preterm delivery.

Trichomonas vaginalisInfection: Can We Afford to Do Nothing?

<i>Trichomonas vaginalis</i>Infection: Can We Afford to Do Nothing?

Failure of Nitazoxanide to Cure Trichomoniasis in Three Women

Failure of Nitazoxanide to Cure Trichomoniasis in Three Women

Epidemiology of Trichomonas vaginalis among Women in Lagos Metropolis, Nigeria

A total of 544 women outpatients comprising 320 and 224 from Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos and Military Hospital, Yaba, Lagos, respectively, were examined for Trichomonas vaginalis infection. Both wet mount microscopy and Giemsa staining technique were used. A prevalence of 3.3% was recorded from the 544 women using both methods, 5.4% in the Military Hospital and 1.9% from LUTH. The difference in prevalence was statistically significant using Chi-square test analysis (p<0.05). Age group 21-30 years had the highest prevalence of 1.8%; A higher prevalence of 2.9% was recorded among married women compared to 0.4% prevalence in unmarried women. About one-fifth of the infected individuals were asymptomatic. Symptomatic patients had characteristic symptoms such as greenish yellow vaginal discharge (33.3%), itching/pruritus (22.2%) and malodorous discharge (11.1%) Water system toilet users had the highest prevalence of T. vaginalis infection compared to others using different types of toilet facilities. About 1% of T. vaginalis infection were mixed with Candida albicans. Single infections of Candida albicans was recorded in 33.6% of the total population examined. Sexual promiscuity, age and socio-economic status were important contributory factors in the pattern of infection amongst studied population.

Real-time PCRs for detection of Trichomonas vaginalis β-tubulin and 18S rRNA genes in female genital specimens

Trichomonas vaginalis is the cause of one of the most common types of vaginitis, trichomoniasis. The incidence of trichomoniasis in developed countries has decreased substantially during the past decade, but high prevalence of this disease can still be found in rural and remote areas of Australia. Clinical manifestations of symptomatic women are generally non-specific, but include vaginal discharge, vaginitis and irritation. T. vaginalis infection has also been linked to the increased risk of human immunodeficiency virus transmission. Current diagnosis of T. vaginalis relies on the visualization of motile organisms in a wet-mount preparation. Culture is used mainly in reference laboratories. The latter two methods require viable organisms and would not be suitable for use where transportation of specimens can be delayed. Two real-time fluorescence resonance energy transfer (FRET) hybridization probe PCR assays were used in this study to test for T. vaginalis DNA, targeting the beta-tubulin and 18S rRNA genes. We tested 500 randomly selected female patients, in an STD setting, for T. vaginalis DNA. The FRET PCRs targeting the beta-tubulin gene and the 18S rRNA gene detected 96 % (85/89) and 100 % (89/89) , respectively, of the positive specimens (first-void urine sample or genital swabs). Wet-mount microscopy was performed on 76 of these PCR-positive specimens and showed a sensitivity of 38 % (29/76). The prevalence, by PCR, of trichomoniasis was 18 % in this study. The two real-time PCRs developed in this study, targeting different genetic regions of the organism, provide a rapid, sensitive and specific diagnosis of T. vaginalis infection.

First Notification of Positive Blood Cultures and the High Accuracy of the Gram Stain Report

When blood cultures turn positive, the attending physicians are usually notified immediately about Gram stain findings. However, information on the accuracy of Gram staining is very limited. We examined the accuracy of preliminary blood culture reports provided by a regional laboratory in an observational study including the years 1996, 2000 to 2001, and 2003. We used data from computer files and technicians' laboratory notes. The study was restricted to cultures with one morphological type. Using cultural identification as a reference, we estimated the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) for the following defined morphological groups: gram-positive cocci in clusters, gram-positive cocci in chains or diplococci, gram-positive rods, gram-negative cocci, gram-negative rods, and yeasts. We further evaluated the Gram stain and wet mount findings for the most frequent bacterial species/groups. We obtained 5,893 positive blood cultures and the following results for the defined groups: sensitivity, range of 91.3 to 99.7%; specificity, 98.9 to 100%; PPV, 94.6 to 100%; and NPV, 99.0 to 100%. The sensitivity for the most frequent species was in the range 91.3 to 100%, with nonhemolytic streptococci having the lowest value (sensitivity, 91.3%; 95% confidence interval, 86.2 to 94.9%). Wet mount reports were less accurate (sensitivity of 30 to 70% for species with peritrichous motility), and Enterobacteriaceae (notably Salmonella spp.) accounted for 25% of the reports stating polar motility. In conclusion, we demonstrated a high accuracy of Gram stain reports, whereas wet mount microscopy was generally less accurate.

Risk Factors and Prevalence of HIV and Sexually Transmitted Infections Among Low-Income Female Commercial Sex Workers in Mongolia

Mongolia has very low HIV prevalence despite high rates of sexually transmitted infections (STIs). Low-income female sex workers (FSWs) may be at high risk for acquiring and spreading the disease in Mongolia. The goal of this study was to assess the prevalence and risk factors associated with the acquisition of HIV, syphilis, gonorrhea, and trichomoniasis among low-income female commercial sex workers in 3 urban centers in Mongolia. One hundred seventy-nine low-income FSWs were tested for HIV (enzyme immunoassay) and 132 were tested for syphilis (Treponema pallidum hemagglutination-confirmed), gonorrhea (Gram stain and culture), and trichomoniasis (wet mount microscopy). Questionnaires detailing socioeconomic characteristics, sexual behaviors, drug and alcohol use, general health, and STI/HIV knowledge were completed by 149 women. No HIV infections were found in 179 women. Of 132 women, 57 (43%), 18 (14%), and 37 (28%) tested positive for syphilis, gonorrhea, and trichomonas, respectively; 88 (67%) tested positive for one or more STIs and 22 (17%) were multiply infected. Socioeconomic factors were correlated to reported condom use and infection status. Low-income FSWs in Mongolia represent a unique population of very high-risk individuals with very low rates of HIV infection. Interventions targeting this population represent a unique opportunity to prevent a potentially rapid increase of HIV infection in urban Mongolia.

Meningitis due toPrototheca wickerhamii: rare case in China

A rare case of Prototheca wickerhamii meningitis is reported in a patient without any underlying immunodeficient condition. Wet-mount microscopy and culture of cerebral spinal fluid specimens, along with temperature resistance, cycloheximide tolerance, carbohydrates assimilation, including API 20C AUX tests of the isolated etiologic agent were performed. In addition, transmission and scanning electron microscopy studies and in vitro antifungal susceptibility tests were conducted. Through the combination of these investigations, the isolate was identified as P. wickerhamii and the patient was successfully treated with intravenous amphotericin B and itraconazole. This is the first detailed report of meningitis caused by P. wickerhamii in China.

Trichomonas vaginalisInfection in Male Sexual Partners: Implications for Diagnosis, Treatment, and Prevention

Trichomonas vaginalis causes a common sexually transmitted infection (STI) in women, yet trichomoniasis in male sexual partners is not well recognized. Nucleic acid amplification tests can increase detection of T. vaginalis in men compared with culture. We conducted a prospective, multicenter study to evaluate T. vaginalis infection among male partners of women with trichomoniasis and factors associated with infection by recruiting patients from 3 public clinics in the United States. Male partners were tested for concordant T. vaginalis infection, defined as a positive urethral culture, urine culture, or urine polymerase chain reaction (PCR) result. A subset of men also provided a semen sample for T. vaginalis culture and PCR. Factors associated with concordant infection were determined from bivariable and multivariable analyses. We enrolled 540 women with trichomoniasis (diagnosed using wet mount microscopy and/or culture) and 261 (48.4%) of their male partners. T. vaginalis infection was detected in 177 (71.7%) of 256 male partners (95% confidence interval [CI], 66.0%-77.3%), of whom 136 (77.3%) were asymptomatic. A vaginal pH of >4.5 in a woman was independently associated with infection in the male partner (adjusted odds ratio, 2.5; 95% CI, 1.0-6.3). Younger male age (20-29 and 30-39 years) was also found to be an independent risk factor for concordant trichomoniasis. The majority of male partners of women with trichomoniasis were infected; however, few factors predicted infection. T. vaginalis causes a highly prevalent STI, necessitating vastly improved partner management, application of sensitive nucleic-acid based testing, and better clinical recognition.

Trichomonas vaginalis detection using real-time TaqMan PCR

1978 women and 93 men, all suspected of having a Trichomonas vaginalis infection, were tested for the presence of T. vaginalis by real-time PCR using the T. vaginalis-specific 2-kb repeated sequence, and by direct microscopy and culture. 40 samples were positive by T. vaginalis real-time PCR and 27 were positive by wet mount microscopy, either direct or after culture. All samples positive by direct microscopy of culture were also positive by real-time PCR. Of the 13 samples which were real-time PCR positive but negative by direct microscopy and culture 11 were confirmed by another T. vaginalis real-time PCR based on the beta tubulin gene. Only 2 samples (0.1%) showed inhibition in the PCR. The prevalence of T. vaginalis infection in the female patients was 1.8%. The sensitivity, specificity, positive and negative predictive values of the real-time PCR were 100%, 99.9%, 95% and 100%, respectively. The same test characteristics for the combined conventional T. vaginalis detection methods (microscopy + culture) were 71%, 100%, 100% and 99%, respectively. Therefore, real-time PCR is the method of choice for the diagnosis of T. vaginalis infection.

Detection of Bacterial Vaginosis, Trichomonas vaginalis Infection, and Vaginal Candida Infection: A Comparative Study of Methods of Extracting Exudates, with and without a Speculum, during Pregnancy

To compare the collection of vaginal exudates with and without the use of a speculum to diagnose vaginal infections. We examined 45 patients with vaginal discharge. Two vaginal swabs were taken, one with and the other without a speculum. Both were examined by wet mount microscopy to detect bacterial vaginosis (BV), Trichomonas vaginalis, and the presence of blastospores with or without pseudomycelium. A total of 90.9% of patients whose vaginal exudates were negative for BV when extracted with a speculum were also negative in the swab taken without a speculum. In the case of BV-positive exudates using a speculum, the correspondence was 90.5% with the swabs taken without a speculum. Among those exudates obtained with a speculum that were negative for Candida, 92.6% of those obtained without a speculum tested negative. In patients with pseudomycelium, when a speculum was used, 100% also presented a diagnosis of pseudomycelium from the swabs taken without a speculum. A concordance test between the techniques involving the use or nonuse of a speculum was performed for each of the diagnoses showed a good agreement according to the observed Kappa statistics (0.8467 and 0.8396 for BV and Candida, respectively). A very good agreement between the results obtained with and without the use of a speculum was observed. Swabbing without the use of a speculum is especially convenient for pregnant women who require frequent testing for these types of infections during their pregnancies.

Aerobic vaginitis: Abnormal vaginal flora entity that is distinct from bacterial vaginosis

Due to shortcomings in the current systems of classifying pathology of the vaginal bacterial flora we aimed to define a new entity of abnormal vaginal flora: aerobic vaginitis. Six hundred thirty-one women were studied for clinical signs of vaginitis during routine prenatal visits and vaginitis clinic visits in the University Hospital Gasthuisberg, Leuven, Belgium. Samples were taken for fresh wet mount microscopy of vaginal fluid and for vaginal cultures. In order to study the difference between aerobic vaginitis and bacterial vaginosis, lactate and succinate levels were measured in vaginal rinsing fluids, and 243 samples were tested for cytokine levels. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis (BV). Aerobic vaginitis (AV) was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and positive for vaginal leukocytes (plus their granular aspect). We conclude that AV is a condition of abnormal vaginal flora that differs from BV. Genital complaints are those of a real vaginitis (red inflammation, yellow discharge, vaginal dyspareunia). Group B streptococci, Escherichia coli , Staphylococcus aureus and Trichomonas vaginalis are frequently cultured. As in BV, vaginal lactate concentration is severely depressed in patients with AV. Unlike patients with BV, vaginal succinate is not produced in AV. Also in contrast to BV, AV produces a host immune response that leads to high production of interleukin-6, interleukin-1-β and leukemia inhibitory factor in the vaginal fluid. Therefore, AV is an entity describing vaginitis associated with aerobic microorganisms, mainly group B streptococci and E. coli . Its characteristics are different from those of BV and elicit an important host response. In theory, AV is a better candidate than BV to be involved in the causation of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery.

The diagnosis of azoospermia depends on the force of centrifugation

To determine the centrifugal force required to pellet sperm. Prospective, in vitro study. Tertiary referral center. Men undergoing semen processing or postvasectomy semen analyses. In Phase I, postvasectomy semen samples were centrifuged at 600 x g, and the pellets were examined. Supernatants from samples with no visible sperm underwent repeat centrifugation at 1,000 x g; the supernatants were removed and centrifuged at 3,000 x g. Pellets from both centrifugations were examined. Phase II examined nonazoospermic semen that was divided into 3 aliquots and centrifuged at 500, 1,000, and 3,000 x g. The supernatants were examined for the presence of sperm. Sperm presence in centrifuged pellets or seminal supernatant. Phase I: After centrifugation at 1,000 x g and 3,000 x g, sperm were noted in 12% and 0% of samples, respectively. Phase II: Sperm were noted in the supernatant in 100% of samples subjected to 500 x g and 1,000 x g, and in 92% of samples subjected to 3,000 x g centrifugation. If sperm are in the seminal plasma, they will also be present in the pellet following centrifugation at a force of 1,000 x g or greater. Semen samples that appear azoospermic upon initial wet mount microscopy should be centrifuged at a minimum of 1,000 x g for 15 minutes.

Use of an Immunochromatographic Assay for Rapid Detection of Trichomonas vaginalis in Vaginal Specimens

Trichomonas vaginalis infection is estimated to be the most widely prevalent nonviral sexually transmitted infection in the world. Wet-mount microscopy is the most common diagnostic method, although it is less sensitive than culture. The OSOM Trichomonas Rapid Test (Genzyme Diagnostics, Cambridge, Mass.) (referred to here as OSOM) is a new point-of-care diagnostic assay for T. vaginalis that uses an immunochromatographic capillary flow (dipstick) assay and provides results in 10 min. The purpose of this study was to determine the test characteristics of OSOM compared to those of a composite reference standard (CRS) comprised of wet-mount microscopy and T. vaginalis culture. This multicenter cross-sectional study enrolled sexually active women > or =18 years of age who presented with symptoms of vaginitis, exposure to T. vaginalis, or multiple sexual partners. Vaginal-swab specimens were obtained for T. vaginalis culture, wet mount, and rapid testing. The prevalence of T. vaginalis in this sample was 23.4% (105 of 449) by the CRS. The sensitivity and specificity of OSOM vaginal-swab specimens were 83.3 and 98.8%, respectively, while wet mount had a sensitivity and specificity of 71.4 and 100%, respectively, compared to the CRS. OSOM performed significantly better than wet mount (P = 0.004) and detected T. vaginalis in samples that required 48 to 72 h of incubation prior to becoming culture positive. The performance of the rapid test was not affected by the presence of coinfections with chlamydia and gonorrhea. The OSOM Trichomonas Rapid Test is a simple, objective test that can be expected to improve the diagnosis of T. vaginalis, especially where microscopy and culture are unavailable.

Prevalence of baculoviruses in spruce budworm (Lepidoptera: Tortricidae) populations in New Brunswick

AbstractOutbreak and declining populations of spruce budworm (Choristoneura fumiferana (Clem.)) were sampled extensively at three locations in New Brunswick, Canada, between 1982 and 1992 and were examined for the prevalence of granulosis and nuclear polyhedrosis viruses (Baculoviridae). Larvae, pupae, and adults were collected using a variety of methods. Spruce budworm nuclear polyhedrosis virus (CfMNPV) genomic DNA probes and wet-mount light microscopy were used to determine CfMNPV prevalence in 50 274 juvenile spruce budworms. Spruce budworm granulosis virus (ChfuGV) genomic DNA probes were used to determine the prevalence of ChfuGV in 25 703 of these same samples. The prevalence of both viruses was low, with ChfuGV and CfMNPV not found in more than 15% and 2%, respectively, of samples in any collection in a given year. Prevalence of ChfuGV was greatest in mid- to late June in sixth-instar larvae. Each virus was detected in only two of 2177 female moths and in none of the 420 male moths examined. In the entire collection, cytoplasmic polyhedrosis virus (Reoviridae) was detected in only two budworm larvae and entomopoxvirus (Poxviridae) was not detected in any.

PREVALENCE OF TRICHOMONAS VAGINALIS AMONG THE SEXUAL PARTNERS OF WOMEN WITH TRICHOMONIASIS IN IBADAN, NIGERIA

This study was conducted to determine the prevalence of Trichomonas vaginalis among the sexual partners of women with Trichomoniasis. While 103 female patients were found to have T. vaginalis using both direct wet mount microscopy and culture, only 44(42.7%) male contacts reported for screening. Trichomonas vaginalis was isolated from 20(45.5%) of the 44 male contact investigated, whilst there was no laboratory evidence of the agent in 13(29.6%) of the study group. Amongst the 60 control subjects, T. vaginalis was recovered from 7(11.7%) of them. The difference in the occurrence of T. vaginalis between the patients and the control group was highly statistically significant (p Key Words: Trichomonas vaginalis, Prevalence, Sexual Partners, Trichomoniasis, Ibadan. (Af J Clinical & Exp Microbiology: 2003 4(2): 107-115)

Validation of a urine-based PCR-enzyme-linked immunosorbent assay for use in clinical research settings to detect Trichomonas vaginalis in men.

Trichomonas vaginalis infection is highly prevalent worldwide and is associated with urethritis, prostatitis, and urethral strictures in men. However, the natural history and importance of T. vaginalis in men are poorly understood, in part because of difficulties in diagnosing infection. Traditional detection methods rely on culture and wet-mount microscopy, which can be insensitive and time consuming. Urethral swabs are commonly used to detect T. vaginalis in men, but discomfort from specimen collection is a barrier to large studies. One thousand two hundred twenty-five Malawian men attending sexually transmitted disease and dermatology clinics were enrolled in this cross-sectional study to validate detection by urine-based PCR-enzyme-linked immunosorbent assay (ELISA) with urine and urethral swab culture as the reference standard. This assay for detection of amplified T. vaginalis DNA in first-catch urine (< or = 30 ml) performed with a sensitivity of 92.7%, a specificity of 88.6%, and an adjusted specificity of 95.2% compared to culture of urethral swabs or urine sediment. For clinical research settings in which urethral swabs are not available and culture is not feasible, the urine-based PCR-ELISA may be useful for detection of trichomoniasis in men.