RESEARCH – September 2014

Relevance of molecular complex diagnostics for genital tract infections

Authors: Paul Naaber, Kaspar Ratnik, Kristi Raud, Epp Sepp, Airi Põder

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Background. Molecular complex diagnostics enables to detect several disease associated microorganisms together from one sample. Usage of molecular complex diagnostics has been shown to improve the sensitivity of testing and to detect more co-infections as compared to traditional methods.

Aim. The aim of our study was to evaluate (1) the current usage of molecular tests for diagnosis of genital tract infections and (2) the inf luence of molecular complex diagnostics on the quality of diagnosis and on the statistics of sexually transmitted infections.

Methods. All genital tract samples sent to Quattromed HTI Laboratories for testing of any sexually transmitted infection in January 2013 were included. _ ese samples (n = 4985) were investigated by the Luminex xMAP panel for N. gonorrhoeae, C. trachomatis, C. trachomatis LGV, T. vaginalis, M. genitalium,M. hominis, U. urealyticum and U. parvum.

Results. Usually, genital samples were sent for detection of one (31%), two (22%) or three (20%) different obligate or opportunistic pathogens. Detection of C. Trachomatis (91% of the samples) was ordered most frequently. The prevalence of the inves- tigated microorganisms in our samples was the following:N. gonorrhoeae 0.2%, C. trachomatis 3.5%, T. vaginalis 0.5%,M. genitalium 1.2%, M. hominis 7.9%, U. urealyticum 7.7% andU. parvum 32%. The prevalence of a particular microorganisms was commonly similar in samples sent for detection of a particular organism and in samples sent for detection of some other organism. The only exception was C. Trachomatis, which we found significantly more frequently in samples sent for investigation of this pathogen. If we do not apply the multiplex diagnostics panel for all genital samples and test only ordered microorganisms, 40% of N. gonorrhoeae, 0.6% of C. trachomatis, 88% of T. vaginalis, and 48% of M. genitaliumcaused STLI cases will remain undiagnosed, according to our sample set.

Conclusions. Positivity percentages of particular disease associated microorganisms were not related to physician suspicion and order (except in the case of C. trachomatis) in the genital samples of patients suspected for genital tract infections. Usage of multiplex diagnostic panels increases signifi cantly the detection rate of some important sexually transmitted microorganisms, especially T. vaginalis and N. gonorrhoeae. _ us, it can improve the quality of management and the accuracy of statistics of several sexually transmitted infections.