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. 2025 Jan 29;101(1):17-20.
doi: 10.1136/sextrans-2024-056263.

Comprehensive assessment of vaginal infections using a single swab

Barbara Van Der Pol  1 , Cheri Aycock  2 , Paula Dixon  2 , Salma Kodsi  3 , Sonia Paradis  3 , Edith Torres-Chavolla  3 , Valentin Parvu  3
Affiliations

Comprehensive assessment of vaginal infections using a single swab

Barbara Van Der Pol et al. Sex Transm Infect. .

Abstract

Background: The decision to use a particular test to diagnose patients presenting with symptoms of vaginitis and/or STI is based primarily on the prevailing standards of care in the clinic at which the patient evaluation takes place. As a result, laboratory testing of vaginal samples for these patients often involves either an STI or a vaginitis test, but rarely both options simultaneously, which complicates the diagnosis and management of concurrent infections.

Methods: Using de-identified remnant vaginal specimens from symptomatic patients previously tested for STI (Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV)) with the Becton Dickinson (BD) CTGCTV2 assay for BD MAX System, positivity for bacterial vaginosis (BV) and Candida spp (associated with vulvovaginal candidiasis (VVC)) were evaluated using the molecular-based BD MAX Vaginal Panel.

Findings: The rate of STI/BV co-infection was 79.4% (227/286) in this symptomatic population, while that of STI/VVC was 27.0% (77/285). Women diagnosed with any one of the three STIs tested had an OR 2.86 (95% CI, 1.99, 4.11; p<0.0001) for a concurrent BV infection and OR 0.96 (95% CI, 0.67, 1.37; p=0.8085) for infection with Candida species.

Conclusion: Our results suggest that women being tested for STI have a high prevalence of co-infection with BV and a lower, although appreciable, prevalence of co-infection with VVC. The detection of co-occurring vaginal infections can be facilitated by molecular testing using a single sample.

Keywords: DIAGNOSIS; INFECTION; Molecular Diagnostic Techniques; Vaginosis, Bacterial.

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Conflict of interest statement

Competing interests: BVDP: Author’s institution received funding from BD Life Sciences for the conduct of this study and has also received study funding from Abbott, Cepheid, Cue, Hologic, MagIC, Rheonix and Roche. BVDP receives consulting fees and/honoraria from Abbott Rapid Diagnostics and Roche Molecular. SK, SP, VP and ET-C are employees of BD and own BD shares. PD and CA: no conflicts of interest.

Figures

Figure 1
Figure 1. Venn diagrams depicting the co-occurrence of BV (diagram 1A) and Candida spp (diagram 1B) with CT and Neisseria gonorrhoeae. The specimens were initially tested for STI (CT, GC and TV) with the BD MAX CTGCTV2 assay and subsequently tested using the BD MAX Vaginal Panel to determine the concurrent positivity of those specimens for BV and Candida spp. TVa represents CTGCTV2 results. BV, bacterial vaginosis; CT, Chlamydia trachomatis; GC, Neisseria gonorrhoeae; TV, Trichomonas vaginalis; VVC, vulvovaginal candidiasis.
See this image and copyright information in PMC

References

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