Molecular Diagnosis of Vaginitis: Comparing Quantitative PCR and Microbiome Profiling Approaches to Current Microscopy Scoring

The largest comprehensive study on diagnostic methods for infectious vaginitis.*

Vaginitis is often diagnosed by microscopy and limited to testing for bacterial vaginosis (BV), vulvovaginal candidiasis, and trichomoniasis. Approximately 10% of vaginal swabs are negative but designated “altered flora” by BV Nugent score, leaving clinicians unsure how to treat patients. Accurate and comprehensive vaginitis diagnostics are needed to direct treatment and reduce risks of recurrent or more severe infections.

Keywords

16s rRNA gene, Nugent score, aerobic vaginitis, bacterial vaginosis, dysbiosis, microbiome, microscopy, molecular diagnostics, qPCR

Discussion

*At the time of publishing, to the best of our knowledge, this is the largest comprehensive study on diagnostic methods for infectious vaginitis. Our study compared the microscopic results for BV and Candida with an extensive qPCR commercial assay that included panels for BV, AV, Candida, and STI pathogens. We also conducted 16S rRNA gene profiling to explore differentiating patterns in the bacterial microflora categorized by the qPCR results. Our data showed that the comprehensive qPCR assay was able to confirm or resolve BV status with higher resolution than the microscopy plus Nugent scoring and also provide alternative etiologies.

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Contributors

Tara Lynch,a,b Gisele Peirano,b Tracie Lloyd,b Ron Read,c,e Julia Carter,d Angel Chu,c,e Jeffrey A. Shaman,f Joseph P. Jarvis,f Evan Diamond,g Umer Zeeshan Ijaz,h Deirdre Churcha,b,c

aDepartment of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

bDivision of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada

cDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada

dSexual and Reproductive Health, Alberta Health Services, Calgary, Alberta, Canada

eCalgary Sexual Transmitted Infections Clinic, Alberta Health Services, Calgary, Alberta, Canada

fCoriell Life Sciences, Philadelphia, Pennsylvania, USA

gThermo Fisher Scientific, San Francisco, California, USA

hSchool of Engineering, Oakfield Avenue, University of Glasgow, Glasgow, United Kingdom

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    Last Updated: October 16, 2020