Korean J Clin Microbiol.  2012 Sep;15(3):104-109. 10.5145/KJCM.2012.15.3.104.

Detection of Trichomonas vaginalis, Gardnerella vaginalis, and Candida Species in Affirm VPIII, Papanicolaou Smear Test and Gram Stain

• Kim KH
• Kim TH
• Lee JH
• Lee TJ
• Lee MK

• KMID: 1434168
• DOI: http://doi.org/10.5145/KJCM.2012.15.3.104

Abstract

BACKGROUND
Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms.
METHODS
A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively.
RESULTS
With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05).
CONCLUSION
The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.

Keyword

Affirm VPIII; Candida; Gardnerella vaginalis; Gram stain; Papanicolaou stain; Trichomonas vaginalis

MeSH Terms

Candida
Candidiasis
Chimera
DNA
Female
Gardnerella
Gardnerella vaginalis
Humans
Trichomonas
Trichomonas Infections
Trichomonas vaginalis
Vaginal Smears
Vaginitis
Vaginosis, Bacterial
DNA

Figure

• 

  Fig. 1 An Affirm VPIII Microbial Identification Test Card for 4 patient samples showing a positive result for Trichomonas vaginalis (A), Gardnerella vaginalis (B), Candida spp. (C), and mixed infection (D). Each card includes positive (bottom) and negative (top) controls for each patient sample.

• 

  Fig. 2 Papanicolaou smear test. (A) Individual squamous cells coated with a layer of coccobacilli along the cell membranes (so-called clue cells) (Papanicolaou stain, ×400). (B) Yeasts and pseudophyphae (Papanicolaou stain, ×400).

• 

  Fig. 3 Gram stained vaginal smear. (A) Gram negative and variable rods on the squamous cells (clue cells) (Gram stain, ×400). (B) Dark blue, dense staining of yeasts (Gram stain, ×400).

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