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Trichomonas

Trichomoniasis is a sexually transmitted infection caused by the parasitic protozoan Trichomonas vaginalis. According to the latest CDC data, infections with T. vaginalis have exceeded the prevalence of Chlamydia, especially in individuals who are older than 25 years of age. Complications of untreated Trichomonas infections include pelvic inflammatory disease, pregnancy difficulties including premature labor, and infertility. Unfortunately, up to 70% of Trichomonas infections are asymptomatic, in both sexes. Symptoms of infection in women include vaginitis, urethritis, or cervicitis. Male symptoms include urethritis or prostatitis.

Several test options are available for the diagnosis of trichomoniasis in women. Wet prep and culture have the lowest sensitivity (35%-80%) and require immediate specimen transport for optimal results. Molecular diagnosis, such as the DNA probe hybridization test (BD Affirm VP), improves sensitivity to 92% and specificity to 99%. Affirm vaginitis testing requires a vaginal swab specimen, submitted in Affirm Ambient Temperature Transport System.

Diagnosis of trichomoniasis in males has been problematic, as neither wet prep nor Affirm can be performed on male specimens. Recently, PCR testing has become available for male urine specimens. For optimal results, the patient should not have urinated for at least one hour prior to specimen collection. A first-catch urine specimen, consisting of 20-30 mL of the initial urine stream, should be submitted in a preservative-free sterile urine collection cup.

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