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Lee TF, Lin KY, Chang SY, Huang YT, Hsueh PR. Performance of two commercial multiplex polymerase chain reaction assays for the etiological diagnosis of sexually transmitted infections among men who have sex with men. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:104-110. [PMID: 36050217 DOI: 10.1016/j.jmii.2022.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE This study aimed to investigate the etiologies of sexually transmitted infections (STIs) among men who have sex with men (MSM) in Taiwan. METHODS Two commercial assays, the BD MAX Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC), and Trichomonas vaginalis (TV) panel and the Allplex™ STI Essential assay (CT, GC, Mycoplasma genitalium [MG], Mycoplasma hominis [MH], Ureaplasma urealyticum [UU], Ureaplasma parvum [UP], and TV) were evaluated. During the first stage, urine and rectal swab samples from 168 patients were evaluated using the BD MAX assay, and the multiplex RT-PCR Allplex™ STI Essential assay was applied only to the patients with positive results on the BD MAX asay (n = 49). During the second stage, urine and rectal swab samples from 90 patients were evaluated using the BD MAX assay and the Allplex™ qPCR. RESULTS The Allplex qPCR identified all CT, missed one and additionally one TV from the positive samples (n = 49) by the BD MAX assay in the first stage. At the second stage, both commercial assays showed similar detection rate of CT, NG or CT/NG coinfection (11.1%, 1.1% and 4.4% by the BD MAX assay; 10.0%, 1.1% and 2.2% by the Allplex qPCR). The positivity rates of MG, MH, and UU by the Allplex qPCR were 4.4%, 2.2%, and 12.2%, respectively, for urine samples and 10%, 13.3%, and 22.2%, respectively, for anal swab samples. CONCLUSIONS High rates of STI-associated etiologies were observed in MSM. The positive rates were higher in rectal swabs than in urine samples.
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Affiliation(s)
- Tai-Fen Lee
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Yin Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sui-Yuan Chang
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Clinical Laboratory Science and Medical Biotechnology College of Medicine, Taipei, Taiwan
| | - Yu-Tsung Huang
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
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Relich RF, Abbott AN. Syndromic and Point-of-Care Molecular Testing. Clin Lab Med 2022; 42:507-531. [PMID: 36368779 DOI: 10.1016/j.cll.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ryan F Relich
- Division of Clinical Microbiology, Indiana University Health Pathology Laboratory, Indiana University Health and Indiana University School of Medicine, Suite 6027E, 350 West 11th Street, Indianapolis, IN 46202, USA.
| | - April N Abbott
- Department of Laboratory Medicine, Deaconess Hospital, 600 Mary Street, Evansville, IN 47747, USA
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Validation of a New High-Throughput BD COR System Using the BD CTGCTV2 Assay. J Mol Diagn 2022; 24:485-493. [PMID: 35304346 DOI: 10.1016/j.jmoldx.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022] Open
Abstract
This study determined the precision and reproducibility of results for the BD CTGCTV2 (CTGCTV2) assay on the BD COR System (COR). The clinical performance of the CTGCTV2 assay conducted on COR was compared with its performance on the BD MAX System (MAX) for detecting Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis. The multiday precision and multisite reproducibility studies were conducted using contrived panels of positive and negative urine and PreservCyt specimens. A total of 433 panel members, generated from remnant clinical specimens, were tested in the clinical comparison study. Each panel member was tested three times on MAX and three times on COR. The results in the same testing group were compared for agreement by target. The cycle threshold scores from MAX and COR were analyzed by paired t-test and Deming regression. The CTGCTV2 assay on COR showed high reproducibility in the multiday and multisite precision analysis. The point estimates of positive percent agreement and negative percent agreement in the clinical comparison study for all three targets were greater than 95%, with all corresponding lower bounds of two-sided 95% CIs greater than 90%. Cycle threshold score comparison showed no systematic difference between the two systems. The results of this study show equivalent performance of the CTGCTV2 assay on the MAX and COR systems.
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Cassidy H, Van Genne M, Lizarazo-Forero E, Gard L, Niesters HGM. A discussion of syndromic molecular testing for clinical care. J Antimicrob Chemother 2021; 76:iii58-iii66. [PMID: 34555161 PMCID: PMC8460109 DOI: 10.1093/jac/dkab243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Current molecular detection methods for single or multiplex pathogens by real-time PCR generally offer great sensitivity and specificity. However, many infectious pathogens often result in very similar clinical presentations, complicating the test-order for physicians who have to narrow down the causative agent prior to in-house PCR testing. As a consequence, the intuitive response is to start empirical therapy to treat a broad spectrum of possible pathogens. Syndromic molecular testing has been increasingly integrated into routine clinical care, either to provide diagnostic, epidemiological or patient management information. These multiplex panels can be used to screen for predefined infectious disease pathogens simultaneously within a 1 h timeframe, creating opportunities for rapid diagnostics. Conversely, syndromic panels have their own challenges and must be adaptable to the evolving demands of the clinical setting. Firstly, questions have been raised regarding the clinical relevance of some of the targets included in the panels and secondly, there is the added expense of integration into the clinical laboratory. Here, we aim to discuss some of the factors that should be considered before performing syndromic testing rather than traditional low-plex in-house PCR.
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Affiliation(s)
- Hayley Cassidy
- The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands
| | - Mart Van Genne
- The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands
| | - Erley Lizarazo-Forero
- The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands
| | - Lilli Gard
- The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands
| | - Hubert G M Niesters
- The University of Groningen, University Medical Centre Groningen, Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, Groningen, The Netherlands
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Van Der Pol B, Torres-Chavolla E, Kodsi S, Cooper CK, Davis TE, Fife KH, Taylor SN, Augenbraun MH, Gaydos CA. Clinical Performance of the BD CTGCTV2 Assay for the BD MAX System for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis Infections. Sex Transm Dis 2021; 48:134-140. [PMID: 33448727 PMCID: PMC7817187 DOI: 10.1097/olq.0000000000001280] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Diagnostic options to combat the increasing rates of sexually transmitted infections recorded throughout the world increasingly include multiplex assays. Here we describe the estimated sensitivity and specificity of a triplex molecular assay that simultaneously detects Chlamydia trachomatis (CT), Neisseria gonorrhoeae (or gonococci [GC]), and Trichomonas vaginalis (TV). METHODS Participants (2547 women and 1159 men) were recruited from 12 clinics in the United States. BD CTGCTV2 for BD MAX System assay (CTGCTV2) results were obtained from vaginal and endocervical swabs, endocervical samples in cytology medium, and female and male urine. Results were compared with infection standards that were sample type and pathogen dependent. RESULTS Female specimen sensitivity estimates ranged from 92.7% to 98.4%, 92.9% to 100%, and 86.6% to 100% for CT, GC and TV, respectively. Male urine sensitivity estimates were 96.7%, 99.2%, and 97.9% for CT, GC, and TV, respectively. Specificity estimates were >98.7% for all sample types. CONCLUSIONS BD CTGCTV2 performed well using a variety of sample types. As a true triplex assay, performed using a benchtop instrument, BD CTGCTV2 may be useful in settings where no testing is currently performed and in settings, such as reference laboratories, where testing turnaround time may be several days. Use of this assay at local laboratories may result in greater access to testing and a shorter time to result, which are important steps for improving our ability to combat sexually transmitted infections.
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Affiliation(s)
- Barbara Van Der Pol
- From the Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | | | - Salma Kodsi
- Becton, Dickinson and Company, BD Life Sciences—Diagnostic Systems, Sparks, MD
| | - Charles K. Cooper
- Becton, Dickinson and Company, BD Life Sciences—Diagnostic Systems, Sparks, MD
| | | | | | - Stephanie N. Taylor
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Charlotte A. Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
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Rodríguez-Granger J, Espadafor López B, Cobo F, Blasco Morente G, Sampedro Martinez A, Tercedor Sánchez J, Aliaga-Martinez L, Padilla-Malo de Molina A, Navarro-Marí J. Update on the Diagnosis of Sexually Transmitted Infections. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rodríguez-Granger J, Espadafor López B, Cobo F, Blasco Morente G, Sampedro Martinez A, Tercedor Sánchez J, Aliaga-Martinez L, Padilla-Malo de Molina A, Navarro-Marí JM. Update on the Diagnosis of Sexually Transmitted Infections. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:711-724. [PMID: 32663448 DOI: 10.1016/j.ad.2019.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 01/12/2023] Open
Abstract
Sexually transmitted infections (STIs) are one of the most frequent and universal Public Health problems. Health professionals should be aware of the possibility of STIs due to their high morbidity and the presence of sequelae. The delay in the diagnosis is one of the factors that justifies the difficulty to infections control. Diagnostic tests allow the introduction of aetiological treatment and also lead to treating symptomatic and asymptomatic patients more effectively, as well as to interrupt the epidemiological transmission chain without delay. In this review we have made an update of the main existing diagnostic methods for the more important STIs.
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Affiliation(s)
- J Rodríguez-Granger
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, España.
| | - B Espadafor López
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - F Cobo
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - G Blasco Morente
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - A Sampedro Martinez
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - J Tercedor Sánchez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - L Aliaga-Martinez
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, España; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
| | | | - J M Navarro-Marí
- Servicio de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, España
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Xiu L, Zhang C, Li Y, Wang F, Peng J. Simultaneous detection of eleven sexually transmitted agents using multiplexed PCR coupled with MALDI-TOF analysis. Infect Drug Resist 2019; 12:2671-2682. [PMID: 31695443 PMCID: PMC6717854 DOI: 10.2147/idr.s219580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/10/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose Sexually transmitted infections (STIs), representing a major global health problem, are caused by different microbes, including bacteria, viruses, and protozoa. Unfortunately, infections of different sexually transmitted pathogens often present similar clinical symptoms, so it is almost impossible to distinguish them clinically. Therefore, the aim of the current study was to develop a sensitive, multitarget, and high-throughput method that can detect various agents responsible for STIs. Methods We developed and tested a 23-plex PCR coupled with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) assay (sexually transmitted infection-mass spectrometry, STI-MS) that simultaneously targets 11 different agents, including 8 most common clinical pathogens related to STIs (HSV-1, HSV-2, Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Trichomonas vaginalis, Mycoplasma genitalium, and Haemophilus ducreyi) and 3 controversial microorganisms as pathogens (Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum). Results The results showed that the STI-MS approach can accurately detect the expected agents, without cross-reaction with other organisms. The limit of detection of each STI-MS assay was ranged from 1.739 to 10.009 copies/reaction, using probit analyses. The verification rate for each target organism of the STI-MS ranged from a minimum of 89.3% to a maximum of 100%, using conventional assays and ultrasensitive digital PCR to confirm the STI-MS-positive results. To further evaluate the clinical performance of this assay, 241 clinical specimens (124 urethral/cervical swabs and 117 urine) were tested in parallel using the STI-MS assay and monoplex real-time PCR for each agent. The overall validation parameters of STI-MS were extremely high including sensitivity (from 85.7% to 100%), specificity (from 92.3% to 100%), PPV (from 50% to 100%), and NPV (from 99.1% to 100%) for each target. Conclusion STI-MS is a useful high-throughput screening tool for detecting mixed infections of STIs and has great potential for application in large-scale epidemiological programs for specific microorganisms of STI.
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Affiliation(s)
- Leshan Xiu
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Chi Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yamei Li
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Junping Peng
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
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