Clinical Significance

Vaginitis is the most commonly encountered female ailment in gynecology, affecting up to 29% of the female population at any time.

Vaginitis accounts for more than 19 million doctors visits each year

Vaginitis can be separated to 3 main categories:

  • Bacterial Vaginosis (BV)
    Polymicrobial infection
  • Candidiasis (CV)
    Recurrent and non-recurrent
  • Trichomoniasis (TV)
    Most common & curable STD

Up to 25% of vaginitis cases are caused by mixed infections

Under the Microscope

Bacterial Vaginosis (BV):

Candida Vaginitis (CV):

Trichomoniasis (TV):

  • Up to 95% of women having BV harbor Gardnerella vaginalis (GV).
  • GV is also found in up to 50% of women with asymptomatic BV.
  • Candida albicans is the most frequently found cause of CV that are non-complicated and non-recurrent!.
  • Trichomoniasis is caused by the parasite Trichomonas vaginalis.

Up to 75% of women with BV are asymptomatic

Up to 50% of women with CV have complicated and recurrent episodes.

The WHO estimates are 7.4 million new cases of Trichomoniasis each year.

  • Mobiluncus spp. are rare in asymptomatic BV and is so is a more sensitive marker.
  • Candida glabrata causes up to 20% of CV, most of which are complicated and recurring.
  • Actual incidence of TV is estimated to be significantly higher due to the low sensitivity of existing testing technologies.

Advantages of MDx

Approximately 30 percent of patients with initial responses to therapy have a recurrence of symptoms within three months... -Hillier, et al.

Improper diagnosis will lead to inappropriate treatment and can result in the recurrence of the disease.

Vaginitis Screening

0 Differentiation of 5 pathogens

  • G. vaginalis
  • C. albicans
  • T. vaginalis
  • Mobiluncus spp
  • C. glabrata

Bacterial Vaginosis

0 Identification of 6 bacteria

  • A. vaginae
  • G. vaginalis
  • M. mulieris
  • B. fragilis
  • M. curtisii
  • P. bivia

Bacterial VaginosisCandida Vaginitis

0 Detection of 6 Candida species

  • C. albicans
  • C. glabrata
  • C. parapsilosis
  • C. dubliniensis
  • C. krusei
  • C. tropicalis

Ability to detect all causative pathogens enables better patient care.

For Sexual health

  • For vaginitis & vaginosis 
  • Vaginitis Screening 
  • Bacterial vaginosis 
  • Candida Vaginitis
  • For sexually transmitted diseases (STD) 
  • Neisseria gonorrhoea 
  • Chlamydia trachomatis 
  • Trichomonas vaginalis 
  • Mycoplasma 
  • Ureaplasma 
  • For Cervical cancer
  • High Risk HPV Detection & Genotyping 
  • Cytology 

References

  1. Clinical Key Elsevier :https://www.clinicalkey.com/topics/obstetrics-and-gynecology/vaginosis.html
  2. Deborah B. Nelson and George Macones. Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions. Epidemiol Rev 2002; 24:102-108.
  3. Carl J. Yeoman et al. Multi-Omic Systems Based Approach Reveals Metabolic Markers of Bacterial Vaginosis and Insight into the Disease. Plos One Feb. 2013. Vol.8;
  4. Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004 Jan-Feb;36(1):6-10.
  5. Kent HL. Epidemiology of vaginitis. Am J Obstet Gynecol. 1991;165:1168-1176
  6. Landers DV et al. Predictive value of the clinical diagnosis of lower genital tract infection in women. Am J Obstet Gynecol. 2004 Apr; 190(4):1004-10.
  7. Duerr, A. et al Immune compromise and prevalence of Candida vulvovaginitis in human immunodeficiency virus-infected women. Obstet Gynecol. 90:252-6.
  8. J Holland et al. Vulvovaginal carriage of yeasts other than Candida albicans. Sex Transm Infect 2003;79:249-250
  9. Odds, FC. Candidosis of the genitalia. In: Odds, FC. Candida and candidosis: A review and bibliography, 2nd ed, Bailhere Tindall, London 1988, p. 124.
  10. Sobel JD. Vulvovaginal candidosis. Lancet 2007; 369:1961.
  11. Spinillo, A. et al.Recurrent vaginal candidiasis. Results of a cohort study of sexual transmission and intestinal reservoir. J Reprod Med. 37:343-7.
  12. Arilla, M. et al. Vulvovaginal candidiasis refractory to treatment with fluconazole. Eur. J. Obstet. Gynecol. Reprod. Biol. 44:77-80.
  13. White, D. J. et al. Management of persistent vulvo vaginal candidosis due to azole-resistant Candida glabrata. Genitourin. Med. 69:112-114.
  14. Klebanoff MA et al. Vulvovaginal symptoms in women with bacterial vaginosis.