bluuebunny/crossref_metadata_2025_split huggingface dataset:
P3-S7.11 Factors associated with persistent Bacterial Vaginosis among young reproductive age women in Mysore, India
Authors: Madhivanan P , Rathod S , Krupp K , Arun A , Reingold A , Cohen C , Klausner J 
Published: July 2011

BackgroundBacterial vaginosis (BV) is a common infection and has been associated with adverse health outcomes including preterm birth, pelvic inflammatory disease and acquisition of HIV and other sexually transmitted diseases. There are limited data on persistent BV in Indian women. This study examined the risk factors for persistent bacterial vaginosis in young reproductive women in India.Study DesignBetween November 2005 and January 2007, a prospective cohort study was carried out to examine the relationship of BV and HSV-2 acquisition among women in Mysore. Quarterly, data were collected on sociodemographics, risk behaviour, partner characteristics, followed by a physical examination to diagnose and treat reproductive tract infections. BV was defined using Nugent scoring of gram stained vaginal smears. Persistent BV was calculated using generalised estimating equation methods. Women gave informed consent prior to enrolment in the study.ResultsOf the 420 women for which there were data available for all three visits, 114 (27%) had two or more BV episodes. Women with a history of 2 or more BV episodes were more likely to be infected withTrichomonas vaginalis[OR 72.93, 95% CI 9.69 to 548.4] and be diagnosed with HSV-2 infection [OR 2.58, 95% CI 1.44 to 4.63] compared to women with no BV history. Women with a history of BV were also more likely to report no education, tubal ligation, being a non-Muslim, and having a sex partner who had other sex partners.ConclusionsYoung reproductive age women in India have a high persistence of BV. Although the association between BV andTrichomonas vaginalisis unclear, it seems prudent to recommend that women with BV or TV be screened for both infections.
P3-S7.13 Evaluation of the Affirm VPIII microbial identifications test for the diagnosis of vaginitis and bacterial vaginosis
Authors: Maseko D V , Radebe F M , Gumede L , Sewphershad N Bhojraj , Khumalo S , Basson I , Lewis D 
Published: July 2011

BackgroundVaginitis and bacterial vaginosis (BV) are the most prevalent causes of vaginal symptoms among women of childbearing age. Diagnosis is based on clinical signs and symptoms, microscopy, pH and the whiff" test, and laboratory performed tests. The Affirm VPIII Microbial Identification test (Becton Dickinson) incorporates non-amplified DNA probes forCandida spp.,Trichomonas vaginalisandGardnerella vaginalisas an indicator for BV.ObjectiveTo compare the Affirm VPIII Microbial Identification test for the detection ofCandida spp.,Gardnerella vaginalisandTrichomonas vaginalisto graded Gram stain for Bacterial Vaginosis and yeast as well as to an in-houseTrichomonas vaginalisPCR (Polymerase Chain Reaction).MethodsIn this study, specimens from 191 patients were evaluated. Specimens were collected consecutively from patients with vaginal discharge syndrome presenting at an STI (Sexually transmitted infection) clinic in Gauteng, South Africa between May 2010 and February 2011. Study inclusion was dependent upon the request and collection of both a vaginal swab for Affirm VP III and a second swab to make a smear for Gram staining. A cervical swab specimen was also collected for PCR at the same visit. Graded Gram stain for Bacterial vaginosis and yeast as well as an in-house real-time PCR method on the Rotorgene platform was performed in the laboratory. The sensitivity and specificity of the assay was determined using the graded Gram staining as a gold standard for BV andCandida spp.. The real-time PCR was the gold standard for theTrichomonas vaginalis(TV).ResultsAnalysis of the Affirm VPIII gave a sensitivity of 98% for BV correctly categorising 80of the 82 BV positive specimens and specificity of 76% correctly identifying 38 of the 50 BV- negative specimens. The Affirm VPIII for Candida yielded a sensitivity of 86% and specificity of 95%. When the Affirm was compared to the Real-time TV PCR the sensitivity was at 45% and specificity at 99%.ConclusionThe Affirm VPIII is an objective system which detects mixed vaginal infections and can be used in any setting. The performance characteristics of the Affirm VPIII for BV and Candida were comparable to those of other published studies. However in this study the Trichomonas vaginalis PCR was used as a gold standard therefore the sensitivity of the Affirm VPII of 45% is similar to that of culture or wet mount.
P3-S7.15 Diagnostic reliability of wet prep microscopy forT Vaginalisin women visiting a high-volume STD clinic
Authors: Fitch J , Anderson T , Thrun M , Mettenbrink C 
Published: July 2011

BackgroundFor years, wet prep microscopy has been the cornerstone of testing forT vaginalisdue to the simplicity of the test and its low cost to perform. Though still recommended as a means of diagnosis for vaginal infections, its diagnostic sensitivity (typically 50%–70%) falls short of other means of testing, including culture (approximately 80% sensitivity). This study compares the performance and costs of wet prep tests to culture in the hands of experienced laboratorians in a high volume STD clinic.MethodsThe Denver Metro Health (STD) Clinic sees over 800 patients and performs over 100 wet prep tests every month. Between 1 January 2010 and 30 September 2010, a wet prep test and aT vaginalisculture were performed on every female patient receiving a comprehensive exam, regardless of symptoms, as part of resistance testing for the STD Surveillance Network (SSuN). The results of the two tests were then compared.ResultsWet prep tests andT vaginaliscultures were performed on 555 female patients. Of those, 51 were positive by wet prep and 62 were positive by culture see Abstract P3-S7.15 table 1. There were no wet prep false positives reported. The average material cost for each in-house wet prep was $0.32 and the cost for each culture was $1.78. In comparision, materials for PCR testing forT vaginaliscost approximately $2 per test. Staff time required to perform wet prep microscopy is less than either culture or PCR.Abstract P3-S7.15 Table 1Diagnostic reliability of wet prep microscopy forT Vaginalisin women visiting a high-volume STD clinicWet prepPositiveNegativeTotalCulture Positive511162 Negative0493493 Total51504555ConclusionsThe wet prep sensitivity rate of 82.2% when compared to culture (which, until recently has been the gold standard for trich testing) suggests that wet prep microscopy may be more useful than previously recognised in venues where clinicians and laboratorians gain experience by performing a large number of tests. Additionally, the costs, both in supply and staff expense, suggest that, in tight budgetary times, wet prep may continue to be a cornerstone ofT vaginalistesting, even with the availability of molecular amplification methods. These results, however, were limited to a single clinic during a single point in time. As next steps, wet prep testing might be compared to molecular amplification tests.
P3-S7.17 Noninvasive high resolution imaging with optical coherence tomography for vaginal product safety assessment in women
Authors: Vincent K , Stanberry L , Moench T , Breitkopf C R , Loza M , Wei J , Paull J , Grady J , Motamedi M , Rosenthal S 
Published: July 2011

BackgroundPrevention of HIV and other STDs using vaginal microbicides must be safe. Colposcopy has not been shown to predict microbicide safety; therefore a more sensitive method is needed in safety evaluations of these vaginal products. The use of optical coherence tomography (OCT) has shown increased sensitivity to tissue injury over colposcopy in animal models. We describe a randomised double blind clinical trial using OCT to detect epithelial changes and injury related to vaginal microbicide use.Methods30 women aged 18–45 were randomised to use hydroxyethyl cellulose (HEC) placebo or nonoxynol-9 (N-9) vaginal gel twice daily for 5.5 days. Imaging with colposcopy and OCT was performed prior to product use, within 6 h of last dose of product, and 1 week after discontinuation of product. Colposcopy was graded based on vascular and epithelial disruption and erythema. OCT images were evaluated both by quantitative measurement of vaginal epithelial thickness and by use of a qualitative scoring system developed in the macaque to determine epithelial disruption and injury. Mixed model and significance of p=0.05 were used in data analysis.ResultsBaseline colposcopy and OCT findings were similar between treatment groups. After treatment, there were no significant colposcopic differences in vascular or epithelial disruption between treatment groups, with only an increase in erythema noted after treatment in the N-9 group (p=0.01). OCT detected differences between groups in OCT scores (p<0.0001) and epithelial thickness, (p=0.008), both indicators of epithelial injury, after treatment with N-9. One week after discontinuation of treatment, OCT scores were similar between treatment groups (p=0.66) but epithelial thickness in the N-9 group was significantly thicker (p=0.0003).ConclusionsOCT can be used in a clinical setting to detect epithelial injury and is more sensitive than colposcopy to detect microscopic epithelial disruption. In addition, it gives information about the thickness of the epithelium, a measure previously available only through invasive biopsy. Vaginal epithelium thinned after treatment in the N-9 group, but then thickened after discontinuation of N-9, possibly due to post injury epithelial proliferation. OCT should be considered for inclusion in clinical trials for the detection of product-related toxicity to the vaginal and cervical epithelium.
P3-S7.18 Aetiological agents of infective vaginal discharge among women attending a STD clinic in Kumasi, Ghana
Authors: Agyarko-Poku T 
Published: July 2011

ObjectiveTo determine the prevalence of aetiological agents in Infective Vaginal Discharge among women attending a sexually transmitted infection (STI) clinic in Kumasi, Ghana. Methodology Three hundred (300) women consisting of 150 sex workers (SW) and 150 non-sex workers (NSW), attending the Suntreso STI clinic in Kumasi, with complaint of vaginal discharge were recruited for the study. Specimens for wet mount, pH determination, whiff test, Gram's stains, culture and polymerase chain reaction (PCR) were collected from the vagina and the cervix for microbial identification. The HIV status of the women was also determined by Western Blot Assay. Details regarding socio demographic characteristics of the women, symptoms and signs as well as sexual behaviour were recorded. Associations of these factors with each of the aetiological agent was recorded and adjusted for other risk factors.ResultBacterial vaginosis was the most common cause of infective vaginal discharge (111/300: 37.0%, p =0.000, SW-61/150{40.7%}; NSW–58/150{38.0%} in the women, followed byCandida spp.(99/300: 32.7%, p=0.000, SW-41/150{27.3%}; NSW-58/150{38.0%}),Trichomonas vaginalis(20/300: 6.7%, p=0.000) SW-12/150{8.0%;NSW–8/150{5.3%}),Chlamydia trachomatis(9/300: 3.0%, p=0.001 SW–6/150{4.0%}; NSW-3/150{150{2.0%}),Neisseria gonorrhoeae(6/300: 2.0%, p=0.014, SW–4/150{2.7%}; NSW–2/150{1.3%}) andMycoplasma genitalium(10/300, 3.3%, p=0.000, SW-7/150{2.0%}). 11.3% (34/300, 30 sex workers, four non-sex workers) of the women were HIV antibody positive. All of the aetiological agents exceptChlamydia trachomatis(p=0.705) were associated with HIV infection. There was no difference in the types of aetiological agent found in sex workers (SW) and non-sex workers (NSW). Prevalence of all the aetiological agents was higher among sex workers except forCandida spp.(27.3%, 41/150 compared with non-sex workers (38.0%, 57/150). Younger age (15–29 years) was found to be the strongest predictor of infection.ConclusionAgents of Bacteria vaginosis,Candida spp.andTrachomonas vaginaliscontinue to be the most predominant aetiological agents responsible for infective vaginal discharge among women in Kumasi, Ghana, while prevalence ofNeisseria gonorrhoeaeandChlamydia trachomatisdecline. Improving the detection and management of these organisms has significant public health implication for STI and possibly HIV control.
P4-S1.02 Coupling of electrochemical detection with PCR amplification for sensitive detection ofNeisseria gonorrhoeae
Authors: Sood S , Verma R , Singh R , Sumana G , Sharma V K , Samataray J C , Pandey R M , Malhotra B D 
Published: July 2011

BackgroundDespite the recent development of different detection methods, better diagnostic tools are required for quick and reliable detection of pathogens. Use of biosensors for detection of pathogens is gradually gaining momentum. However, PCR amplification of DNA target is still necessary for application on biosensor for accurate detection of the pathogen. An in-house PCR using self-designed primers targeting the opa gene (GenBank accession no. PUID 9716120 SNUM 2706 Ng_opa) was performed. The generated amplicons were used to evaluate the DNA biosensor utilising a 19-mer oligonucleotide sequence (GenBank PUID SNUM: 9716119 2705 Ng_opa) as probe.MethodsIn-house PCR was standardised and an amplified product (amplicons) of 188 bps were obtained for positive samples. Fabrication of bioelectrode was performed by immobilising the activated probe onto pre-treated screen-printed gold electrodes. The fabricated nucleic acid functionalised gold electrode was characterised using, SEM, CV, DPV techniques. The presence of target DNA was detected electrochemically by monitoring the redox peak of methylene blue indicator. Standardisation of working conditions was done using complementary, non-complementary, one base mismatch DNA, and amplicons from standard strain of N. gonorrhoeae (ATCC 49226) & 16 clinical isolates. In addition, DPV measurements of hybridised bioelectrode with amplicons of 26 clinical samples of which 10 were culture positive, was done. A cut-off value for positives was determined by using the software STATA (version 9).ResultsThe analytical sensitivity of PCR was 10–17 M of DNA and the bioelectrode could detect up to 1.0×10–20 M of the DNA amplicons. An 11.49% decrease in signal intensity was taken as the cut-off. Samples giving an equivalent or more decrease than this value were considered as positives.ConclusionsThe coupling of electrochemical detection with PCR amplification showed the advantage of higher sensitivity and increased specificity for detection ofN gonorrhoeae. This may prove to be particularly valuable for the identification of asymptomatic infections and could greatly improve gonorrhoea control.
P4-S1.03 Demonstrating performance of a low-cost, ultra-rapid PCR device with true point-of-care applications
Authors: Pearce D , Shenton D , Brake S , Larry A , Green M , Gaydos C 
Published: July 2011

BackgroundWe are developing a highly sensitive, ultra-rapid, multiplex PCR method with fully-integrated DNA preparation and ambient-stable reagents. The assay was used in conjunction with a novel electrochemical detection method to demonstrate low copy number amplification and detection in <20 min, as a point-of-care (POC) diagnostic test forChlamydia trachomatis(CT).MethodsThe method employs custom PCR cards, utilising a thin-film laminate construction to achieve rapid heat transfer, in conjunction with an ultra-rapid thermocycler. All reagents necessary to perform the extraction, amplification and detection are deposited into the cards and air dried at the point of manufacture. Novel, ambient-stable reagent formulations with an 18 month shelf life have been developed. A sample is added to the card and DNA extracted from the sample. The resulting eluate reconstitutes dried PCR reagents and a 40-cycle multiplex PCR is performed using rapid thermocycling. Amplified target is detected using electrochemically-labelled target-specific probes and a double-stranded DNA-specific exonuclease to release the electrochemical label. Released label is read by applying a voltage to a screen printed carbon electrode and at a known oxidation potential the label is oxidised producing a measurable current. The unique rapid performance of this device has been demonstrated in terms of analytical sensitivity and reagent stability under ambient storage conditions. Multiplex capability is demonstrated in this test with the presence of internal control (IC) DNA.ResultsAnalytical sensitivity of the device was evaluated by testing dilutions of CT in the presence of IC DNA. The results show CT detection down to 50 copies when co-extracted, amplified in duplex and detected electrochemically with the IC DNA (see graph). Tests on the reagents dried into the device showed stability for 18 months when stored at ambient temperature (20–25°C). Reagent performance after 18 months' storage was shown to be equivalent to performance at time zero see Abstract P4-S1.03 figure 1.Abstract P4-S1.03 Figure 1ConclusionsThe results show that this device could be used to perform ultra-rapid multiplex PCR with no user intervention after sample addition, allowing minimally-trained staff to carry out the assay in <20 min, meeting the needs for a “true” POC device. Ambient stability of the reagents negates the requirement for any specialised storage conditions.
P4-S1.07 Chlamydia trachomatisDNA stability independent of preservation temperature, type of medium en storage duration
Authors: van Dommelen L , van Tiel F H , Dukers N H , Wolffs P F , Herngreen S B , Hoebe C J P A 
Published: July 2011

BackgroundIn almost all diagnostic studies, stored samples are used. This is also the case inChlamydia trachomatisresearch. The performance of diagnostic assays, such as nucleic acid amplification tests, is dependent on the preservation ofC trachomatisDNA. However, the influence of different storage conditions onC trachomatisDNA has not been thoroughly explored yet. Therefore, we have studied the impact of temperature, type of medium and duration of storage on the preservation ofC trachomatisDNA.MethodsPhosphate buffered saline (PBS), 2-sucrose-phosphate medium (2-SP), COBAS Amplicor medium and urine samples were spiked withC trachomatisserovar D elementary bodies and stored at room temperature, 4°C, −20°C and −80°C. DNA was isolated using the Qiagen DNA mini kit (Qiagen GmbH, Hilden, Germany). Samples were tested in triplicate with a TaqMan PCR at day 0, 1, 7, 14 and 30. Furthermore, clinicalC trachomatispositive urine samples were collected and pooled, and stored and tested in triplicate, at the same temperatures and time intervals. This same procedure was executed with pooledC trachomatispositive swab samples.ResultsC trachomatiswas detected in all samples, irrespective of the different storage temperature conditions, different types of medium and the different durations of storage. Regarding storage time, the cycle threshold (ct) overall did not increase, in fact it tended to decrease within 30 days. If there was an increase in ct over time, this occurred in <10% of the experiments, it did not outreach three (corresponding to a decline in load of 1 log). This mainly occurred in the spiked COBAS samples which were frozen.ConclusionsAll samples tested positive forC trachomatisin our experiments, with on average no decrease in cycle threshold over time. We can therefore conclude that PBS, 2-SP, COBAS Amplicor medium and urine are all excellent media to preserveC trachomatisDNA for a longer period of time, independent of storage temperature.
P1-S1.51 Prevalence of anogenital Warts among STD clinic patients-STD surveillance network, USA, January 2010–September 2010
Authors: Llata E , Pugsley R , Tabidze I , Asbel L , Bernstein K , Kerani R , Schwebke J , Longfellow L , Mettenbrink C , Guerry S , Zenilman J , Klingler E , Weinstock H 
Published: July 2011

BackgroundSTD clinics routinely provide diagnostic and treatment services for anogenital warts. With the availability and increasing use of a highly effective quadrivalent vaccine against the HPV types associated with 90% of anogenital warts, the impact on patients presenting with anogenital warts to STD clinics may be significant. To be positioned to estimate the population-level impact of HPV vaccine on STD clinics, we conducted a baseline cross sectional analysis of patients with anogenital wart-related visits.MethodsWe reviewed STD clinic data collected on patients seen by a clinician from 1 January 2010 to 30 September 2010 in 11 sites (38 clinics) participating in the STD Surveillance Network (SSuN)—Seattle, WA (1 clinic); San Francisco, CA (1); Los Angeles, CA (12); Denver, CO (1); Chicago, IL (5); New Orleans, LA (1); Birmingham, AL (1); Richmond, VA (3); Baltimore, MD (2); Philadelphia, PA (2); New York City, NY (9). SSuN uses a collaboratively developed protocol to collect demographic, risk behaviour, and clinical data on all patients with anogenital warts at participating STD clinics. The unit of analysis was unique patients; patients were considered to have anogenital warts if warts were identified at any visit.ResultsAmong SSuN sites, 3–13% (median 4%) of STD clinic patients had anogenital wart-related visits, with 5063 patients presenting for 6989 visits. Among patients with anogenital warts, 20% of the patients had multiple anogenital warts-related visits (range 2–26 visits). Overall, the median prevalence rate was 2% (range 1–5%) for women and 6% (range 4–22%) for men. By age and sex, median prevalence rates were highest among women aged 20–24 at 3% (range 1–7%) and among men aged 25–29 at 8% (range 5–25%). Among men who have sex with men (MSM), the median prevalence was 7% (range 4–18%) and among men who have sex with women only (MSW) it was 6% (range 3–23%). Of patients with anogenital warts, 40% were African American, 32% were white, 21% were Hispanic compared to all clinic patients who were 58% African American, 18% white, and 18% Hispanic. 59% received treatment and most treatment (97%) was provider applied.ConclusionsThe prevalence of anogenital warts among women is low in STD clinics. It may thus be difficult to monitor the impact of the HPV vaccine in women in these settings. However, the higher prevalence in MSM and MSW suggest that these clinics may provide settings in which to monitor anogenital warts in men.