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When T.
vaginalis was detected using both culture and PCR, age and the
presence of urethritis were not associated with infection in men.
Use of urine
polymerase chain reaction to define the prevalence and clinical
presentation of Trichomonas vaginalis in men attending an STD
clinic.
Wendel KA, Erbelding EJ, Gaydos CA, Rompalo
AM.
Sexually
Transmitted Infections 2003;79:151-153
Summary:
Question
What are the prevalence and clinical features of T. vaginalis
infection in men attending an STD clinic?
Design
T. vaginalis PCR and culture of urine sediment were used to
determine the prevalence of T. vaginalis infection in men attending
an urban STD clinic.
Participants
Three hundred fifty-five men attending a Baltimore City Health Department
STD clinic were tested. The mean age was 31 years; 99% were
African-American. The prevalence of chlamydia and gonorrhea were 11% and
19%, respectively.
Description of Tests and Diagnostic
Standard
Fifteen ml of first-void urine were centrifuged and the sediment
inoculated into the InPouch TV test (Biomed Diagnostics, Santa Clara, CA).
Microscopic examination for motile trichomonads was performed after 1, 2
and 5 days of incubation. One to 7 ml of urine, stored frozen for 11 to 17
months, was used to test for T. vaginalis DNA by PCR. After
thawing, the urine was centrifuged and the pellet was suspended in a
buffer with chelating resin (Chelex 100, Sigma, St. Louis, MO). Primers
BTUB9/2 were used to amplify112 bp conserved regions of the β-tubulin
genes of T. vaginalis. If results of the PCR and culture were
discordant, PCR primers TVK3/7 and AP65 A/B were used for adjudication.
True positive samples were defined as positive by culture or by PCR that
was confirmed with a second PCR assay. Intraurethral secretions were Gram
stained. Urethritis was defined as >5 polymorphonuclear cells
per oil immersion field.
Main Outcome Measures
The prevalence of and factors associated with T. vaginalis
infection were determined when T. vaginalis infection was diagnosed
by culture and by a combination of culture and PCR results.
Main Results
Forty-seven (13%) of 355 men were T. vaginalis positive. Culture
was positive for 13 (28%) and PCR for 44 (94%) of 47 cases. Three cases
were positive by culture only. Of the 46 cases that were only PCR
positive, 34 were confirmed by a second PCR. Older age (>28 years) was
associated with a positive culture (p=0.03) but was not associated with
infections based on either a positive culture or PCR. In men without
gonorrhea or chlamydia, a positive culture was associated with urethritis
(p=0.02) but infection defined by culture and PCR was not associated with
urethritis.
Authors' Conclusions
Older age and urethritis were not
significantly associated with T. vaginalis infections in men as defined by
a positive culture or a confirmed positive PCR result on urine samples.
Source of funding: None given.
For correspondence: E. J. Erbelding,
1830 E. Monument Street, Suite 445, Baltimore, MD 21287. E-mail address:
eerbeldi@jhmi.edu.
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