Molecular diagnostics could improve the accuracy of vaginitis diagnosis and lead to more appropriate and timely treatment decisions, according to a new peer-reviewed study.

In the paper, Performance of a Vaginal Panel Assay Compared With the Clinical Diagnosis of Vaginitis—which reports the findings from a BD clinical trial—the three causes of vaginitis (bacterial vaginosis [BV], vulvovaginal candidiasis [VVC] or Trichomonas vaginalis [TV]) were studied to compare clinician assessment with results from a molecular test.

The study—published in the journal of Obstetrics & Gynecology—found that compared to the molecular test, clinician diagnosis of vaginitis missed 45.3% of positive cases and incorrectly identified 12.3% of negative cases as positives.

Between 6 million and 10 million health care visits by women in the U.S. are related to symptoms of vaginitis.1,2 Although vaginitis is a common condition, diagnosis of its usual causes3,4 (BV, VVC, or TV) in women of reproductive age is not standardized.

“A misdiagnosis means inappropriate treatment recommendations — either undertreatment or overtreatment,” says study co-author Molly Broache, medical science liaison for Integrated Diagnostic Solutions at BD. “A woman might be asked to make return visits to the doctor that aren’t necessary, or she may develop antimicrobial resistance because she’s taking antibiotics she doesn’t actually need.”

The study compared clinician diagnosis of vaginitis to results of a vaginal panel assay performed on the BD MAX System, an FDA-market authorized molecular test that uses nucleic acid amplification to detect the microbial causes of BV, VVC, and TV.

The study involved 489 symptomatic participants. Participants received a clinical diagnosis and had a vaginal assay swab collected during their visit. Swabs were sent to a separate testing facility and later compared to clinician diagnosis.

“We really do women a medical disservice when we do not use the best tools we have available to diagnose the cause or causes of the symptoms that drove them to seek health care,” says study co-author Barbara Van Der Pol, PhD, MPH, and professor of Medicine and Public Health. “Too many infections are caused by multiple organisms for us to think that we can correctly identify them without high-quality diagnostic testing. The data in this paper confirms that we owe women the best options available and clinical observations are not sufficient.”

The BD MAX Vaginal Panel Assay can help address the limitations of clinical diagnosis and can help improve diagnostic accuracy. This automated assay has a shorter turnaround time, so same-day results are possible if the clinician has the instrument available on site.

“When a woman is misdiagnosed either way — told that she doesn’t have vaginitis but actually does or told that she does have vaginitis but is not infected — it creates hardship and risk,” says Broache. “Women deserve better.”

References:

1. Owen MK, Clenney TL. Management of vaginitis. Am Fam Physician 2004;70:2125-32.

2. Eckert LO. Acute vulvovaginitis. N Engl J Med 2006;355:1244-52. Doi: 10.1056/nejmcp053720

3. Koumans EH, Sternberg M, Bruce C, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004: associations with symptoms, sexual behaviors, and reproductive health. Sexually Transmitted Diseases. 2007;34:864–9.

4. Sutton M, Sternberg M, Koumans EH, et al. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004. Clinical Infectious Diseases. 2007;45:1319–26.

Featured image: A peer-reviewed study published in the journal of Obstetrics & Gynecology showed molecular diagnostics could improve the accuracy of vaginitis diagnosis and lead to more appropriate and timely treatment decisions. Photo: BD