Detection of Gardnerella vaginalis, Candida spp. and Trichomonas vaginalis DNA in symptomatic women

While vaginitis caused by Trichomonas vaginalis is now less frequent, fungal Candida spp. infections are frequently found and the bacterial vaginosis is one of the most common vaginal diseases caused by anaerobic microorganisms such as Gardnerella vaginalis. Purpose of this study is to evaluate the usefulness of a rapid molecular test for the diagnosis of vaginitis/bacterial vaginosis in symptomatic women. In our clinic, between January 2008 - June 2009, we admitted 1592 (388 were pregnant) symptomatic women with a specific request to test them for fungi, Trichomonas and Gardnerella on vaginal fluid. The samples were tested with the kit Affirm (Becton Dickinson) that provides results in 40 minutes and allows the simultaneous identification of the DNA of Gardnerella vaginalis, Candida spp. and Trichomonas vaginalis. One hundred and eight out of 388 pregnant women were positive only for Gardnerella; 53 for Candida and Gardnerella; 59 were positive only for Candida and 10 for Trichomonas. As to the remaining 1204 not pregnant patients, 356 were positive only for Gardnerella; 98 for Candida and Gardnerella, 143 were positive only for Candida and 21 for Trichomonas.A simultaneous positivity for Trichomonas and Candida or for Trichomonas and Gardnerella has not been observed in any case. Molecular testing is obviously more sensitive and specific than culture method and microscopic research, especially for the detection of Gardnerella. It also enables differential diagnosis between bacterial vaginosis and vaginitis and therefore allows a targeted therapeutic intervention.