Abnormal Vaginal pH and Mycoplasma genitalium Infection

作者：Huppert Jill S^*; Bates Justin R; Weber Akilah F; Quinn Nicole; Gaydos Charlotte A

来源：Journal of Pediatric and Adolescent Gynecology, 2013, 26(1): 36-39.

DOI：10.1016/j.jpag.2012.09.005

• Female
• Adolescent
• Mycoplasma genitalium isolation
• Mycoplasma genitalium purification
• Hydrogen-ion concentration
• Vagina chemistry
• Vagina microbiology
• Vaginosis
• Bacterial diagnosis
• Human

Study Objective: Mycoplasma genitalium (MG) is a sexually transmitted pathogen linked to female morbidity, but testing for MG is not standardized. We aimed to determine which point-of-care (POC) vaginal tests could predict MG infection.
Design, Setting, Participants: A cross sectional study recruited sexually active adolescent women, aged 14-22 y (n = 217) from an urban medical center.
Interventions and Main Outcome Measures: Vaginal swabs were POC tested for pH, amines, clue cells, sialidase, and Trichomonas vaginalis (TV). MG was detected by research-use-only transcription mediated amplification (TMA) assay. Presence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were confirmed using TMA. Three criteria were required for diagnosis of clinical BV: pH > 4.5, presence of amines, and > 20% clue cells. Associations were assessed using logistic regression (LR).
Results: TMA detected MG in 30 (14%), a in 49 (23%), and NG in 21(10%) of the samples tested. POC vaginal tests were positive for TV in 21%, amines in 52%, clue cells in 33%, sialidase in 22%, pH > 4.5 in 56%, and clinical BV in 19% of the samples tested. Using LR, pH > 4.5 was a predictor of MG (odds ratio 4.4, P < .05). Of 131 women without clinical BV or TV, 25% of those with pH > 4.5 had MG, compared to 9% of those with pH <= 4.5 (P = .02).
Conclusions: Until standardized, approved testing for MG is available, pH may be a useful indicator to suspect MG, especially in the absence of BV and TV.

• 出版日期2013-2