(P464) Molecular-based Testing for Vaginitis Using Samples Previously Collected and Tested for Sexually Transmitted Infections

Background

Vaginal symptoms are a leading cause of primary care visits for women. Individuals exhibiting symptoms often receive laboratory testing based on clinic-specific standards of care. Thus, women seen at a family practice clinic might only receive a vaginitis workup, whereas those seen at a sexually transmitted diseases clinic may be more likely to receive only sexually transmitted infection (STI) testing.

Methods

The likelihood of common causes of vaginitis (Bacterial Vaginosis (BV) or vulvovaginal candidiasis (VVC) associated with Candida species) was assessed in women from whom samples were previously tested for STI (Chlamydia trachomatis [CT], Neisseria gonorrhea [GC], or Trichomonas vaginalis [TV]) using the CTGCTV2 assay for the BD MAX™ System. Vaginal swab specimens were self-collected from symptomatic women (N=606) in a clinical setting (STD/HIV, n=169; family planning, n=177; OB/GYN clinics, n=219; and Other, n=41) using the BD Molecular Swab Collection Kit and utilized for STI testing with the BD CTGCTV2 molecular assay. All STI-positive, and a random subset of STI-negative remnant specimens, were thawed, briefly vortexed and utilized for vaginitis testing (BV or VCC) using the BD MAX™ Vaginal Panel for BD MAX™ System. Positivity rates and odds ratios were calculated for BV and VCC among specimens that were positive and negative for an STI.

Results

There was a higher prevalence of BV among specimens with a positive STI result when compared to those with an STI-negative result: 79.4 vs. 57.4%. The odds ratio associated with a STI-positive result was 2.86 (p-value < 0.0001) for BV and 0.96 (p-value =0.8085) for VVC.

Conclusion

In this study, the same specimen generated both STI panel and Vaginal Panel results, enabling more comprehensive care for women with vaginal symptoms. Here, BV, but not VVC, had a significant association with STI-positivity, and therefore, it may be important to test for both vaginitis and STIs in women with vaginal symptoms. This could help alleviate bias for testing and treatment, which might otherwise occur due to clinic type or socioeconomic stigmas associated with these conditions. Molecular testing could provide broad diagnostic coverage for symptomatic women and improve patient management.