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Bacterial STIs
P72 Microscopy and culture for Trichomonas vaginalis (TV): are both tests required and should test of cures (TOC) be performed routinely?
  1. C Gilmour,
  2. L Jones,
  3. R Jones,
  4. C E Cohen
  1. Chelsea and Westminster NHS Foundation Trust, London, UK

Abstract

Background Testing for TV has changed locally in recent years dependant upon whether the woman has symptoms. Microscopy and culture are now only performed in symptomatic women or in contacts of TV. All patients diagnosed with TV must be seen by the Health Advisers to discuss partner notification and to arrange a TOC within 2 weeks.

Aim To ascertain if both microscopy and culture remain warranted for symptomatic women and those attending for TOC or whether microscopy alone is sufficient for diagnosis. To compare audit findings with previous audits using BASHH auditable standards.

Method Case notes of patients diagnosed with a KC60 code of C6A between 1 October 2009 and 31 October 2010 were reviewed.

Results A total of 58 patients were included in the audit pertaining to 65 episodes. Largest ethnic group was Black/Black British Caribbean (34%). The majority (93%) were symptomatic. Nine (14%) patients had positive microscopy and negative culture, 10 (15%) had negative microscopy and positive culture and 46 (71%) had positive microscopy and culture results. The majority (97%) received Metronidazole therapy. 43 (74%) saw a Health Adviser after initial diagnosis. Almost all (88%) had documented partner notification and 27 contacts attended for treatment. 46 (79%) attended for TOC and of these 36 (78%) attended within 2 weeks. Of the 46 attending for TOC, 42 (91%) were symptomatic but only five (12%) were TV positive on TOC. Auditable standards comparison (see abstract P72 table 1).

Abstract P72 Table 1

Comparison of auditable standards and rate

Discussion Overall the results from this audit have demonstrated an improvement in respect to previous audits in line with BASHH auditable standards. Findings related to microscopy and culture results do not appear to demonstrate a significant risk in missed diagnoses and those who were microscopy negative (subsequently culture positive) had Hay and Ison Grade 2/3 and treatment with Metronidazole. In skilled hands, microscopy alone may be sufficient to diagnose TV in those attending with symptoms.

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