Bacterial Vaginosis (Sialidase), Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, NAA, Vaginal Yeast Culture

CPT: 87102; 87491; 87591; 87661; 87905
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Test Details

Synonyms

  • BV (Sialidase), Ct/Ng/Tv (NAA), Vaginal Yeast (Culture)

Use

BV (sialidase) activity: Enzyme activity test for use in the detection of vaginal fluid specimens for sialidase activity, an enzyme produced by bacteria associated with bacterial vaginitis, including Bacteroides spp, Prevotella spp, and Mobiluncus spp, and some G vaginalis. In a recent study, Bradshaw et al demonstrated the test to be 88% sensitive and 95% specific.

Vaginal yeast culture: Detect yeast in vaginal fluid

Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis by NAA: Diagnosis of C trachomatis, N gonorrhoeae, and T vaginalis infections

Limitations

BV (sialidase) activity: Collecting specimens from the cervix should be avoided because (a) it might increase the risk to OB patients, and (b) cervical sialidase activity is usually higher than vaginal sialidase activity. Do not collect specimens from patients who have (a) used a vaginal cream or ointment product, (b) douched, or (c) used spermicides, vaginal lubricants, or feminine sprays within 72 hours of testing. If insufficient sample is collected or collected from a patient undergoing antimicrobial therapy, the test may yield a false-negative result.

Methodology

BV (sialidase) activity: chromogenic enzyme activity test; vaginal yeast culture: culture; C trachomatis, N gonorrhoeae, T vaginalis by NAA: nucleic acid amplification (NAA)

Specimen Requirements

Specimen

Vaginal fluid

Volume

Multiple swab specimens

Container

Copan double swab in Amies liquid medium and Aptima® unisex swab transport

Collection

Using transport swabs provided, collect vaginal fluid sample by contacting the lower one-third of the vaginal wall, rotating for 10 to 20 seconds to absorb fluid. Immediately place the swabs into the transport tubes. For the Aptima® swab, carefully break the swab shaft against the side of the tube. Tightly screw on the cap.

Storage Instructions

Maintain specimen at room temperature or refrigerate (2°C to 30°C).

Causes for Rejection

Specimen collected or transport other than previously described; unlabeled specimens or those with a discrepancy between the specimen label and the test request form; Aptima® Combo 2 (AC2) swab specimen transport tube with two swabs or swab not supplied by Gen-Probe® or no swab; UTM transport from an inappropriate site; vaginal swab devices from patients younger than 16 years of age; ProbeTec™ swabs.Note: Specimens collected from children younger than 13 years of age or specimens submitted without the age of the patient or date of birth may be tested and will be reported with a disclaimer.

Clinical Information

References

Bradshaw CS, Morton AN, Garland SM, Horvath LB, Kuzevska I, Fairley CK. Evaluation of a point-of-care test, BVBlue, and clinical laboratory criteria for diagnosis of bacterial vaginosis. J Clin Microbiol. 2005 Mar; 43(3):1304-1308. 15750100
Garcia LS. Diagnostic Medical Parasitology. 4th ed. Washington, DC: ASM Press; 2001.
Leber AL, Novak SM. Intestinal and urogenital amebae, flagellates, and ciliates. Manual of Clinical Microbiology. 7th ed. Washington, DC: ASM Press;1999.
Rein MF. Trichomonas vaginalis. In: Mandell GL, Bennett JE, Dolin R, edsPrinciples and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingston; 2000.
Van Der Schee C, van Belkum A, Zwijers L, et al. Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimen compared to diagnosis by wet mount microscopy, culture, and fluorescent staining. J Clin Micro. 1999 Dec; 37(12):4127-4130. 10565943

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
182725 BV+Ct/Ng/Tv NAA+Yeast Culture 180036 BV, Sialidase Activity 41477-1
182725 BV+Ct/Ng/Tv NAA+Yeast Culture 182495 Vaginal Yeast Culture 18483-8
182725 BV+Ct/Ng/Tv NAA+Yeast Culture 183161 Chlamydia by NAA 43304-5
182725 BV+Ct/Ng/Tv NAA+Yeast Culture 183162 Gonococcus by NAA 43305-2
182725 BV+Ct/Ng/Tv NAA+Yeast Culture 188053 Trich vag by NAA 46154-1

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