MOLECULAR DIAGNOSTICS :: STIs
ings coming out of the pandemic and will likely experience higher volumes in the months and years ahead as more patients resume regular screening. As the CDC states in its April 12, 2022 press release: “There is much to be done to rebuild, innovate, and expand STD prevention and control in the United States—and this will require many groups working together, including local healthcare systems, clinics, and community-based organizations; public and private sectors; health care providers; and public health workers.”12
REFERENCES:
1. New data suggest STDs continued to increase during first year of the COVID-19 pandemic, CDC, April 12, 2022,
https://www.cdc.gov/nchhstp/ newsroom/2022/2020-STD-surveillance-report-
press-release.html
2. How the COVID-19 Pandemic has Impacted Sexually Transmitted Diseases (STD) Programs, CDC,
https://www.cdc.gov/std/program/327850- A_FS_COVID19_STD_Impact_508_FINAL.pdf
Puritan UniTranz-RT universal transport media product
epidemic and further work is required for the development of superior diagnostic assays that are both sensitive and specific.”
Testing for multiple STD diagnosis The CDC recommends certain popula- tions be screened for multiple STDs. For example, all pregnant women should be tested for HIV, syphilis, and hepatitis B surface antigen (HBsAg), at their first prenatal visit, and hepatitis C virus (HCV) during each pregnancy, except in settings where the HCV infection rate is <0.1%. The agency urges sexually active
women who are under the age of 25 or who have new or multiple sex partners to get annual tests for chlamydia and gonorrhea. Sexually active gay and bi- sexual men should get tested for syphilis, chlamydia, and gonorrhea at least once a year, or every three to six months if they have multiple sexual partners, according to CDC guidelines.9
“It is critical for labs and healthcare systems to offer STI tests that have a quick time to result and user-friendly techniques for processing,” said Walker.” BD offers the BD CTGCTV2 assay for BD MAX System, a test that simultaneously and separately diagnoses the three most common non-viral STIs: Chlamydia tra- chomatis (CT), Neisseria gonorrhoeae (GC), and Trichomonas vaginalis (TV).” Walker says TV is often not included in STI testing, but it should be. Accord- ing to the CDC, there were more than 2
3 JUNE 2022
MLO-ONLINE.COM 8
million TV infections in the U.S. in 2018, but only 30% of those individuals infected develop symptoms.10 “The BD assay diagnoses TV using
the highly sensitive CDC-recommend NAAT technology,” Walker explained. “For GC diagnosis, the assay has a dual-target design, meaning detection of both GC genes is needed to produce a positive result. This makes a big dif- ference because it provides confidence in your result, confidence that a positive IS a positive, and that you are providing the physician and ultimately the patient with an accurate result.” Walker says the GC test is run on the BD MAX System, a benchtop instrument that can process 24 samples in about three hours. Plus, the BD CTGCTV2 assay uses a variety of specimen types: clinician and self-collected vaginal swabs (in a clinical setting), urine, liquid-based cytology (CT & GC only), and endocervical swabs.
Looking ahead
Preliminary CDC data on STD rates in 2021 reveal a continued increase in infections, specifically for primary and secondary syphilis among adults. Cases among women are up 34% and among men 9%. In addition, syphilis among newborns is up 6%, with 2,268 cases already reported in the preliminary 2021 data, which the CDC will continue to report through the fall of 2022.11 Laboratories are just beginning to see the front end of increased STD screen-
3. New data suggest STDs continued to increase during first year of the COVID-19 pandemic, CDC, April 12, 2022,
https://www.cdc.gov/nchhstp/ newsroom/2022/2020-STD-surveillance-report-
press-release.html
4. LeGoff, J., Péré, H. & Bélec, L. Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virol J 11, 83 (2014). https://doi. org/10.1186/1743-422X-11-83.
5. Human Papillomavirus (HPV) Statistics, CDC,
https://www.cdc.gov/std/hpv/stats.htm
6. Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States, CDC,
https://www.cdc.gov/std/statistics/ prevalence-2020-at-a-glance.htm
7. National Overview of STDs, 2020, CDC, https://
www.cdc.gov/std/statistics/2020/overview. htm#Syphilis
8. Shukalek, Caley & Lee, Bonita & Fathima, Sumana & Chu, Angel & Fonseca, Kevin & Somayaji, Ranjani. (2021). Comparative Analysis of Molecu- lar and Serologic Testing for Primary Syphilis: A Population-Based Cohort Study. Frontiers in Cellular and Infection Microbiology. 11. 579660. 10.3389/ fcimb.2021.579660.
https://www.researchgate. net/publication/351086070_Comparative_Analy- sis_of_Molecular_and_Serologic_Testing_for_Pri- mary_Syphilis_A_Population-Based_Cohort_Study
9. Screening Recommendations and Consider- ations Referenced in Treatment Guidelines and Original Sources, CDC,
https://www.cdc.gov/ std/treatment-guidelines/screening-recommen-
dations.htm
10. Trichomoniasis – CDC Fact Sheet, CDC,
https://www.cdc.gov/std/trichomonas/STDFact- Trichomoniasis.htm
11. Preliminary 2021 Data: Syphilis, CDC,
https://www.cdc.gov/std/statistics/2020/pre- liminary2021.htm
12. New data suggest STDs continued to increase during first year of the COVID-19 pandemic, CDC,
https://www.cdc.gov/media/releases/2022/p0412- STD-Increase.html
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