From microscopy to molecular diagnostics: identifying the complexities of clinical diagnostics for vaginal infections

The use of molecular-based assays to diagnose vaginitis has become increasingly common. In a recent study, J. Elvy, K. Carter, J. Paterson, M. Smith, et al. (Microbiol Spectr 13: e0127424, 2025, https://doi.org/10.1128/spectrum.01274-24) compared the performance of the Hologic Panther Aptima BV and CV/TV assays for the diagnosis of vaginitis to that of the current standard-of-care diagnostic methods that include microscopy, culture, and PCR. The study suggests that the Hologic Panther Aptima BV and CV/TV assays are useful alternatives to conventional testing but would likely lead to higher treatment rates and additional testing costs. However, additional studies are needed to determine the clinical significance of these diagnostic assays, especially for BV and vulvovaginal candidiasis, wherein the presence or absence of specific organisms does not necessarily indicate clinical disease.