Clinical and Molecular Diagnostic Profiling of Vaginitis Using Multiplex Real-Time PCR: A Multicenter Study

Area of Science:

• Gynecology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Vaginal infections present with overlapping symptoms, complicating diagnosis.
• The link between symptoms and specific pathogens, especially in mixed infections, is unclear in routine care.
• Understanding these connections is crucial for effective treatment.

Purpose of the Study:

• To investigate the relationship between clinical symptoms and molecularly identified pathogen profiles in women with vaginitis.
• To assess the utility of multiplex real-time PCR and clinical indicators for diagnosing multi-pathogen infections.
• To compare symptom burden and infection prevalence between different healthcare settings.

Main Methods:

• A multicenter cross-sectional study involving 289 symptomatic women in Northern Vietnam.
• Clinical data collection included demographics and physician-assessed symptoms.
• Vaginal swabs were analyzed using multiplex real-time PCR for pathogen detection and pH measurement.

Main Results:

• Abnormal vaginal discharge and itching were the most frequent symptoms.
• Gardnerella vaginalis was the most common pathogen, often part of multi-pathogen infections.
• Multi-pathogen infections correlated significantly with abnormal discharge (OR=5.44), itching (OR=2.13), and elevated pH (OR=4.70).
• Women at a tertiary hospital had higher symptom burden (OR=1.75) and multi-pathogen prevalence (OR=9.75) than those at a provincial CDC.

Conclusions:

• Multiplex real-time PCR combined with clinical indicators (symptom clustering, vaginal pH) is valuable for diagnosing multi-pathogen vaginal infections.
• This integrated approach supports accurate etiologic diagnosis.
• It can guide rational testing strategies, particularly in resource-limited settings.