Frequency of sexually transmitted diseases and main methodological implications

Background. High risk Human Papillomavirus (HR-HPV) persistence is the most important cervical cancer risk factor, while Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma hominis (MH), Mycoplasma genitalium(MG), Ureaplasma urealyticum (UU) and parvum (UP) are sexually transmitted diseases (STDs) causing infertility, pregnancy complication, lung problems in newborns. Methods. 135 urine, 135 urethral swabs, 553 cervical swabs, 110 seminal fluids and 1440 Thin Prep, were tested with culture methods, Real-Time PCR (RT-PCR) and multiplex SYBR Green PCR-endpoint to detect STDs. PCR- endpoint was performed to detect HPV. Results. Culture methods showed the lowest sensitivity: for MH it was only 24% (compared to RT-PCR). UP/UU were the most frequent pathogens (13% with culture, 29% with PCR-endpoint, 41,67% with RT-PCR). Turn Around Time was respectively: 48h, 6h and 2h. RT-PCR cervical frequencies for CT, MH, MG, UU, UP were: 5.42%, 11.03%, 1.81%, 11.21% and 35.08%. HPV positivity in primary and secondary screening was 17.33% and 51.14%. Highes t positivity age group was: 23-32 years for CT (17%), and 18-27 years for HPV (33%). Conclusions. RT-PCR is more sensitive, faster, less expensive than other molecular tests like PCR-endpoint and microarrays. It allows more efficient laboratory organization: pre-analytical phase is more automated and enable the implementation of further diagnostic tests for pathologies that need rapid identification, such as meningitidis and sepsis, with reduced human and instrumental resource. Regarding STDs screening, it should be performed in women: for CT at least up to 27 years; for HPV between 35-50 years, since persisting HR-HPV infection is responsible of high-grade lesions.