Original Research

Strong correlation between urine and vaginal swab samples for bacterial vaginosis

Deshanta Naicker, Veron Ramsuran, Meleshni Naicker, Fazana Dessai, Jennifer Giandhari, Partson Tinarwo, Nathlee Abbai
Southern African Journal of Infectious Diseases | Vol 36, No 1 | a199 | DOI: https://doi.org/10.4102/sajid.v36i1.199 | © 2021 Deshanta Naicker, Veron Ramsuran, Meleshni Naicker, Fazana Dessai, Jennifer Giandhari, Partson Tinarwo, Nathlee Abbai | This work is licensed under CC Attribution 4.0
Submitted: 24 March 2020 | Published: 17 June 2021

About the author(s)

Deshanta Naicker, School of Clinical Medicine Research Laboratory, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Veron Ramsuran, KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
Meleshni Naicker, School of Clinical Medicine Research Laboratory, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Fazana Dessai, School of Clinical Medicine Research Laboratory, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Jennifer Giandhari, KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
Partson Tinarwo, Department of Biostatistics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Nathlee Abbai, School of Clinical Medicine Research Laboratory, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa


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Abstract

Background: Vaginal swabs have been traditionally used for the diagnosis of bacterial vaginosis (BV). Currently, there are limited studies that have investigated the use of other sample types other than vaginal swabs for the detection of BV from South African populations. This study investigated whether urine can be used for the detection of BV-associated microorganisms in South African pregnant women.

Methods: One-hundred self-collected vaginal swabs and urine samples were obtained from women presenting for antenatal care at King Edward VIII Hospital in Durban. The BD MAX™ vaginal panel assay was used for diagnosing BV and droplet digital polymerase chain reaction was used to quantify Gardnerella vaginalis, Prevotella bivia, Atopobium vaginae and Lactobacillus crispatus. The absolute counts were determined on the QX200 Droplet Reader (Bio-Rad) using the QuantaSoft Software. Data analysis was performed with statistical computing software called R, version 3.6.1.

Results: Median copy numbers obtained for G. vaginalis and P. bivia across urine and swabs in BV-positive samples were not significantly different (p = 0.134 and p = 0.652, respectively). This was confirmed by the correlation analysis that showed a good correlation between the two sample types (G. vaginalis [r = 0.63] and P. bivia [r = 0.50]). However, the data obtained for A. vaginae differed, and a weak correlation between urine and swabs was observed (r = 0.21). Bacterial vaginosis-negative samples had no significant difference in median copy numbers for L. crispatus across the urine and swabs (p = 0.062), and a good correlation between the sample types was noted (r = 0.71).

Conclusion: This study highlights the appropriateness of urine for the detection of microorganisms associated with BV.


Keywords

pregnant women; bacterial vaginosis; urine; swab; BV; ddPCR; G. vaginalis; South Africa

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