Detection of sexually transmitted infection and human papillomavirus in negative cytology by multiplex-PCR

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to determine the prevalence of human papillomavirus (HPV) and 15 species that cause sexually transmitted infections (STIs) in negative cytology. In addition, we compared the diagnostic performance of multiplex polymerase chain reaction (PCR) with widely available techniques used to detect HPV.</p> <p>Methods</p> <p>We recruited 235 women of reproductive age who had negative cytology findings in a liquid-based cervical smear. STIs were identified by multiplex PCR, and HPV genotypes by multiplex PCR, hybrid capture 2, and DNA microaray; discordant results were analyzed by direct sequencing.</p> <p>Results</p> <p>Approximately 96.6% of patients with negative cytology results were positive for pathogens that cause STIs. The pathogens most frequently detected were <it>Gardnerella vaginalis, Ureaplasma urealyticum</it>. The incidence of HPV in negative cytology was 23.3%. Low-risk HPV infection was significantly correlated with <it>Chalmaydia trachomatis</it>, and high-risk HPV infection was significantly correlated with <it>Group β streptococcus</it>. The analytical sensitivities of the multiplex PCR and DNA microarray were higher than 80%, and the analytical specificity was nearly 100% for all tests.</p> <p>Conclusions</p> <p>Multiplex PCR yielded results that most of patients with negative cytology were positive for pathogens that cause STIs, and were more similar to that of DNA microarray, than that of hybrid capture 2 in terms of analytical sensitivity and prediction value of HPV infection.</p

Évaluation des compétences pour la pratique de la biométrie échographique fœtale : validation prospective du score OSAUS METHOD

International audienceObjectivesTo develop and validate a customized variant for fetal biometry of the generic OSAUS score (Objective Structured Assessment of Ultrasound Skills)MethodsThe 5-points OSAUS METHOD grid was elaborated by defining five target skills specific to fetal biometry for each thematic item of the generic score. The level of skills of 43 trainees was prospectively assessed during an ultrasound examination by using this grid. The results of the “novice” level group (experience < 10 ultrasounds) were compared to those of the “intermediate” level group (experience ≥ 10 ultrasounds) (I). The reached/non-reached skills ratio within the different items composing the score allowed the identification of priority areas of improvement (II). Previously published distribution and actual distribution of ratings according to the generic pass/fail score were compared (III).ResultsMedian scores of “novices” (n = 29) and “intermediates” (n = 14) groups were statistically different, 1.87 (±0.75) and 3.31 (±0.83) (P = 1.85-5), respectively and corresponded to the pre-existing experience (I). A lower ratio of reached skill allowed the identification of “documentation of the examination” item as a priority area of improvement for both groups (II). The relevance of the pass/fail score is consolidated, even if an overlap was observed between novices and intermediates groups (III).ConclusionsThe relevancy and feasibility of using OSAUS scoring method for fetal biometry are supported. In addition, the possibility of comparisons with generic OSAUS remains.ObjectifsDévelopper et évaluer la pertinence clinique d’une version du score générique OSAUS (Objective Structured Assessment of Ultrasound Skills) dédiée à la biométrie fœtale.Matériel et méthodesCinq compétences cibles spécifiques à la biométrie fœtale ont été définies pour chaque item thématique du score générique permettant d’établir une grille d’évaluation OSAUS-METHOD sur 5 points (MEasurements TeacHing in Obstetrics Design). Le niveau de compétence de 43 étudiants a été évalué à l’aide grille OSAUS-METHOD (MEasurements TeacHing in Obstetrics Design) lors d’examens pratiques. Les notes des étudiants débutants (expérience pratique < 10 examens) ont été comparées à celles des étudiants de niveau intermédiaire (expérience pratique ≥ 10 examens) (I). La proportion de compétences validées ou non au sein de chacun des items thématiques du score a permis d’identifier les axes de progression prioritaires (II). La distribution des notes obtenues par rapport au seuil de certification utilisé pour le score générique a été comparée à celle précédemment publiée (III).RésultatsLe score moyen au sein du groupe « débutants » (n = 29) était significativement plus faible que celui au sein du « intermédiaires » (n = 14) (1,87 ± 0,75 et 3,31 ± 0,83 respectivement, p = 1,855) (I). Une proportion plus importante de compétences non validée a permis d’identifier l’item « documentation de l’examen » comme axe de progression prioritaire (II). La pertinence du score seuil pour discriminer les étudiants en fonction du niveau d’expertise est confortée mais un minime chevauchement entre les groupes de niveau est observé (III).ConclusionLa faisabilité et la pertinence de l’utilisation d’un score OSAUS dédié à la biométrie sont confirmées ainsi que la possibilité de comparaisons avec le score OSAUS générique