Clinical Impact Of Usage Of Luminex Diagnostic Panels For Sexually Transmitted Infections (Stis)

Background: Usage of molecular complex diagnostics has been shown to improve sensitivity of testing and to detect more co-infections. The aim of our study was to evaluate the improvement of diagnosis of STIs using complex diagnostics panels instead of the single tests ordered. Methods & Materials: STI diagnostic panel (STI DP) detecting N. gonorrhoeae (NG), C. trachomatis (CT), C. trachomatis LGV (LGV), T. vaginalis (TV), M. genitalium (MG), M. hominis (MH), U. urealyticum (UU), U. parvum (UP) and genital ulcer diagnostic panel (GU DP) detecting Herpes simplex virus 1 (HSV1), and 2 (HSV2), T. pallidum (TP), H. duckreyi (HD), C. trachomatis LGV (LGV) were developed using Luminex xMAP technology. All samples sent in suspicion of STI were analyzed by STI DP (during 1 month) or in case of genital ulcer by GU DP (2 months) regardless which particular pathogen detection was ordered by physician. Results: Totally 4985 STI and 336 GU samples from patients admitted to STI clinics were included. From these 253 (5%) and 16 (4.7%) were ordered for full STI DP and GU DP by physicians, and the rest for single pathogens/pathogen combinations. In case of STIs % investigations ordered by physicians from all samples were following: NG 49%, CT 91%, LGV 7%, TV 19%, MG 46%, MH 14%, UU 51%, UP 51% and in GU: HSV1 95%, HSV2 95%, HD 9%, TP 11%. Positive results from samples sent for particular pathogen testing and sent for some other pathogen(s) testing were following: NG 0.25/0.16%, CT 2.8/0.2% (p < 0.001), LGV 0/0%, TV 0.32/0.52%, MG 1.4/1.0%, MH 7.1/8.1%, UU 7.4/8.1%, UP 31.2/33.7%, HSV1 6.6/16.7%, HSV2 12.9/5.9%, HD 0/0%, TP 0/0%. In our settings, testing only pathogens ordered by physicians (instead of full panels) we lose 40% NG, 0.6% CT, 87.5% TV, 47.5% MG, 87.3% MH, 51% UU%, 51% UP, 12.5% HSV1 and 2.4% of HSV2 which actually present in clinical materials. Conclusion: Routine usage of diagnostic panels increases detection rate of some STI pathogens especially T. vaginalis and N. gonorrhoeae.