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EPIC ORDER CODE LAB1928 Trichomonas vaginalis, Nucleic Acid Amplification, Varies

Important Note

TVRNAM: Trichomonas vaginalis, NAAT for Endocervix/Cervix, Vaginal, or Urine specimens (MALE OR FEMALE)

 MTRNA: mayo test is for MALE urethral swab only.  

 

Additional Codes

SQ: TVRNAM

MAYO CODE: TVRNA 

Useful For

Detecting Trichomonas vaginalis in urine, cervical/endocervical or vaginal specimen types

Reporting Name

Trichomonas vaginalis Amplified RNA

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Endocervix/Cervix

Supplies: Aptima Unisex Swab Collection Kit (T583)

Container/Tube: Aptima Unisex Swab

Specimen Volume: Swab

Collection Instructions:

1. Specimens must be collected using the Aptima Unisex Swab Collection Kit.

2. Use cleaning swab (white shaft) to remove excess mucus from endocervix/cervix.

Discard the cleaning swab.

3. Insert second swab (blue shaft) 1 to 1.5 cm into endocervical canal, and rotate swab gently for 30 seconds. Avoid touching vaginal wall when removing swab.

4. Place second swab (blue shaft) into Aptima transport tube provided in collection kit. Snap off swab at score line so swab fits into closed tube.

5. Cap tube securely and label tube with patient's entire name and collection date and time.

6. Maintain swab container at 2 to 30° C (refrigerate temperature is preferred), transport within 60 days of collection.

 

Specimen Type: Vaginal

Supplies: Aptima Multitest Swab Collection Kit (T584)

Container/Tube: Aptima Multitest Swab

Specimen Volume: Swab

Collection Instructions:

1. Specimens must be collected using the Aptima Multitest Swab Collection Kit.

2. Insert swab (pink shaft) about 5 cm past introitus and rotate gently for 30 seconds.

3. Place swab into Aptima transport tube provided in collection kit. Snap off swab at score line so swab fits into closed tube.

4. Cap tube securely and label tube with patient's entire name and collection date and time.

5. Maintain swab container at 2 to 30° C (refrigerate temperature is preferred), transport within 60 days of collection.

 

Specimen Type: ThinPrep Specimen (Endocervix/Cervix)

Supplies: Aptima Thin Prep Transport Tube (T652)

Container/Tube: Thin Prep Transport Tube

Specimen Volume: 1 mL

Collection Instructions:

1. Collect ThinPrep sample as per normal collection process.

2. ThinPrep specimen must be aliquoted (as outlined below) before it is processed/tested for Pap smear.

3. Vortex ThinPrep/PreservCyt vial 3 to 10 seconds. Within 1 minute of vortexing:

a. Transfer 1 mL of specimen into the Aptima specimen transfer tube using a disposable transfer pipette or a pipette tip containing a filter (aerosol barrier or hydrophobic plug).

b. Process only 1 ThinPrep and transfer tube set at a time.

c. Recap Aptima specimen transfer tube tightly and gently invert 3 times to mix.

3. Label Aptima transfer tube with appropriate label.

4. Use remainder of ThinPrep specimen for Pap testing.

5. Maintain specimen transport tube at 2 to 30° C (refrigerate temperature is preferred), transport within 30 days of collection when stored at 2 to 14° C or within 14 days when stored at 15 to 30° C.

 

Specimen Type: Urine

Supplies: Aptima Urine Transport Tube (T582)

Container/Tube: Aptima urine specimen transport tube

Specimen Volume: 15 to 20 mL

Collection Instructions:

1. Patient should not have urinated for at least 1 hour prior to specimen collection.

2. Patient should collect first portion of random voided urine (first part of stream) into a sterile, plastic, preservative-free container.

3. Within 24 hours of collection, transfer 2 mL of urine into the Aptima urine specimen transport tube using the disposable pipette provided. The correct volume of urine has been added when the fluid level is between the black fill lines on the Aptima urine transport tube.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) APTIMA VIAL
  Frozen  180 days APTIMA VIAL
  Ambient  APTIMA VIAL

Reject Due To

Midstream urine specimen
Clean catch urine specimen
Over-filled or under-filled urine transport tubes
Specimen collected into a SurePath device
Transport tubes containing a cleaning swab or more than 1 swab
Reject

Clinical Information

Trichomonas vaginalis is a protozoan parasite that commonly infects the genital tract of men and women. It is considered to be the most common nonviral sexually transmitted infection (STI), with an estimated 2.6 million cases documented in 2020 in the United States. Although up to 70% of infected individuals are asymptomatic, infections may be associated with vaginitis, urethritis, and cervicitis in women and urethritis and prostatitis in men. Patients that are infected with T vaginalis have an increased risk of acquiring other STIs, such as HIV, while infections in pregnant women are associated with premature labor, low birth-weight offspring, premature rupture of membranes, and post-hysterectomy/post-abortion infection.

 

Symptoms of T vaginalis overlap considerably with other STIs; therefore, laboratory diagnosis is required for definitive diagnosis. The most frequently used method for detection is microscopic examination of a wet-mount preparation of vaginal secretions. However, this method has only 35% to 80% sensitivity compared with culture. Culture also suffers from relatively low sensitivity (38%-82%) when compared to molecular methods. Culture is technically challenging and takes 5 to 7 days to complete. Molecular methods, such as the Aptima T vaginalis assay, offer high sensitivity and specificity for detection of trichomoniasis. The Aptima test utilizes target capture, transcription-mediated amplification, and hybridization protection assay technologies for detection of T vaginalis ribosomal RNA.

Reference Values

Negative

Interpretation

A positive result indicates the presence of nucleic acid from Trichomonas vaginalis and is strongly supportive of a diagnosis of trichomoniasis.

 

A negative result indicates the absence of nucleic acid from T vaginalis.

 

A negative result does not exclude the possibility of infection. If clinical indications strongly suggest gonococcal or chlamydial infection, additional specimens should be collected for testing.

 

A result of inconclusive indicates that a new specimen should be collected.

 

The predictive value of an assay depends on the prevalence of the disease in any specific population. In settings with a high prevalence of sexually transmitted infections, positive assay results have a high likelihood of being true-positive results. In settings with a low prevalence of sexually transmitted infections, or in any setting in which a patient's clinical signs and symptoms or risk factors are inconsistent with infection, positive results should be carefully assessed, and the patient retested by other methods if appropriate.

Clinical Reference

1. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187

2. Andrea SB, Chapin KC. Comparison of Aptima Trichomonas vaginalis transcription-mediated amplification assay and BD affirm VPIII for detection of T. vaginalis in symptomatic women: performance parameters and epidemiological implications. J Clin Microbiol. 2011;49(3):866-9. doi:10.1128/JCM.02367-10

3. Chernesky M, Jang D, Gilchrist J, et al. Ease and comfort of cervical and vaginal sampling for Chlamydia trachomatis and Trichomonas vaginalis with a new Aptima specimen collection and transportation kit. J Clin Microbiol. 2014;52(2):668-70. doi:10.1128/JCM.02923-13

Method Description

The APTIMA Trichomonas vaginalis assay combines the technologies of target capture, transcription-mediated amplification, and hybridization protection assay for detection of 16S ribosomal RNA from T vaginalis.(Package insert: APTIMA Trichomonas vaginalis Assay. Hologic, Inc; Rev. 003, 06/2023)

Day(s) Performed

Monday through Sunday

Report Available

1 to 4 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87661

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TVRNA Trichomonas vaginalis Amplified RNA 46154-1

 

Result ID Test Result Name Result LOINC Value
SRC29 SOURCE: 31208-2
34810 Trichomonas vaginalis amplified RNA 46154-1

Method Name

Transcription-Mediated Amplification

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.