Rapid antigen testing for trichomoniasis in an emergency department

Nikki R. Postenrieder, Jennifer L. Reed, Elizabeth Hesse, Jessica A. Kahn, Lili Ding, Charlotte A Gaydos, Anne Marie Rompalo, Lea E. Widdice

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Trichomoniasis is a prevalent cause of vaginitis among adolescents that increases the risk of acquiring other sexually transmitted diseases and of negative pregnancy outcomes. Treatment of trichomoniasis is therefore essential for improving sexual and reproductive health outcomes. A timely, sensitive diagnostic test for T vaginalis may increase the accuracy of clinician's treatment decisions, resulting in more infected women receiving treatment and fewer uninfected women receiving treatment. METHODS: This study was a retrospective observational assessment of electronic medical records before and after point-of-care (POC) implementation of the rapid antigen test. Records were collected from women aged 14 to 20 years who received a T vaginalis test in the emergency department during either study period. The main outcome measures were rates of accurate treatment, inaccurate treatment, and missed treatment of trichomoniasis in each study period. RESULTS: Overall rates of accurate treatment increased from 78.7% pre-POC to 87.7% post- POC (P = .02). Specifically, rates of not treating uninfected women increased from 61.4% pre-POC to 70.4% post-POC (P = .06), and rates of treating infected women were the same pre-POC (17.3%) and post-POC (17.3%; P = .99). Rates of inaccurate treatment decreased from 23.1% pre-POC to 13.1% post-POC (P = .02). Changes in missed treatment rates (14.0% pre-POC; 8.8% post-POC; P = .73) were not statistically significant. CONCLUSIONS: POC testing can improve clinical care by decreasing the use of antibiotics in uninfected women. The results of this study support the use of a T vaginalis rapid antigen POC test for adolescents presenting to the emergency department.

Original languageEnglish (US)
Article numbere20152072
JournalPediatrics
Volume137
Issue number6
DOIs
StatePublished - Jun 1 2016

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Point-of-Care Systems
Hospital Emergency Service
Antigens
Therapeutics
Reproductive Health
Vaginitis
Electronic Health Records
Pregnancy Outcome
Sexually Transmitted Diseases
Routine Diagnostic Tests

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Postenrieder, N. R., Reed, J. L., Hesse, E., Kahn, J. A., Ding, L., Gaydos, C. A., ... Widdice, L. E. (2016). Rapid antigen testing for trichomoniasis in an emergency department. Pediatrics, 137(6), [e20152072]. https://doi.org/10.1542/peds.2015-2072

Rapid antigen testing for trichomoniasis in an emergency department. / Postenrieder, Nikki R.; Reed, Jennifer L.; Hesse, Elizabeth; Kahn, Jessica A.; Ding, Lili; Gaydos, Charlotte A; Rompalo, Anne Marie; Widdice, Lea E.

In: Pediatrics, Vol. 137, No. 6, e20152072, 01.06.2016.

Research output: Contribution to journalArticle

Postenrieder, NR, Reed, JL, Hesse, E, Kahn, JA, Ding, L, Gaydos, CA, Rompalo, AM & Widdice, LE 2016, 'Rapid antigen testing for trichomoniasis in an emergency department', Pediatrics, vol. 137, no. 6, e20152072. https://doi.org/10.1542/peds.2015-2072
Postenrieder NR, Reed JL, Hesse E, Kahn JA, Ding L, Gaydos CA et al. Rapid antigen testing for trichomoniasis in an emergency department. Pediatrics. 2016 Jun 1;137(6). e20152072. https://doi.org/10.1542/peds.2015-2072
Postenrieder, Nikki R. ; Reed, Jennifer L. ; Hesse, Elizabeth ; Kahn, Jessica A. ; Ding, Lili ; Gaydos, Charlotte A ; Rompalo, Anne Marie ; Widdice, Lea E. / Rapid antigen testing for trichomoniasis in an emergency department. In: Pediatrics. 2016 ; Vol. 137, No. 6.
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abstract = "BACKGROUND AND OBJECTIVES: Trichomoniasis is a prevalent cause of vaginitis among adolescents that increases the risk of acquiring other sexually transmitted diseases and of negative pregnancy outcomes. Treatment of trichomoniasis is therefore essential for improving sexual and reproductive health outcomes. A timely, sensitive diagnostic test for T vaginalis may increase the accuracy of clinician's treatment decisions, resulting in more infected women receiving treatment and fewer uninfected women receiving treatment. METHODS: This study was a retrospective observational assessment of electronic medical records before and after point-of-care (POC) implementation of the rapid antigen test. Records were collected from women aged 14 to 20 years who received a T vaginalis test in the emergency department during either study period. The main outcome measures were rates of accurate treatment, inaccurate treatment, and missed treatment of trichomoniasis in each study period. RESULTS: Overall rates of accurate treatment increased from 78.7{\%} pre-POC to 87.7{\%} post- POC (P = .02). Specifically, rates of not treating uninfected women increased from 61.4{\%} pre-POC to 70.4{\%} post-POC (P = .06), and rates of treating infected women were the same pre-POC (17.3{\%}) and post-POC (17.3{\%}; P = .99). Rates of inaccurate treatment decreased from 23.1{\%} pre-POC to 13.1{\%} post-POC (P = .02). Changes in missed treatment rates (14.0{\%} pre-POC; 8.8{\%} post-POC; P = .73) were not statistically significant. CONCLUSIONS: POC testing can improve clinical care by decreasing the use of antibiotics in uninfected women. The results of this study support the use of a T vaginalis rapid antigen POC test for adolescents presenting to the emergency department.",
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