Role of molecular biology in the diagnosis of genital infections
ESC Congress Library. Donders G. May 6, 2016; 133841; CS11.2
Prof. Dr. Gilbert Donders
Prof. Dr. Gilbert Donders
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What where and when to use in the diagnosis of vulvovaginal microflora alterations. Limitations and shortcomings of NAATs. Future developments.
Role of molecular biology in diagnosis and characterization of vulvo-vaginitis
Gilbert G. G. Donders, MD; Jacques Ravel, PhD; Beatrice Vitali, PhD; Mihai G. Netea,PhD; Andres Salumets, PhD; Magnus Unemo, PhD
From the Genital Infectious Diseases, Department of Obstetrics and Gynaecology Antwerp University Hospital, Department of Obstetrics and Gynaecology Regional Hospital H Hart Tienen, and Femicare, Clinical Research For Women, Tienen, Belgium (Dr Donders); Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA (Dr Ravel); Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy (Dr Vitali); Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands (Dr Netea); and WHO Collaborating Centre for Gonorrhoea and other STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (Dr Unemo).

The diagnosis and differential diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately, in a world where women find readily on the internet what disease their symptoms correspond to, and find the appropriate treatment over the counter, as specialists we are increasingly confronted with patients with complex and combined conditions.
Simultaneously, extremely accurate and detailed diagnostic tools are developed at an rapid pace, allowing us physicians to diagnose vulvo-vaginal disease with a precision never seen. Even more, many of these molecular biology based tests became so common and affordable that self testing is no longer an utopia.
On the other hand, too much information, too readily available, too affordable, also encompasses pitfalls, leading to gross overtreatment and psychological burden. As experienced care-givers, we should supervise these evolutions, define their place and proper use as diagnostic tools, utilize their potential as an ad hoc tool to follow up treatment efficacy and guide how such tools can be used for responsible self-testing.
In this contribution, responding to the need for appropriate, quality assured and accessible tests for vulvo-vaginitis and the huge potential delivered by the rapidly developing molecular biology methods, we plea for broad and regular discussion forum, composed of both clinical and technical experts and opinion makers, in order to match the needs with the potential possibilities and optimally combine the initiatives and forces into the same direction. This forum should then translate into regularly updated, evidence based national and international guidelines.
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