Uji Diagnostik Point of Care Test (POCT) Lateral Flow Immunochromatographic Assay (LFIA) Gardnerella vaginalis pada Duh Tubuh Vagina
Monika Puspitasari, Dr. dr. Satiti Retno Pudjiati, Sp.KK(K); dr. Agnes Sri Siswati, Sp.KK(K)
2024 | Tesis | S2 Kedokteran Klinik
Latar Belakang: Vaginosis bakterial (VB) merupakan penyebab yang paling umum keputihan/duh tubuh vagina yang disebabkan oleh disbiosis mikrobiota vagina anaerob, terutama Gardnerella vaginalis. Baku emas diagnosis VB adalah skor Nugent, berdasarkan penilaian jumlah dan proporsi mikrobiota melalui pemeriksaan mikroskopis. Pemeriksaan mikroskopis, saat ini belum tersedia di beberapa layanan kesehatan dan juga sering diabaikan oleh karena jumlah pasien yang banyak atau kurangnya keterampilan analisis mikroskopis. Point of care test lateral flow immunochromatographic assay (LFIA) merupakan alat yang dapat mendeteksi antigen Gardnerella vaginalis, namun uji diagnostik alat ini belum pernah dilakukan di Indonesia.
Tujuan: mengukur kemampuan POCT LFIA Gardnerella vaginalis untuk diagnosis VB pada wanita dengan keluhan duh tubuh vagina.
Metode: Penelitian observasional potong lintang dengan rancangan uji diagnostik, menggunakan sampel duh tubuh vagina. Penelitian ini mengikutsertakan 31 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi. Sampel duh tubuh vagina dilakukan pemeriksaan POCT LFIA dengan Medomic Candida albicans/ Trichomonas vaginalis/ Gardnerella vaginalis Antigen Combo Test Kit® dan pemeriksan skor Nugent.
Hasil: Hasil pemeriksaan skor Nugent dari 31 sampel, didapatkan 15 sampel positif VB (48%). Point of care test LFIA Gardnerella vaginalis memiliki sensitivitas 86,67%, spesifitas 93,75%, akurasi 90,32%, LR(+) 13,87; LR(-) 0,14, PPV 92,86%, NPV 88,24% untuk diagnosis VB pada wanita dengan keluhan duh tubuh vagina.
Kesimpulan: Point of care test LFIA Gardnerella vaginalis dapat digunakan untuk diagnosis VB pada wanita dengan keluhan duh tubuh vagina.
Background: Bacterial vaginosis (VB) is the most common cause of vaginal discharge caused by dysbiosis of anaerobic vaginal microbiota, especially Gardnerella vaginalis. The gold standard for VB diagnosis is the Nugent score, based on assessing the number and proportion of microbiota through microscopic examination. Microscopic examination is currently not available in some health services and is also often neglected due to the large number of patients or lack of microscopic analysis skills. The point of care test lateral flow immunochromatographic assay (LFIA) is a tool that can detect Gardnerella vaginalis antigens, but this diagnostic test has never been carried out in Indonesia.
Aim: to measure ability of POCT LFIA Gardnerella vaginalis for the diagnosis of BV in women with complaints of vaginal discharge.
Methods: Cross-sectional observational study with a diagnostic test design, using vaginal discharge samples. This study included 31 research subjects who met the inclusion and exclusion criteria. Vaginal discharge samples were subjected to POCT LFIA examination with Medomic Candida albicans/ Trichomonas vaginalis/ Gardnerella vaginalis Antigen Combo Test Kit® and Nugent score examination.
Results: The results of the Nugent score examination of 31 samples showed that 15 samples were positive for VB (48%). Point of care test LFIA Gardnerella vaginalis has sensitivity 86.67%, specificity 93.75%, accuracy 90.32%, LR(+) 13.87; LR(-) 0.14, PPV 92.86%, NPV 88.24% for the diagnosis of VB in women with complaints of vaginal discharge.
Conclusion: The POCT LFIA Gardnerella vaginalis can be used for diagnosis of BV in women with complaints of vaginal discharge.
Kata Kunci : vaginosis bakterial, skor Nugent, point of care test, lateral flow immunochromatographic assay
