PCR testingMultiplex PCR testing is a form of bacterial detection that looks for bacterial RNA and DNA, instead of trying to grow the bacteria in a petri dish (culturing). Before you get any antibiotics, you should demand both an extensive culture and multiplex PCR tests, since many bacteria associated with bacterial vaginosis (BV) have natural and/or acquired antibiotic resistant, or are very quick to develop resistance.

You may also have aerobic vaginitis or desquamative inflammatory vaginitis, or something else entirely. Only a test will clear it up. If your symptoms are not simply fishy odour and discharge, then you have something else – classic BV does not cause itching, irritation or inflammation. That’s one of its features. Aerobic vaginitis, on the other hand, involves other types of bacteria, and does cause inflammation. You need to be sure what is in your vagina before you do any treatments.

If you are given antibiotics, you may be given the wrong sort for too short of a time, and cause antibiotic resistance in undetected bacteria, thus creating a bigger problem. Antibiotic resistance means you’ll have recurrent BV that will not respond to regular treatments, and will get harder and harder to treat with every failed attempt.

When getting multiplex PCR tested, you want to ensure you get the full swathe of appropriate tests (such as for STIs if applicable) for your circumstance, which might include (but is not limited to) testing for the following bacteria:

  1. Atopobium vaginae
  2. Candida albicans
  3. Candida glabrata
  4. Candida parapsilosis
  5. Candida tropicalis
  6. Chlamydia trachomatis
  7. Enterococcus faecalis
  8. Epstein-Barr virus (EBV)
  9. Escherichia coli
  10. Gardnerella vaginalis
  11. Group B Streptococcus (GBS)
  12. Haemophilus ducreyi
  13. Haemophilus influenzae
  14. Herpes simplex virus types 1 and 2
  15. Human adenovirus
  16. Lactobacillus (BV & AV Panel) (L. crispatus, L. jensenii, L. gasseri, L. iners)
  17. Megasphaera species (type 1 and type 2)
  18. Mobiluncus curtisii
  19. Mobiluncus mulieris
  20. Mycoplasma genitalium
  21. Neisseria gonorrhoeae
  22. Neisseria meningitidis
  23. Staphylococcus aureus
  24. Streptococcus pneumoniae
  25. Trichomonas vaginalis
  26. Treponema pallidum
  27. Ureaplasma urealyticum
  28. Ureaplasma parvum

Make sure your doctor has this list, and the full spectrum of tests is performed both with culture and multiplex PCR as is applicable to your symptoms – not all of these bacteria will match your symptoms, but do your homework and establish a basic understanding so you are informed.

Many of these bacteria could be antibiotic resistant and not appear on cultures – some are slow-growing and hard to culture. Multiplex PCR is not a replacement for culturing, which is an excellent method of detection for many bacteria, so both should be done with as many suspect bacteria as possible. If the multiplex PCR test can do as many as possible in one test, great.

Get a copy of all of your test results every time you get tested so you can see exactly for what and how you have been tested, and record any treatments you are given including antibiotic name, dose and treatment duration. This matters if treatment fails.

 

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