Introduction
Microbiology is a fundamental branch of medical science from which the discovery and treatment of various microbial causing diseases takes place. In terms of practice, Obstetrics and Gynecology are unified aspects of medical specialty that deals with management of pregnancy and care of female reproductive health. With the two concepts employed, more sophisticated women’s health issues can be effectively addressed. The role of microbiology in OB/GYN practice includes detection, prevention, and treatment of several bacterial infections among women including the common ones such as Trichomonas vaginalis and Chlamydia Trachomatis. These bacterial infections do not often manifest in symptoms until further testing done on microbiological level. The discussion will highlight the issue of the aforementioned bacterial infections based on evidence from previous research findings.
Microbiology in Infection Detection
Physical examination of women’s reproductive organ alone cannot be a reliable source of evidence for the prevalence of T.Vaginalis and CT particularly when no apparent symptoms are found. However, methodologies such as culture and non-culture made it possible for detection of T-Vaginalis and CT at microscopic level. Other methods of detection also include nucleic acid amplification testing of NAAT (Papp et al.). In addition, antigen detection tests and enzyme immunoassays (EIAs) can be also an effective detection approach. However, diagnostic testing apart from NAAT has their drawbacks because they fail to determine the substantial portion of the infection, which makes NAAT the most effective approach for detection (Papp et al.).
Microbiology in OB/GYN Practice and Research
The unification of obstetrics and gynecology allowed the medical field to improve women’s reproductive health with the help of research. On the other hand, the field of microbiology further enhanced OB/GYN practices with evidence from researches that provides significant insights on issues concerning infection. For instance, the study by Ginocchio et al. (2012), suggests that the prevalence of T.Vaginalis may also coexist with CT and Neisseria Gonorrhoeae, which was determined by NAAT. The findings also suggests that despite the probability of co-infection, it was found to be relatively low in all female age groups in the United States (Ginocchio et al.). In this particular study, the findings was able to determine that high prevalence of T.Vaginalis are also considered highly at risk of other STIs, which places greater importance for T.Vaginalis screening. The result of the study provides a new perspective for OB/GYN practices in the early detection of infections among highly at risk female population.
Research in both microbiology and OB/GYN practices also enabled a varying approach to treatment through antibiotic. According to Geisler et al. (2012), variations in antibiotic treatment has an impact in the effective treatment of infections both complicated and uncomplicated such as urogenital CT. The study conducted a randomized, double dummy, double blind, and active-controlled trials to determine safety and efficacy of vibramycin against WC2031 (doxycycline hyclate). The findings of the multicenter trials for safety and efficacy of the two medications shows that both azithromycin is nearly as effective as doxycycline with a marginal 0.3 difference (Geisler et al.). However, more relevant result was found after conducting NAAT to test the microbial cure capacity of the two medications showed that azithromycin is less effective than doxycycline. The significance of the results in OB/GYN practice can be attributed to the manner of recommending cure, which reveals that CDC’s recommendation of azithromycin for CT treatment is less effective (Geisler et al.).
On the other hand, determining whether the treatment approach is yielding positive results for the patient encompasses a need for test-of-cure in order to ascertain recovery from infection. The field of microbiology also plays an important role on this aspect of OB/GYN practice because ascertaining the effectiveness of treatment entails a greater probability of preventing the infection from reoccurring. In a study conducted by Dukers-Muijrers et al. (2012), it was found that a single and highly sensitive laboratory test such as NAAT taken three weeks after the treatment may not be a reliable basis for test-of-cure. Furthermore, findings also suggests that the current test-of-cure practices for CT lacks evidence of reliability because of the intra-individual and inter-individual variation in test results in relation to the type of NAAT used. This means that a single attempt of test-of-cure is not sufficient to assume that the patient has fully recovered from the infection. The findings from the study implies a change in the testing approach in OB/GYN practice particularly in assuring the patient of full recovery.
Conclusion
The results of the previous studies provide substantial evidence to the relationship between the field of microbiology and OB/GYN. It is apparent that microbiology enhances the OB/GYN practice both in terms of research and addressing women’s health particularly on issues of bacterial infections such as T.Vaginalis and CT. The field of microbiology provides OB/GYN practices with new perspectives on addressing infections from early detection, treatment, and test of cure. The importance of microbiology in OB/GYN is to enable evidence-based practices that will ascertain improvement in women’s reproductive health.
Works Cited
Dukers-Muijrers, Nicole H. T. M. et al. "Chlamydia Trachomatis Test-Of-Cure Cannot Be Based On A Single Highly Sensitive Laboratory Test Taken At Least 3 Weeks After Treatment". PLoS ONE 7.3 (2012): e34108. Web. 27 June 2016.
Geisler, W. M. et al. "Safety And Efficacy Of WC2031 Versus Vibramycin For The Treatment Of Uncomplicated Urogenital Chlamydia Trachomatis Infection: A Randomized, Double-Blind, Double-Dummy, Active-Controlled, Multicenter Trial". Clinical Infectious Diseases 55.1 (2012): 82-88. Web. 27 June 2016.
Ginocchio, C. C. et al. "Prevalence Of Trichomonas Vaginalis And Coinfection With Chlamydia Trachomatis And Neisseria Gonorrhoeae In The United States As Determined By The Aptima Trichomonas Vaginalis Nucleic Acid Amplification Assay". Journal of Clinical Microbiology 50.8 (2012): 2601-2608. Web. 27 June 2016.
Papp, John et al. Recommendations For The Laboratory-Based Detection Of Chlamydia Trachomatis And Neisseria Gonorrhoeae. Washington, DC: Centers for Disease Control and Prevention, 2014. Web. 27 June 2016. Recommendations And Reports.
