USE OF A LACTOFERRIN ASSAY IN THE DIFFERENTIAL-DIAGNOSIS OF FEMALE GENITAL-TRACT INFECTIONS AND IMPLICATIONS FOR THE PATHOPHYSIOLOGY OF BACTERIAL VAGINOSIS

Background and Objectives: Lactoferrin has served as a marker for leuk ocytes (polymorphonuclear neutrophils [PMN]) in clinical specimens. Go al: To investigate the potential of a lactoferrin latex agglutination test in the differential diagnosis of female genital infection. Study Design: Lactoferrin was quantified in the vaginal discharge of women w ith genital infections. Polymorphonuclear neutrophils were added to va ginal discharge and observed over 8 hours. Results: Vaginal lactoferri n titers were significantly elevated in women with trichomoniasis, can didiasis, and bacterial vaginosis (BV). Using a lactoferrin titer of g reater than or equal to 1:40, the assay has a sensitivity of 79.3% and a specificity of 83.3% for the presence of trichomoniasis or bacteria l vaginosis. Vaginal discharge from women with BV significantly destro yed added PMN. Conclusions: Vaginal lactoferrin determinations may pro vide a useful screen for inflammatory genital infections and identify individuals who require additional diagnostic evaluation. The observed absence of PMN in bacterial vaginosis may result from the destruction of PMN in vaginal discharge rather than the absence of a primary infl ammatory response.