Evidence Against the “Booty Pack”: Trichomonas Not Associated with Gonorrhea or Chlamydia

Abstract 

Many Emergency Physicians armed with a positive Trichomonas wet mount will also treat for Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT). This study estimates the association between Trichomonas microscopy result and a DNA test result for GC or CT. Using laboratory records from patients who had simultaneous sampling for all three infections, we calculated an odds ratio for the association between the Trichomonas result and a positive test for either GC or CT. Among 795 eligible females, 105 (13%) had Trichomonas, 74 (9%) had CT, and 35 (4%) had GC. Whereas CT and GC were strongly associated with each other (odds ratio 5.9, 95% confidence interval 2.8–12.4, p < 0.0001), Trichomonas infection was unrelated to infection with either GC or CT (odds ratio 1.1, 95% confidence interval 0.6–2, p = 0.9). Trichomonas results do not predict results for GC and CT; they should not influence the decision to treat for GC and CT.

Keywords: Trichomonas, chlamydia, gonorrhea, sexually transmitted diseases, epidemiology