Willem Melchers, head of lab biologists at University Medical Centre, is a strong advocate of the benefits of using real-time PCR technology. He is a firm believer that using the right diagnostics tools for sexually transmitted infections (STIs) can save time and improve public health.
"Chlamydia and neisseria are the two major infections currently seen in Europe, and, for any screening, they are the main targets," he says. "Of course, their prevalence depends on the population being screened.
"What we do at the public health centres - where people go anonymously to be tested for possible STIs - is not really applicable to the general population. It's for people that are afraid of having the diseases. In this population, the prevalence for chlamydia is about 5-8% and for neisseria it's about 1-3%."
What this means, according to Melchers, is that the actual prevalence of STIs is much more prevalent, as there is no general population-based screening for STIs.
"The only people being screened are those that are asking for it," he says. "That means only the people who want to be screened are being screened. It's ridiculous to assume that, in the normal population, there are no STIs."
It is important to be able to quickly and accurately detect the pathogens that cause various STIs - particularly so in the case of chlamydia, as early intervention can solve a lot of problems.
"If somebody is positive, then you need to do a partner research to identify other people either at risk or already with an STI," says Melchers.
"That means patients can then be treated in a timely manner, which, for chlamydia, is extremely important, because it is related to a large number of different health issues, including infertility."
It is with this need for expediency that real-time PCR really comes into its own in comparison with more traditional methods, according to Melchers. "There are many different pathogens - if you try to identity those pathogens by conventional methods, they are mostly insensitive and time-consuming. Mycoplasma genitalium also turns out to have a high prevalence when qPCR detection is used, and is a common cause of non-gonococcal urethritis (NGU) and cervicitis, requiring adapted antibiotherapy.
"If you are not doing molecular diagnosis, you can't do amplification-based methods. If you don't use these methods for the detection of these pathogens, you are living in the dinosaur age."
