K Number
K243345
Device Name
Aptima BV Assay; Aptima CV/TV Assay
Manufacturer
Date Cleared
2024-11-25

(28 days)

Product Code
Regulation Number
866.3975
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Aptima BV Assay: The Aptima BV Assay is an in vitro nucleic acid amplification test that utilizes real time Transcription-Mediated Amplification (TMA) technology for detection and quantitation of ribosomal RNA from bacterial vaginosis (BV), including Lactobacillus (L. gasseri, L. crispatus, and L. jenseni), Gardnerella vaginalis), and Atopobium vaginae (A. vaginae). The assay reports a qualitative result for BV and does not report results for individual organisms. The assay is intended to aid in the diagnosis of BV on the automated Panther System using clinician-collected and patient-collected vaginal swab specimens from females with a clinical presentation consistent with vaginitis and/or vaginosis. Aptima CV/TV Assay: The Aptima CV/TV Assay is an in vitro nucleic acid amplification of RNA from microorganisms associated with vulvovaginal candidiasis and trichomoniasis. The assay utilizes real time Transcription-Mediated Amplification (TMA) technology to detect and qualitatively report results for the following organisms: Candida species group (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata (C. glabrata), Trichomonas vaginalis (TV). The assay differentiates between C. glabrata and the Candida species group (C spp) by targeting the RNA component of RNAse P ribonucleoprotein; the assay does not differentiate among C spp. For TV, the assay targets ribosomal RNA (rRNA) and differentiates the results for C. glabrata and C spp. The assy is intended to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis on the automated Panther System using clinician-collected and patientcollected vaginal swab specimens from females with a clinical presentation consistent with vagintis.
Device Description
Aptima BV Assay: Like the Aptima BV assay 100 test kit, the Aptima BV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of rRNA from bacteria associated with bacterial vaginosis in women with a clinical presentation consistent with vaginitis/vaginosis. The Aptima BV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of bacterial vaginosis. Aptima CV/TV Assay: Like the Aptima CV/TV assay 100 test kit, the Aptima CV/TV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of RNA from microorganisms associated with vaginitis, trichomoniasis, and vulvovaginitis, in women with a clinical presentation consistent with vaginitis, trichomoniasis, and vulvovaginitis. The Aptima CV/TV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis.
More Information

Not Found

No
The summary describes a nucleic acid amplification test (NAAT) that uses real-time Transcription-Mediated Amplification (TMA) technology. There is no mention of AI, ML, or any computational methods beyond standard signal processing for qualitative results. The performance studies focus on Limit of Detection (LoD) and C95 values, which are typical metrics for molecular diagnostic assays, not AI/ML models.

No.
This device is an in vitro diagnostic test intended to aid in the diagnosis of bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis by detecting and quantitating specific ribosomal RNA. It provides diagnostic information and does not directly treat or prevent a disease or condition.

Yes

The "Intended Use / Indications for Use" section explicitly states that both the Aptima BV Assay and the Aptima CV/TV Assay are "intended to aid in the diagnosis" of specific conditions (bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis).

No

The device is described as an in vitro nucleic acid amplification test kit that utilizes the automated Panther system. This involves physical reagents and hardware (the Panther system), not just software.

Yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use/Indications for Use: Both the Aptima BV Assay and the Aptima CV/TV Assay explicitly state they are "in vitro nucleic acid amplification tests." They are intended to be used on biological specimens (vaginal swabs) to detect and identify specific microorganisms associated with medical conditions (bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis) to aid in diagnosis. This directly aligns with the definition of an in vitro diagnostic device.
  • Device Description: The descriptions reiterate that these are "in vitro nucleic acid amplification tests" used for the detection and quantitation of RNA from microorganisms in biological samples.
  • Performance Studies: The performance studies focus on determining the Limit of Detection (LoD) of the assays for various microorganisms in biological matrices (SVSM, NVSM). This is a typical type of performance evaluation for IVD tests.
  • Key Metrics: The key metrics reported (LoD, C95) are standard performance characteristics for IVD assays that detect and quantify analytes in biological samples.

The information provided clearly indicates that these devices are designed to be used outside of the body to examine specimens from the human body for the purpose of providing information for the diagnosis of disease.

N/A

Intended Use / Indications for Use

Aptima BV Assay: The Aptima BV Assay is an in vitro nucleic acid amplification test that utilizes real time Transcription-Mediated Amplification (TMA) technology for detection and quantitation of ribosomal RNA from bacterial vaginosis (BV), including Lactobacillus (L. gasseri, L. crispatus, and L. jenseni), Gardnerella vaginalis), and Atopobium vaginae (A. vaginae). The assay reports a qualitative result for BV and does not report results for individual organisms. The assay is intended to aid in the diagnosis of BV on the automated Panther System using clinician-collected and patient-collected vaginal swab specimens from females with a clinical presentation consistent with vaginitis and/or vaginosis.

Aptima CV/TV Assay: The Aptima CV/TV Assay is an in vitro nucleic acid amplification of RNA from microorganisms associated with vulvovaginal candidiasis and trichomoniasis. The assay utilizes real time Transcription-Mediated Amplification (TMA) technology to detect and qualitatively report results for the following organisms:

  • Candida species group (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis)
  • Candida glabrata (C. glabrata)
  • Trichomonas vaginalis (TV)
    The assay differentiates between C. glabrata and the Candida species group (C spp) by targeting the RNA component of RNAse P ribonucleoprotein; the assay does not differentiate among C spp. For TV, the assay targets ribosomal RNA (rRNA) and differentiates the results for C. glabrata and C spp. The assy is intended to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis on the automated Panther System using clinician-collected and patientcollected vaginal swab specimens from females with a clinical presentation consistent with vagintis.

Product codes (comma separated list FDA assigned to the subject device)

PQA, NSU, PMN

Device Description

Aptima BV Assay: Like the Aptima BV assay 100 test kit, the Aptima BV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of rRNA from bacteria associated with bacterial vaginosis in women with a clinical presentation consistent with vaginitis/vaginosis. The Aptima BV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of bacterial vaginosis. The Aptima BV assay involves three main steps, all of which take place in a single tube on the Panther system: target capture, target amplification by TMA, and detection of the amplification products (amplicon) by fluorescent labeled probes (torches). The assay incorporates an internal control (IC) in every test to monitor nucleic acid capture, amplification and detection. The Panther system detects and discriminates between four fluorescent signals corresponding to Lactobacillus group, Atopobium vaginae, Gardnerella vaginalis and IC amplification products. The Panther system software compares signal emergence times for each target organism to calibration information in order to determine the BV Positive or Negative status of each sample. The Aptima BV 250 test kit provides enough reagents to run 250 tests. The 250 test kit configuration has been designed for and validated on the Panther system. The Panther system is an integrated hardware and software system that together with the Aptima BV assay fully automates all the steps necessary to perform the assay from sample preparation through amplification of nucleic acid, detection, data reduction and amplicon inactivation.

Aptima CV/TV Assay: Like the Aptima CV/TV assay 100 test kit, the Aptima CV/TV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of RNA from microorganisms associated with vaginitis, trichomoniasis, and vulvovaginitis, in women with a clinical presentation consistent with vaginitis, trichomoniasis, and vulvovaginitis. The Aptima CV/TV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis. The Aptima CV/TV assay involves three main steps, all of which take place in a single tube on the Panther system: target capture, target amplification by TMA, and detection of the amplification products (amplicon) by fluorescent labeled probes (torches). The assay incorporates an internal control (IC) in every test to monitor nucleic acid capture, amplification and detection. The Panther system detects and discriminates between four fluorescent signals corresponding to Cspp, C. glabrata. T. vaginalis and IC amplification products. The Panther system software uses an Aptima CV/TV assay-specific algorithm that interprets the amplification signal emergence times to generate a Positive or Negative status for each target organism in the sample. The Aptima CV/TV 250 test kit provides enough reagents to run 250 tests. The 250 test kit configuration has been designed for and validated on the Panther system. The Panther system is an integrated hardware and software system that together with the Aptima CV/TV assay fully automates all the steps necessary to perform the assay from sample preparation through amplification of nucleic acid, detection, data reduction and amplicon inactivation.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Vaginal

Indicated Patient Age Range

Females

Intended User / Care Setting

Clinician; High User Complexity.

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Aptima BV Assay: A Limit of Detection (LoD) Confirmation study was performed to verify that the Aptima BV 250 Test Kit configuration meets the established Aptima BV 100 Test Kit LoD. The analytical sensitivity study confirmed the LoD for L. crispatus (LC) is 143 CFU/mL, L. gasseri (LG) is 2,207 CFU/mL, and L. jensenii (LJ) is 10 CFU/mL. The BV Positivity Limit (C95) for A.vaginae (AV) was verified to be 5.10 log CFU/mL (128,397 CFU/mL), and for G. vaginalis (GV) was 4.86 log CFU/mL (72,836 CFU/mL).

Aptima CV/TV Assay: A Limit of Detection (LoD) Confirmation study was performed to verify that the Aptima CV/TV 250 Test Kit configuration meets the established Aptima CV/TV 100 Test Kit LoD. The analytical sensitivity study confirmed that the C95 (LoD) for C. albicans is 4439 CFU/mL, for C. parapsilosis is 9416 CFU/mL, for C. tropicalis is 811 CFU/mL, for C. dubliniensis is 1176 CFU/mL. The LoD for C. glabrata is 41 CFU/mL, and for T. vaginalis is 0.0024 cells/mL.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K190452, K190472

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

N/A

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November 25, 2024

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG" in blue, and then the word "ADMINISTRATION" in a smaller font size below that.

Hologic, Inc. Gabriela Mccoole Regulatory Affairs Specialist 10210 Genetic Center Dr San Diego, California 92121

Re: K243345

Trade/Device Name: Aptima BV Assay: Aptima CV/TV Assay Regulation Number: 21 CFR 866.3975 Regulation Name: Device That Detects Nucleic Acid Sequences From Microorganisms Associated With Vaginitis And Bacterial Vaginosis Regulatory Class: Class II Product Code: PQA Dated: October 23, 2024 Received: October 28, 2024

Dear Gabriela Mccoole:

We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safetyreporting-combination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

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Sincerely,

Digitally signed by Bryan M. Bryan M. Grabias -S Date: 2024.11.25 Grabias -S 12:19:01 -05'00'

Bryan Grabias, Ph. D. Acting Branch Chief Bacterial Respiratory and Medical Countermeasures Branch Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K243345

Device Name Aptima BV Assay; Aptima CV/TV Assay

Indications for Use (Describe)

Aptima BV Assay

The Aptima BV Assay is an in vitro nucleic acid amplification test that utilizes real time Transcription-Mediated Amplification (TMA) technology for detection and quantitation of ribosomal RNA from bacterial vaginosis (BV), including Lactobacillus (L. gasseri, L. crispatus, and L. jenseni), Gardnerella vaginalis), and Atopobium vaginae (A. vaginae). The assay reports a qualitative result for BV and does not report results for individual organisms. The assay is intended to aid in the diagnosis of BV on the automated Panther System using clinician-collected and patient-collected vaginal swab specimens from females with a clinical presentation consistent with vaginitis and/or vaginosis.

Aptima CV/TV Assay

The Aptima CV/TV Assay is an in vitro nucleic acid amplification of RNA from microorganisms associated with vulvovaginal candidiasis and trichomoniasis. The assay utilizes real time Transcription-Mediated Amplification (TMA) technology to detect and qualitatively report results for the following organisms:

  • · Candida species group (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis)
  • · Candida glabrata (C. glabrata)
  • Trichomonas vaginalis (TV)

The assay differentiates between C. glabrata and the Candida species group (C spp) by targeting the RNA component of RNAse P ribonucleoprotein; the assay does not differentiate among C spp. For TV, the assay targets ribosomal RNA (rRNA) and differentiates the results for C. glabrata and C spp. The assy is intended to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis on the automated Panther System using clinician-collected and patientcollected vaginal swab specimens from females with a clinical presentation consistent with vagintis.

Type of Use (Select one or both, as applicable)

X Prescription Use (Part 21 CFR 801 Subpart D)

| Over-The-Counter Use (21 CFR 801 Subpart C)

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Image /page/4/Picture/0 description: The image shows the word "HOLOGIC" in large, bold, blue letters. A small registered trademark symbol is located to the right of the letter "C". The font is sans-serif and the letters are evenly spaced.

510(k) SUMMARY Aptima BV Assay

I. SUBMITTER

Hologic, Inc. 10210 Genetic Center Drive San Diego, CA 92121

Contact Person: Gabriela McCoole, MS, RAC Regulatory Affairs Specialist Gabriela.McCoole@Hologic.com Phone: (619) 322-7535 Fax: (858) 410-5557

Date Prepared: October 25, 2024

II. DEVICE

Proprietary Name of Device: Aptima BV Assay Classification Name: Device that detects nucleic acid sequences from microorganisms associated with vaginitis and bacterial vaginosis. Regulation Number: 21 CFR 866.3975 Regulatory Class: Class II PQA, NSU, and PMN Product Code:

III. PREDICATE DEVICE

The predicate device is the Aptima BV Assay (K190452; cleared May 23, 2019), which

is a 100 test kit configuration.

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DEVICE DESCRIPTION IV.

Like the Aptima BV assay 100 test kit, the Aptima BV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of rRNA from bacteria associated with bacterial vaginosis in women with a clinical presentation consistent with vaginitis/vaginosis. The Aptima BV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of bacterial vaginosis.

Principles of the Procedure

The Aptima BV assay involves three main steps, all of which take place in a single tube on the Panther system: target capture, target amplification by TMA, and detection of the amplification products (amplicon) by fluorescent labeled probes (torches). The assay incorporates an internal control (IC) in every test to monitor nucleic acid capture, amplification and detection.

Specimens are collected in a tube containing specimen transport media (STM) that lyses the cells, releases the RNA, and protects it from degradation during storage. When the Aptima BV assay is performed, capture oligonucleotides hybridize to highly conserved regions of the target RNA, if present, in the test specimen. The hybridized target is then captured onto magnetic microparticles that are separated from the specimen in a magnetic field. Wash steps remove extraneous components from the reaction tube.

Target amplification occurs via TMA, a transcription-based nucleic acid amplification method that utilizes two enzymes, Moloney murine leukemia virus (MMLV) reverse transcriptase and T7 RNA polymerase. The reverse transcriptase is used to generate a DNA copy of the target RNA sequence, adding a promoter sequence for T7 RNA polymerase. T7 RNA polymerase produces multiple copies of RNA amplicon from the DNA copy template.

Detection is achieved using single-stranded nucleic acid torches that are present during the amplification of the target and hybridize specifically to the amplicon in real time. Each torch has a fluorophore and a quencher. The quencher suppresses the fluorescence

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of the fluorophore when the torch is not hybridized to the amplicon. When the torch binds to the amplicon, the fluorophore is separated from the quencher and emits a signal at a specific wavelength when excited by a light source. The Panther system detects and discriminates between four fluorescent signals corresponding to Lactobacillus group, Atopobium vaginae, Gardnerella vaginalis and IC amplification products. The Panther system software compares signal emergence times for each target organism to calibration information in order to determine the BV Positive or Negative status of each sample.

Assay Components

The Aptima BV 250 test kit provides enough reagents to run 250 tests. Like the Aptima BV assay 100 test kit, the Aptima BV assay 250 test kit master kit contains 8 reagents, 1 calibrator, and 2 controls required for sample processing. There are 4 boxes that make up the assay master kit. Boxes 1 and 2 contain the Aptima BV assay reagents packaged according to storage conditions. Box 3 contains the calibrator, and Box 4 contains the controls when provided as part of the master kit. The Aptima BV Calibrator and Controls kit may also be procured separately if customers need additional calibrators or controls. A listing of the components that are required to perform the Aptima BV assay are detailed in Table 1. In addition, there is one ancillary kit (Aptima Assay Fluids Kit) required to run the assay, and one collection kit (Aptima Multitest Swab Specimen Collection Kit ) utilized for collection of specimens.

BoxComponents Description
1Amplification Reagent
Enzyme Reagent
Promoter Reagent
Internal Control
2Amplification Reconstitution Solution
Enzyme Reconstitution Solution
Promoter Reconstitution Solution
Target Capture Reagent
3Positive Calibrator
4Negative Control
Positive Control
Table 1 Reagents Required to Perform the Aptima BV Assay 250 test kit

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Instrumentation

Like the Aptima BV assay 100 test kit, the 250 test kit configuration has been designed for and validated on the Panther system. The Panther system is an integrated hardware and software system that together with the Aptima BV assay fully automates all the steps necessary to perform the assay from sample preparation through amplification of nucleic acid, detection, data reduction and amplicon inactivation.

V. INDICATIONS FOR USE

The Aptima® BV Assay is an in vitro nucleic acid amplification test that utilizes real time Transcription-Mediated Amplification (TMA®) technology for detection and quantitation of ribosomal RNA from bacteria associated with bacterial vaginosis (BV), including Lactobacillus (L. gasseri, L. crispatus, and L. jensenii), Gardnerella vaginalis (G. vaginalis), and Atropbium vaginae (A. vaginae). The assay reports a qualitative result for BV and does not report results for individual organisms. The assay is intended to aid in the diagnosis of BV on the automated Panther® System using clinician-collected and patient-collected vaginal swab specimens from females with a clinical presentation consistent with vaginitis and/or vaginosis.

COMPARISON OF TECHNOLOGICAL VI. CHARACTERISTCS WITH THE PREDICATE DEVICE

Table 2 displays a comparison of the Aptima BV Assay 250 Test Kit (subject device) with the Aptima BV Assay 250 Test Kit (predicate device).

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| Feature | Aptima BV Assay 100 Test Kit
(Predicate Device, K190452) | Aptima BV Assay 250 Test Kit
(Subject Device) Comparison to the
Predicate | Predicate and Subject
Device Comparison |
|-----------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | The Aptima BV assay is an in vitro nucleic acid
amplification test that utilizes real time
transcription-mediated amplification (TMA) for
detection and quantitation of ribosomal RNA
from bacteria associated with bacterial vaginosis
(BV), including Lactobacillus (L. gasseri, L.
crispatus, and L. jensenii), Gardnerella vaginalis,
and Atopobium vaginae. The assay reports a
qualitative result for BV and does not report
results for individual organisms. The assay is
intended to aid in the diagnosis of BV on the
automated Panther system using clinician-
collected and patient-collected vaginal swab
specimens from females with a clinical
presentation consistent with vaginitis and/or
vaginosis. | The Aptima® BV Assay is an in vitro nucleic
acid amplification test that utilizes real time
Transcription-Mediated Amplification (TMA®)
technology for detection and quantitation of
ribosomal RNA from bacteria associated with
bacterial vaginosis (BV), including
Lactobacillus (L. gasseri, L. crispatus, and L.
jensenii), Gardnerella vaginalis (G. vaginalis),
and Atopobium vaginae (A. vaginae). The assay
reports a qualitative result for BV and does not
report results for individual organisms. The
assay is intended to aid in the diagnosis of BV
on the automated Panther® System using
clinician-collected and patient-collected vaginal
swab specimens from females with a clinical
presentation consistent with vaginitis and/or
vaginosis. | Same; some editorial
changes were made to the
intended use statement
(added trademark symbols
and abbreviations for
Gardnerella vaginalis and
Atopobium vaginae). |
| Organisms
Detected | Lactobacillus (L. gasseri, L. crispatus, and L.
jensenii), Gardnerella vaginalis, and Atopobium
vaginae | Lactobacillus (L. gasseri, L. crispatus, and L.
jensenii), Gardnerella vaginalis, and Atopobium
vaginae | Same |
| Test Quantity | 100 Tests | 250 Tests | Different; The subject
device quantity is 250 Tests. |
| Assay Controls | Incorporates an Internal Control in every test.
Uses external positive and negative controls. | Incorporates an Internal Control in every test.
Uses external positive and negative controls. | Same |
| Feature | Aptima BV Assay 100 Test Kit
(Predicate Device, K190452) | Aptima BV Assay 250 Test Kit
(Subject Device) Comparison to the
Predicate | Predicate and Subject
Device Comparison |
| Patient
Population | Women with a clinical presentation of
vaginitis/vaginosis | Women with a clinical presentation of
vaginitis/vaginosis | Same |
| Specimen Types | Vaginal swabs in patients who are symptomatic
for vaginitis/vaginosis | Vaginal swabs in patients who are symptomatic
for vaginitis/vaginosis | Same |
| Analyte | ribosomal RNA | ribosomal RNA | Same |
| Assay Calibrators | Positive Calibrator | Positive Calibrator | Same |
| Technology
Principle of
Operation | Real-time Transcription Mediated Amplification
(TMA) | Real-time Transcription Mediated Amplification
(TMA) | Same |
| User Complexity | High | High | Same |
| Platform | Panther System | Panther System | Same |
| Platform
Software | Panther System Software | Panther System Software | Same |
| Assay Software | Panther Aptima BV 100 Test Kit Assay
Software | Panther Aptima BV 250 Test Kit Assay
Software. | Different. The subject
device uses the Panther
Aptima BV 250 Test Kit
Assay Software. |

Table 2 Comparison of Predicate and Subject Device

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PERFORMANCE DATA VII.

The Aptima BV assay 100 Test Kit and the 250 Test Kit (subject device) share the same intended use, operating principle, formulation, and accessories. Based on these similarities, a risk analysis determined the analytical studies performed for the 100 Test Kit also support the Aptima BV 250 Test Kit configuration performance. A Limit of Detection (LoD) Confirmation study was performed to verify that the Aptima BV 250 Test Kit configuration meets the established Aptima BV 100 Test Kit LoD. The Aptima BV 100 Test Kit LoD was confirmed in the Aptima BV 250 Test Kit configuration, and thus all other previously validated analytical and clinical performance testing performed with the Aptima BV 100 Test Kit configuration is valid and appropriate to show performance for the Aptima BV 250 Test Kit configuration.

Analytical Sensitivity

To confirm the Limit of Detection (LoD) for L. crispatus (LC), L. gasseri (LG), L. jensenii (LJ) and the BV Positivity Limit (C95) for A.vaginae (AV) and G. vaginalis (GV), dilutions of cell lysates were prepared in SVSM. Dilutions were then tested with at least 20 replicates per concentration, per reagent lot, using three lots over the course of three days (7 replicates per day) for a total of at least 60 replicates per strain. The results verified that the LoD for each strain is as follows: LC is 143 CFU/mL, LG is 2,207 CFU/mL, and LJ is 10 CFU/mL. The BV Positivity Limit (C95) for AV and GV were verified to be 5.10 log CFU/mL (128,397 CFU/mL), and 4.86 log CFU/mL (72,836 CFU/mL) respectively.

CONCLUSIONS VIII.

The performance study results demonstrate that the Aptima BV assay 250 Test Kit on the Panther system performs comparably to the predicate device that is currently marketed for the same intended use. Hardware and software verification and validation demonstrate that the Aptima BV assay 250 Test Kit on the Panther system will perform as intended.

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Image /page/11/Picture/0 description: The image shows the word "HOLOGIC" in a bold, sans-serif font. The letters are a dark blue color. There is a registered trademark symbol to the upper right of the "C".

510(k) SUMMARY Aptima CV/TV Assay

I. SUBMITTER

Hologic, Inc. 10210 Genetic Center Drive San Diego, CA 92121

Contact Person: Gabriela McCoole, MS, RAC Regulatory Affairs Specialist Gabriela.McCoole@Hologic.com Phone: (619) 322-7535 Fax: (858) 410-5557

Date Prepared: October 25, 2024

II. DEVICE

Proprietary Name of Device: Aptima CV/TV Assay Classification Name: Device that detects nucleic acid sequences from microorganisms associated with vaginitis and bacterial vaginosis. Regulation Number: 21 CFR 866.3975 Regulatory Class: Class II Product Code: PQA, NSU

III. PREDICATE DEVICE

The predicate device is the Aptima CV/TV Assay (K190472; cleared February 26, 2019),

which is a 100 test kit configuration.

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DEVICE DESCRIPTION IV.

Like the Aptima CV/TV assay 100 test kit, the Aptima CV/TV assay 250 test kit is an in vitro nucleic acid amplification test for the detection and quantitation of RNA from microorganisms associated with vaginitis, trichomoniasis, and vulvovaginitis, in women with a clinical presentation consistent with vaginitis, trichomoniasis, and vulvovaginitis. The Aptima CV/TV assay utilizes the automated Panther system to provide qualitative results to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis.

Principles of the Procedure

The Aptima CV/TV assay involves three main steps, all of which take place in a single tube on the Panther system: target capture, target amplification by TMA, and detection of the amplification products (amplicon) by fluorescent labeled probes (torches). The assay incorporates an internal control (IC) in every test to monitor nucleic acid capture, amplification and detection.

Specimens are collected in a tube containing specimen transport media (STM) that lyses the organisms, releases the RNA, and protects it from degradation during storage. When the assay is performed, capture oligonucleotides hybridize to highly conserved regions of the target RNA, if present, in the test specimen. The hybridized target is then captured onto magnetic microparticles that are separated from the specimen in a magnetic field. Wash steps remove extraneous components from the reaction tube.

Target amplification occurs via TMA, a transcription-based nucleic acid amplification method that utilizes two enzymes, Moloney murine leukemia virus (MMLV) reverse transcriptase and T7 RNA polymerase. The reverse transcriptase is used to generate a DNA copy of the target RNA sequence, adding a promoter sequence for T7 RNA polymerase. T7 RNA polymerase produces multiple copies of RNA amplicon from the DNA copy template.

Detection is achieved using single-stranded nucleic acid torches that are present during the amplification of the target and hybridize specifically to the amplicon in real time.

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Each torch has a fluorophore and a quencher. The quencher suppresses the fluorescence of the fluorophore when the torch is not hybridized to the amplicon. When the torch binds to the amplicon, the fluorophore is separated from the quencher and emits a signal at a specific wavelength when excited by a light source. The Panther system detects and discriminates between four fluorescent signals corresponding to Cspp, C. glabrata. T. vaginalis and IC amplification products. The Panther system software uses an Aptima CV/TV assay-specific algorithm that interprets the amplification signal emergence times to generate a Positive or Negative status for each target organism in the sample

Assay Components

The Aptima CV/TV 250 test kit provides enough reagents to run 250 tests. Like the Aptima CV/TV assay 100 test kit, the Aptima CV/TV assay 250 test kit master kit contains 8 reagents, 1 calibrator, and 2 controls required for sample processing. There are 4 boxes that make up the assay master kit. Boxes 1 and 2 contain the Aptima CV/TV assay reagents packaged according to storage conditions. Box 3 contains the calibrator, and Box 4 contains the controls when provided as part of the master kit. The Aptima CV/TV Calibrator and Controls kit may also be procured separately if customers need additional calibrators or controls. A listing of the components that are required to perform the Aptima CV/TV assay are detailed in Table 1. In addition, there is one ancillary kit (Aptima Assay Fluids Kit) required to run the assay, and one collection kit (Aptima Multitest Swab Specimen Collection Kit ) utilized for collection of specimens.

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BoxComponents Description
1Amplification Reagent
Enzyme Reagent
Promoter Reagent
Internal Control
2Amplification Reconstitution Solution
Enzyme Reconstitution Solution
Promoter Reconstitution Solution
Target Capture Reagent
3Positive Calibrator
4Negative Control
Positive Control

Table 1 Reagents Required to Perform the Aptima CV/TV Assay 250 test kit

Instrumentation

Like the Aptima CV/TV assay 100 test kit, the 250 test kit configuration has been designed for and validated on the Panther system. The Panther system is an integrated hardware and software system that together with the Aptima CV/TV assay fully automates all the steps necessary to perform the assay from sample preparation through amplification of nucleic acid, detection, data reduction and amplicon inactivation.

INDICATIONS FOR USE V.

The Aptima® CV/TV Assay is an in vitro nucleic acid amplification test for the detection of RNA from microorganisms associated with vulvovaginal candidiasis and trichomoniasis. The assay utilizes real time Transcription-Mediated Amplification (TMA®) technology to detect and qualitatively report results for the following organisms:

  • Candida species group (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis)
  • Candida glabrata (C. glabrata) ●
  • Trichomonas vaginalis (TV)

The assay differentiates between C. glabrata and the Candida species group (C spp) by targeting the RNA component of RNAse P ribonucleoprotein; the assay does not differentiate among C spp. For TV, the assay targets ribosomal RNA (rRNA) and

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differentiates the result from results for C. glabrata and C spp. The assay is intended to aid in the diagnosis of vulvovaginal candidiasis and trichomoniasis on the automated Panther® System using clinician-collected and patient-collected vaginal swab specimens from females with a clinical presentation consistent with vaginitis or vulvovaginitis.

COMPARISON OF TECHNOLOGICAL VI. CHARACTERISTCS WITH THE PREDICATE DEVICE

Table 2 displays a comparison of the Aptima CV/TV Assay 250 Test Kit (subject device) with the Aptima CV/TV Assay 250 Test Kit (predicate device).

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| Item | Aptima CV/TV Assay 100 Test Kit
(Predicate Device, K190472) | Aptima CV/TV Assay 250 Test Kit
(Subject Device) | Predicate and Subject
Device Comparison |
|-----------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------|
| Intended Use | The Aptima CV/TV assay is an in vitro nucleic acid
amplification test for the detection of RNA from
microorganisms associated with vaginitis,
trichomoniasis, and vulvovaginitis. The assay
utilizes real time transcription-mediated
amplification (TMA) to detect and qualitatively
report results for the following organisms:
• Candida species group (C. albicans, C. tropicalis,
C. parapsilosis, C. dubliniensis)
• Candida glabrata
• Trichomonas vaginalis
The assay differentiates between Candida glabrata
and the Candida species group (C spp) by targeting
the RNA component of RNAse P ribonucleoprotein;
the assay does not differentiate among C spp. For
Trichomonas vaginalis, the assay targets ribosomal
RNA (rRNA) and differentiates the result from
results for Candida glabrata and C spp. The assay is
intended to aid in the diagnosis of vulvovaginal
candidiasis and trichomoniasis on the automated
Panther system using clinician-collected and patient-
collected vaginal swab specimens from women with
a clinical presentation consistent with vaginitis,
trichomoniasis, and/or vulvovaginitis. | The Aptima® CV/TV Assay is an in vitro nucleic
acid amplification test for the detection of RNA
from microorganisms associated with
vulvovaginal candidiasis and trichomoniasis. The
assay utilizes real time Transcription-Mediated
Amplification (TMA®) technology to detect and
qualitatively report results for the following
organisms:
• Candida species group (C. albicans, C.
tropicalis, C. parapsilosis, C.
dubliniensis)
• Candida glabrata (C. glabrata)
• Trichomonas vaginalis (TV)
The assay differentiates between C. glabrata and
the Candida species group (C spp) by targeting
the RNA component of RNAse P
ribonucleoprotein; the assay does not
differentiate among C spp. For TV, the assay
targets ribosomal RNA (rRNA) and differentiates
the result from results for C. glabrata and C spp.
The assay is intended to aid in the diagnosis of
vulvovaginal candidiasis and trichomoniasis on
the automated Panther® System using clinician-
collected and patient-collected vaginal swab
specimens from females with a clinical
presentation consistent with vaginitis or
vulvovaginitis. | Same. Added trademarks
and Candida glabrata and
Trichomonas vaginalis
abbreviations. |
| Item | Aptima CV/TV Assay 100 Test Kit
(Predicate Device, K190472) | Aptima CV/TV Assay 250 Test Kit
(Subject Device) | Predicate and Subject
Device Comparison |
| Organisms
Detected | Candida species (C. albicans, C. tropicalis, C.
parapsilosis, C. dubliniensis); Candida glabrata;
Trichomonas vaginalis | Candida species (C. albicans, C. tropicalis, C.
parapsilosis, C. dubliniensis); Candida glabrata;
Trichomonas vaginalis | Same |
| Test Quantity | 100 Tests | 250 Tests | Different.
The subject device
quantity is 250 Tests. |
| Assay
Controls | Incorporates an Internal Control in every test. Uses
external positive and negative controls. | Incorporates an Internal Control in every test. Uses
external positive and negative controls. | Same |
| Patient
Population | Women with a clinical presentation of vaginitis,
trichomoniasis, or vulvovaginitis | Women with a clinical presentation of vaginitis,
trichomoniasis, or vulvovaginitis | Same |
| Specimen
Types | Vaginal swabs in patients who are symptomatic for
vaginitis, trichomoniasis, or vulvovaginitis | Vaginal swabs in patients who are symptomatic for
vaginitis, trichomoniasis, or vulvovaginitis | Same |
| Analyte | ribosomal RNA | ribosomal RNA | Same |
| Assay
Calibrators | Positive Calibrator | Positive Calibrator | Same |
| Technology
Principle of
Operation | Real-time Transcription Mediated Amplification
(TMA) | Real-time Transcription Mediated Amplification
(TMA) | Same |
| User
Complexity | High | High | Same |
| Item | Aptima CV/TV Assay 100 Test Kit
(Predicate Device, K190472) | Aptima CV/TV Assay 250 Test Kit
(Subject Device) | Predicate and Subject
Device Comparison |
| Platform | Panther System | Panther System | Same |
| Platform
Software | Panther System Software | Panther System Software | Same |
| Assay
Software | Panther Aptima CV/TV 100 Test Kit Assay
Software | Panther Aptima CV/TV 250 Test Kit Assay
Software | Different.
The subject device uses
Panther Aptima CV/TV
250 Test Kit Assay
Software. |

Table 2 Comparison of Predicate and Subject Device

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PERFORMANCE DATA VII.

The Aptima CV/TV assay 100 Test Kit and the 250 Test Kit (subject device) share the same intended use, operating principle, formulation, and accessories. Based on these similarities, a risk analysis determined the analytical studies performed for the 100 Test Kit also support the Aptima CV/TV 250 Test Kit configuration performance. A Limit of Detection (LoD) Confirmation study was performed to verify that the Aptima CV/TV 250 Test Kit configuration meets the established Aptima CV/TV 100 Test Kit LoD. The Aptima CV/TV 100 Test Kit LoD was confirmed in the Aptima CV/TV 250 Test Kit configuration, and thus all other previously validated analytical and clinical performance testing performed with the Aptima CV/TV 100 Test Kit configuration is valid and appropriate to show performance for the Aptima CV/TV 250 Test Kit configuration.

Analytical Sensitivity

To confirm the Limit of Detection (LoD) or C95 of C. albicans, C. glabrata, and T. vaginalis, cell lysates were diluted into Natural Vaginal Swab Matrix (NVSM). Cell lysates of C. tropicalis and C. dubliniensis and suspension of C. parapsilosis were diluted into Simulated Vaginal Swab Matrix (SVSM). Dilutions were then tested with at least 20 replicates per concentration, per reagent lot, using three lots for a total of at least 60 replicates per strain.

The results verified that the LoD for each strain is as follows: The C95 (LoD) for C. albicans is 4439 CFU/mL, for C. parapsilosis is 9416 CFU/mL, for C. tropicalis is 811 CFU/mL, for C. dubliniensis is 1176 CFU/mL. The LoD for C. glabrata is 41 CFU/mL, and for T. vaginalis is 0.0024 cells/mL.

VIII. CONCLUSIONS

The performance study results demonstrate that the Aptima CV/TV assay 250 Test Kit on the Panther system performs comparably to the predicate device that is currently marketed for the same intended use. Hardware and software verification and validation

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demonstrate that the Aptima CV/TV assay 250 Test Kit on the Panther system will perform as intended.