Volume 25, Issue 3 (Iranian South Medical Journal 2022)
Iran South Med J 2022, 25(3): 240-249 |
Back to browse issues page
1- Department of Microbiology & Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bu-shehr, Iran
2- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- Department of Microbiology & Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bu-shehr, Iran , mfooladvand39@yahoo.com
2- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- Department of Microbiology & Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bu-shehr, Iran , mfooladvand39@yahoo.com
Abstract: (1099 Views)
Background: Trichomoniasis is the most common non-viral sexually transmitted disease caused by the protozoan parasite Trichomonas vaginalis. Metronidazole (MTZ), a 5-nitroimidazole derivative, is the main antitrichomonal agent of choice for the treatment of trichomoniasis. Since 1962, some cases of treatment failure with metronidazole have been reported, and the increased resistance of the parasite to MTZ has emerged as a highly problematic public health issue. This study aimed to determine the current susceptibility of isolates of T. vaginalis to metronidazole in Bushehr city.
Materials and Methods: This study was performed on 20 T. vaginalis isolates collected from comprehensive health service centers and hospitals in Bushehr city. After the culture of the parasites, susceptibility testing was carried out using serial twofold dilutions of MTZ (2 to 64 μg/ml). The minimum inhibitory concentration (MIC) and the minimum lethal concentration (MLC) of the trichomonads were determined after 24 and 48 h of incubation at 36 °C. Drug susceptibility assays of all the isolates were carried out twice in triplicate under aerobic and anaerobic conditions.
Results: One hundred percent of the T. vaginalis isolates (20/20) were susceptible to MTZ. Resistance to metronidazole was defined as aerobic MIC ≥50 μg/ml, which was not detected in any of the isolates. The mean aerobic MIC and MLC and the mean anaerobic MIC of the parasites were 3.8, 3.2 and 2.1 μg/ml, respectively.
Conclusion: The present study was the first to investigate drug susceptibility in T. vaginalis isolates in Bushehr city. Since no metronidazole-resistant isolates were found, the situation looked very promising. Nevertheless, the need for larger-scale research is inevitable in the province. Considering that most results are based on in vitro observations, conducting an in vivo study has also been recommended in recent years, as these studies could help develop real standards about clinical and microbiological responses to MTZ treatment.
Materials and Methods: This study was performed on 20 T. vaginalis isolates collected from comprehensive health service centers and hospitals in Bushehr city. After the culture of the parasites, susceptibility testing was carried out using serial twofold dilutions of MTZ (2 to 64 μg/ml). The minimum inhibitory concentration (MIC) and the minimum lethal concentration (MLC) of the trichomonads were determined after 24 and 48 h of incubation at 36 °C. Drug susceptibility assays of all the isolates were carried out twice in triplicate under aerobic and anaerobic conditions.
Results: One hundred percent of the T. vaginalis isolates (20/20) were susceptible to MTZ. Resistance to metronidazole was defined as aerobic MIC ≥50 μg/ml, which was not detected in any of the isolates. The mean aerobic MIC and MLC and the mean anaerobic MIC of the parasites were 3.8, 3.2 and 2.1 μg/ml, respectively.
Conclusion: The present study was the first to investigate drug susceptibility in T. vaginalis isolates in Bushehr city. Since no metronidazole-resistant isolates were found, the situation looked very promising. Nevertheless, the need for larger-scale research is inevitable in the province. Considering that most results are based on in vitro observations, conducting an in vivo study has also been recommended in recent years, as these studies could help develop real standards about clinical and microbiological responses to MTZ treatment.
Type of Study: Original |
Subject:
Parasitology
Received: 2022/06/25 | Accepted: 2022/09/4 | Published: 2022/09/22
Received: 2022/06/25 | Accepted: 2022/09/4 | Published: 2022/09/22
References
1. Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev 2004; 17(4): 794–803. [DOI]
2. Zhang ZF, Graham S, Yu SZ, et al. Trichomonas vaginalis and cervical cancer. A prospective study in China. Ann Epidemiol 1995; 5(4): 325–32. [DOI]
3. Sorvillo F, Smith L, Kerndt P, et al. Trichomonas vaginalis, HIV, and AfricanAmericans. Emerg Infect Dis 2001; 7(6): 927–32. [DOI]
4. Soper D. Trichomoniasis: under control or undercontrolled? Am J Obstet Gynecol 2004; 190(1): 281–90. [DOI]
5. Ali V, Nozaki T. Current therapeutics, their problems, and sulfur-containing-amino-acid metabolism as a novel target against infections by “amitochondriate” protozoan parasites. Clin Microbiol Rev 2007; 20(1): 164–87. [DOI]
6. Petrin D, Delgaty K, Bhatt R, et al. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev 1998; 11(2): 300–17. [DOI]
7. Workowski KA, Berman Stuart M. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59(RR-12): 1-110. [PubMed]
8. Fouladvand MA, Khorami S, Sartavi K. Evaluation of Lethal Effect of Pergularia Tomentosa and Priploca aphylla on Trichomonas Vaginalis In Vitro. Iran South Med J 2017; 20(4): 370-9. (Persian) [Article]
9. Cudmore SL, Delgaty KL, HaywardMcClelland SF, et al. Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev 2004; 17(4): 783–93. [DOI]
10. Narcisi EM, Secor WE. In vitro effect of tinidazole and furazolidone on metronidazole-resistant Trichomonas vaginalis. Antimicrob Agents Chemother 1996; 40(5): 1121–5. [DOI]
11. Matini M, Rezaie S, Mohebali M, et al. Prevalence of Trichomonas vaginalis Infection in Hamadan City, Western Iran. Iran J Parasitol 2012; 7(2): 67–72. [Article]
12. Meingassner JG, Havelec L, Mieth H. Studies on strain sensitivity of Trichomonas vaginalis to metronidazole. Br J Vener Dis 1978; 54(2): 72–6. [DOI]
13. Schwebke JR, Barrientes FJ. Prevalence of Trichomonas vaginalis Isolates with Resistance to Metronidazole and Tinidazole. Antimicrob Agents Chemother 2006; 50(12): 4209–10. [DOI]
14. Upcroft JA, Upcroft P. Drug susceptibility testing of anaerobic protozoa. Antimicrob Agents Chemother 2001; 45(6): 1810–4. [DOI]
15. Meri T, Jokiranta TS, Suhonen L, et al. Resistance of Trichomonas vaginalis to metronidazole: report of the first three cases from Finland and optimization of in vitro susceptibility testing under various oxygen concentrations. J Clin Microbiol 2000; 38(2): 763–7. [DOI]
16. Marques‐Silva M, Lisboa C, Gomes N, et al. Trichomonas vaginalis and growing concern over drug resistance: a systematic review. J Eur Acad Dermatol Venereol 2021; 35(10): 2007-21. [DOI]
17. Lin HC, Chu LJ, Huang PJ, et al. Proteomic signatures of metronidazole-resistant Trichomonas vaginalisreveal novel proteins associated with drug resistance. Parasit Vectors 2020; 13(1): 1-14. [DOI]
18. Snipes LJ, Gamard PM, Narcisi EM, et al. Molecular epidemiology of metronidazole resistance in a population of Trichomonas vaginalis clinical isolates. J Clin Microbiol2000; 38(8): 3004– 9. [DOI]
19. Matini M, Rezaeian M, Mohebali M, et al. Genotyping of Trichomonas vaginalis isolates in Iran by using single stranded conformational polymorphism-PCR technique and internal transcribed spacer regions. Trop Biomed 2012; 29(4): 605–12. [Article]
20. Matini M, Maghsood AH, Mohebali M, et al. In vitro susceptibility of Iranian isolates of Trichomonas vaginalis to metronidazole. Iran J Parasitol 2016; 11(1): 46-51. [Article]
21. Bahadory S, Aminizadeh S, Taghipour A, et al. A systematic review and meta-analysis on the global status of Trichomonas vaginalis virus in Trichomonas vaginalis. Microb Pathog 2021; 158: 105058. [DOI]
22. Perez S, Fernandez-Verdugo A, Perez F, et al. Prevalence of 5-nitroimidazole resistant Trichomonas vaginalis in Oviedo, Spain. Sex Transm Dis 2001; 28(2): 115–6. [DOI]
23. Rabiee S, Bazmani A, Matini M, et al. Comparison of Resistant and Susceptible Strains of Trichomons vaginalis to Metronidazole Using PCR Method. Iran J Parasitol 2012; 7(3): 24–30. [Article]
24. Muller M, Lossick JG, Gorrell TE. In vitro susceptibility of Trichomonas vaginalis to metronidazole and treatment outcome in vaginal trichomoniasis. Sex Transm Dis 1988; 15(1): 17-24. [DOI]
25. Rasoloson D, Tomková E, Cammack R, et al. Metronidazole-resistant strains of Trichomonas vaginalis display increased susceptibility to oxygen. Parasitology 2001; 123(Pt 1): 45– 56. [DOI]
| Rights and Permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |