Genotyping, Drug Susceptibility and Prevalence Survey of Trichomonas vaginalis among Women Attending Gynecology Clinics in Hamadan, Western Iran, in 2014-2015
AbstractBackground: In spite of sufficient knowledge about phenotypic variation of Trichomonas vaginalis, its genetic characteristics are poorly understood. We carried out a molecular epidemiology study in which in vitro metronidazole susceptibility of T. vaginalis isolates was considered.Methods: This study was conducted on 862 women admitted to Gynecology Clinics in Hamadan, west of Iran, during 2014-2015. After recording the socio-demographic and clinical characteristics of participants, vaginal swab samples were taken and subjected to microscopic examination, culture, in vitro sensitivity testing and PCR-restriction fragment length polymorphism (RFLP) analysis.Results: T. vaginalis was detected in 1.9% (16/862) of the samples using two parasitological methods. The all T. vaginalis isolates that subjected to drug susceptibility analysis were sensitive to metronidazole with MICs ranged from 0.4 to 12.8 µg/ml. T. vaginalis genotyping by using actin gene and PCR-RFLP analysis identified three actin type; A (9, 56%), I (6, 38%) and E (1, 6%). No significant correlation was observed between actin genotypes and their clinical manifestation (P>0.05). Conclusion: The prevalence of T. vaginalis infection is not noticeable in the region and the most of isolates are hypersensitive to metronidazole. Further studies are needed to clarify the efficiency of the actin gene, as a reliable genetic marker, for molecular epidemiology of trichomoniasis.
Secor WE, Meites E, Starr MC, Workowski KA. Neglected parasitic infections in the United States: trichomo-niasis. Am J Trop Med Hyg. 2014; 90(5):800-4.
Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev. 2004; 17(4):794-803.
Petrin D, Delgaty K, Bhatt R, Garber G. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. 1998; 11(2):300-17.
World Health Organization. Global incidence and prevalence of selected curable sexually transmitted infections-2008. WHO: 2012. http://www.who.int/reproductivehealth/publications/rtis/stisestimates/en/index.html
Shafir SC, Sorvillo FJ, Smith L. Current issues and considerations regarding trichomoniasis and human immunodeficiency virus in African-Americans. Clin Microbiol Rev. 2009; 22(1):37-45.
Wang CC, McClelland RS, Reilly M, Overbaugh J, Emery SR, Mandaliya K, et al. The effect of treatment of vaginal infections on shedding of human immunodeficiency virus type1. J Infect Dis. 2001; 183(7):1017-22.
Workowski KA, Berman SM. Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Clin Infect Dis. 2011; 53(suppl 3):S59-S63.
Vanacova S, Tachezy J, Kulda J, Flegr J. Characterization of trichomonad species and strains by PCR fingerprinting. J Eukaryot Microbiol. 1997; 44(6): 545-52.
Rojas L, Fraga J, Sariego I. Genetic variability between Trichomonas vaginalis isolates and correlation with clinical presentation. Infect Genet Evol. 2004; 4(1): 53-8.
Stiles JK, Shar PH, Xue L, Meade JC, Lushbaugh WB, Cleary JD, et al. Molecular typing of Trichomonas vaginalis isolates by HSP70 restriction fragment length poly-morphism. Am J Drop Med Hyg. 2000; 62(4):441–445.
Conrad M, Zubacova Z, Dunn LA, Upcroft J, Sullivan SA,Tachezy J, Carlton JM. Microsatellite polymorphism in the sexually transmitted human pathogen Trichomonas vaginalis indicates a genetically diverse parasite. Mol Biochem Parasitol. 2011; 175(1): 30-8.
Cornelius DC, Robinson DA, Muzny CA, Mena LA, Aanensen DM, Lushbaugh WB, et al. Genetic characterization of Trichomonas vaginalis isolates by use of multilocus sequence typing. J Clin Microbiol. 2012; 50(10):3293-3300.
Crucitti T, Abdellati S, Van Dyck E, Buve. Molecular typing of the actin gene of Trichomonas vaginalis isolates by PCR-restriction fragment length polymorphism. Clin Microbiol Infect. 2008; 14(9): 844-52.
Matini M, Rezaie S, Mohebali M, Maghsood A, Rabiee S, Fallah M, et al. Prevalence of Trichomonas vaginalis Infection in Hamadan City, Western Iran. Iran J Parasitol. 2012; 7(2):67-72.
Schwebke JR, Barrientes FJ. Prevalence of Trichomonas vaginalis isolates with resistance to metronidazole and tinidazole. Antimicrob Agents Chemother. 2006; 50(12):4209-10.
Meingassner J, Havelec L, Mieth H. Studies on strain sensitivity of Trichomonas vaginalis to metronidazole. Br J Vener Dis. 1978; 54(2):72-6.
Matini M, Maghsood AH, Mohebali M, Rabiee S, Fallah M, Rezaie S, et al. In Vitro Susceptibility of Iranian Isolates of Trichomonas vaginalis to Metro-nidazole. Iran J Parasitol. 2016; 11(1):46-51.
Rojas L, Fraga J, Sariego I. Genetic variability between Trichomonas vaginalis isolates and correlation with clinical presentation. Infect Genet Evol. 2004; 4(1): 53–58.
Kassem H, Majoud O. Trichomoniasis among women with vaginal discharge in Benghazi city, Libya. J Egypt Soc Parasitol. 2006; 36(3):1007-16.
Madani TA. Sexually transmitted infections in Saudi Arabia. BMC Infect Dis. 2006; 6:3.
Valadkhani Z, Assmar M, Esfandiari B, Amirkhani A, Hassan N, Lotfi ML, et al. Trichomoniasis in asymptomatic patients. Iran J Public Health. 2008; 37(3):113-7.
Valadkhani Z, Assmar M, Hassan N, Aghighi Z, Amirkhani A, Kazemi F, et al. The prevalence of trichomoniasis in high-risk behavior women attending the clinics of tehran province penitentiaries. Iran J Med Sci. 2010; 35(3):190-4.
Arbabi M, Fakhrieh Z, Delavari M, Abdoli A. Prevalence of Trichomonas vaginalis infection in Kashan city, Iran (2012-2013). Iran J Reprod Med. 2014; 12(7):507-512.
Rezaeian M, Vatanshenassan M, Rezaie S, Mohebali M, Niromand N, Niyyati M, et al. Prevalence of Trichomonas vaginalis using parasitological methods in Tehran. Iran J Parasitol. 2009; 4(4):43-7.
Rabieea S, Fallah M, Zahabic F. Frequency of Trichomoniasis in Patients Admitted To Outpatient Clinics in Hamadan (2007) and Relationship between Clinical Diagnosis and Laboratory Findings. J Res Health Sci. 2010; 10(1):31-35.
Gavgani A-SM, Namazi A, Ghazanchaei A, Alizadeh S, Sehhati F, Rostamzadeh S, et al. Prevalence and risk factors of trichomoniasis among women in Tabriz. Iran J Clin Infect Dis. 2008; 3(2):67-71.
Valadkhani Z, Kazemi F, Hassan N, Aghighi Z, Esmaili I, Talebi M. Gene Diversity of Trichomonas vaginalis Isolates. Iran J Parasitol. 2011; 6(3):101–106.
Simões-Barbosa A, Lobo TT, Xavier J, Carvalho SE, Leornadecz E. Trichomonas vaginalis: intrastrain polymorphisms within the ribosomal intergenic spacer do not correlate with clinical presentation. Exp Parasitol. 2005; 110(2):108-13.
Matini M, Rezaeian M, Mohebali M, Maghsood AH, Rabiee S, Rahimi-Foroushani A, 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.
Matini M, Rezaie S, Mohebali M, Maghsood A-H, Rabiee S, Fallah M, et al. Genetic Identification of Trichomonas vaginalis by Using the Actin Gene and Molecular Based Methods. Iran J Parasitol. 2014; 9(3):329-35.