In Vitro Susceptibility of Iranian Isolates of Trichomonas vaginalis to Metronidazole
Background: Metronidazole, a 5-nitroimidazole derivative, is the main antitrichomonal agent of choice for treatment of trichomoniasis. Since 1962, some cases of treatment failure with metronidazole have been reported and recently drug resistance is now on the rise in the world. This study was aimed to determine current susceptibility of Iranian isolates of Trichomonas vaginalis to metronidazole.
Methods: This study was performed on 50 T. vaginalis isolates collected from west and central areas of Iran. After axenisation of the parasites, susceptibility testing was carried out by using serial twofold dilutions of metronidazole (400 to 0.1 µg/ml). The minimum inhibitory concentration (MIC) and the minimum lethal concentration (MLC) of the trichomonads were determined after 48 h incubation at 35.5 °C. Drug susceptibility assays of the all isolates were carried out two times in triplicate under aerobic and anaerobic conditions.
Results: Ninety-eight percent of the T. vaginalis isolates (49/50) were sensitive to metronidazole. Metronidazole resistance was defined as aerobic MIC ≥50 µg/ml, detected in one isolate. The means of aerobic MICs and MLCs and that of anaerobic MICs of the parasites were 2.91, 1.95 and 0.28 µg/ml, respectively.Conclusion: This investigation showed in vitro low-level tolerance to metronidazole in a few T. vaginalis isolates that may be leading to the development of drug resistance.
Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev. 2004; 17(4):794-803.
Zhang ZF, Graham S, Yu SZ, Marshall J, Zielezny M, Chen YX, et al. Trichomonas vaginalis and cervical cancer. A prospective study in China. Ann Epidemiol. 1995; 5(4):325-332.
Sorvillo F, Smith L, Kerndt P, Ash L. Trichomo¬nas vaginalis, HIV, and African-Americans. Emerg Infect Dis. 2001; 79(6):927-932.
Soper D. Trichomoniasis: undercontrol or un¬dercontrolled? Am J Obstet Gynecol. 2004; 190 (1):281-290.
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):164-187.
Petrin D, Delgaty K, Bhatt R, Garber G. Clini¬cal and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. 1998 Apr; 11(2):300-317.
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guide¬lines. Morbid. Mortal. Weekly Rep. 2010; 59:58–61.
Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE. Treat¬ment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev. 2004; 17(4):783-793.
Narcisi EM, Secor WE. In vitro effect of tinidazole and furazolidone on metronidazole-resistant Trichomonas vaginalis. Antimicrob Agents Chemother. 1996 ; 40(5):1121-1125.
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.
Meingassner JG, Havelec L, Mieth H. Studies on strain sensitivity of Trichomonas vaginalis to metronidazole. Br J Vener Dis. 1978; 54(2):72-76.
Schwebke JR, Barrientes FJ. Prevalence of Trichomonas vaginalis Isolates with Resistance to Metronidazole and Tinidazole. Antimicrob Agents Chemother. 2006; 50(12):4209-4210.
Upcroft JA, Upcroft P. Drug susceptibility testing of anaerobic protozoa. Antimicrob Agents Chemother. 200; 45(6):1810-1814.
Meri T, Jokiranta TS, Suhonen L, Meri S. Re¬sistance of Trichomonas vaginalis to metronida¬zole: report of the first three cases from Fin¬land and optimization of in vitro susceptibility testing under various oxygen concentrations. J Clin Microbiol. 2000; 38(2):763-767.
Snipes LJ, Gamard PM, Narcisi EM, Beard CB, Lehmann T, Secor WE. (2000). Molecular epidemiology of metronidazole resistance in a population of Trichomonas vaginalis clinical iso¬lates. J Clin Microbiol. 2000; 38(8):3004-3009.
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):605-612.
Perez S, Fernandez-Verdugo A, Perez F, Vazquez F. Prevalence of 5-nitroimidazole re¬sistant Trichomonas vaginalis in Oviedo, Spain. Sex Transm Dis. 2001; 28 (2):115–116.
Bradshaw-Sydnor AC, Sawyer KE, Holland M, Papp J, Unger E, Markowitz L, et al. Trich or treat: drug resistant trichomoniasis among adolescents, abstr. 74834. In Abstracts of the 131st Annual Meeting of the American Public Health Association. 2003.
Rabiee S, Bazmani A, Matini M, Fallah M. Comparison of Resistant and Susceptible Strains of Trichomons vaginalis to Metronidazole Using PCR Method. Iran J Parasitol. 2012; 7(3):24-30.
Muller M, Lossick LG, Gorrell TE. In vitro susceptibility of Trichomonas vaginalis to metroni¬dazole and treatment outcome in vaginal trich¬omoniasis. Sex. Transm. Dis. 1988; 15(1):17–24.
Rasoloson D, Tomková E, Cammack R, Kulda J, Tachezy J. Metronidazole-resistant strains of Trichomonas vaginalis display increased suscepti¬bility to oxygen. Parasitology. 2001; 123(Pt 1):45-56.
|Issue||Vol 11 No 1 (2016)|
|In vitro Iran Metronidazole Parasitic sensitivity tests Trichomonas vaginalis|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|