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Trichomoniasis, the most common non-viral sexually transmitted infection worldwide, is caused by the protozoon Trichomonas vaginalis. The 5- nitroimidazole drugs, of which metronidazole is the most prescribed, are the only effective drugs to treat trichomoniasis. Resistance against metronidazole is increasingly reported among T. vaginalis isolates. T. vaginalis can establish an endosymbiosis with two Mycoplasma species, Mycoplasma hominis and Candidatus Mycoplasma girerdii, whose presence has been demonstrated to influence several aspects of the protozoan pathobiology. The role of M. hominis in T. vaginalis resistance to metronidazole is controversial, while the influence of Ca.M. girerdii has never been investigated. In this work, we investigate the possible correlation between the presence of Ca.M. girerdii and/or M. hominis and the in vitro drug susceptibility in a large group of T. vaginalis isolated in Italy and in Vietnam. We also evaluated, via RNA-seq analysis, the expression of protozoan genes involved in metronidazole resistance in a set of syngenic T. vaginalis strains, differing only for the presence/absence of the two Mycoplasmas. Our results show that the presence of M. hominis significantly increases the sensitivity to metronidazole in T. vaginalis and affects gene expression. On the contrary, the symbiosis with Candidatus Mycoplasma girerdii seems to have no effect on metronidazole resistance in T. vaginalis.

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Fusarium spp. are the common onychomycosis pathogens in non-dermatophyte molds, and are considered resistant to many antifungal agents. We reportedonychomycosis of the fingernail caused by Fusarium solani in Vietnam. The minimum inhib- itory concentration of terbinafine against the tested isolate was1µg/ml, which was the lowest of all antimycotic agents. The patient was successfully treated with a daily dose of 250mg terbinafine for two months, and norecurrence occurred after a one-year follow-up. Antifungal susceptibility testing is recommended in Fusarium onychomycosis.

Background: The flagellate protist Trichomonas vaginalis is the causative agent of the most common non - viral sexually transmitted infection. T. vaginalis is a major health problem in the community. Symbiotic between T. vaginalis and M. hominis related to severe clinical manifestations of T. vaginalis infection and have been identified by many studies in the world but currently, there has not been studied in Vietnam. Objectives: To identify the rate of Trichomonas vaginalis infection in women visiting the Thua Thien Hue Reproductive Health Care Centre and the propotion of coinfection and symbiosis of T. vaginalis with M. hominis. Methodology: Cross-sectional and in-vitro study of vaginal discharge infected by T. vaginalis. Results: The rate of Trichomonas vaginalis infection in women visiting the Thua Thien Hue Reproductive Health Care Centre was 0.5%; the propotion of coinfection and symbiosis of T. vaginalis and M. hominis were 37.5% and 29.2% respectively. Conclusion: This is the first study in Vietnam recording the symbiosis between T. vaginalis and M. hominis by molecular techniques. Key words: Trichomonas vaginalis, Mycoplasma hominis, symbiosis