Susceptibility of Trichomonas vaginalis Strains to Metronidazole

Ralph, Edward D.; Darwish, Rula; Austin, Thomas W.; Smith, Elizabeth A.; Pattison, F. L. M.

doi:10.1097/00007435-198307000-00003

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…In agreement with previous studies, aerobic incubation was necessary to demonstrate the highest levels of resistance to metronidazole (20,21). The MICs of metronidazole ranged from <0.06 to 25 ,ug/ml, roughly approximating values previously reported for unselected T. vaginalis isolates by a variety of qualitative methods (10,17,22,28). However, determination of trichomonad viability by direct observation of parasite motility correlated imperfectly with production of colonies in pour plates.…”

supporting

confidence: 88%

Use of a time-kill technique for susceptibility testing of Trichomonas vaginalis

Krieger¹,

Dickins²,

Rein³

1985

Antimicrob Agents Chemother

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The emergence of metronidazole-resistant Trichomonas vaginalis and questions about the safety of metronidazole are significant concerns in treatment of trichomoniasis. At 24 h, a microtiter assay was used to test antimicrobial susceptibility of 16 recent isolates; the MICs of metronidazole ranged from less than 0.06 to 25 micrograms/ml. Observable motility as an endpoint correlated imperfectly with survival as measured in pour plates. Quantitative pour plate cultures of six T. vaginalis isolates after timed exposures to antimicrobial drugs demonstrated exquisite sensitivity to metronidazole with minimal trichomonacidal concentrations of 0.025 to 0.100 micrograms/ml. Killing of some T. vaginalis isolates by clotrimazole and rosoxacin occurred only at concentrations of 100 micrograms/ml. Resistance to both rosoxacin and clotrimazole correlated with increasing resistance to metronidazole (P less than 0.01).

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supporting

confidence: 88%

Use of a time-kill technique for susceptibility testing of Trichomonas vaginalis

Krieger¹,

Dickins²,

Rein³

1985

Antimicrob Agents Chemother

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“…Many different methods are used in laboratories to test for drug susceptibility, and it is not possible to define accurate threshold values for resistant and sensitive strains. There is also uncertainty whether the MIC or MLC can be used as such to determine the suitable drug dosage for the patient (23,34). We suggest that a patient-derived strain is judged to be resistant after comparing it to a known, highly resistant strain by an easily interpretable method.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2000

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Trichomonas vaginalis is a globally common sexually transmitted human parasite. Many strains of T. vaginalis from around the world have been described to be resistant to the current drug of choice, metronidazole. However, only a few cases of metronidazole resistance have been reported from Europe. The resistant strains cause prolonged infections which are difficult to treat. T. vaginalis infection also increases the risk for human immunodeficiency virus transmission. We present a practical method for determining the resistance of T. vaginalis to 5-nitroimidazoles. The suggested method was developed by determining the MICs and minimal lethal concentrations (MLCs) of metronidazole and ornidazole forT. vaginalis under various aerobic and anaerobic conditions. Using this assay we have found the first three metronidazole-resistant strains from Finland, although the origin of at least one of the strains seems to be Russia. Analysis of the patient-derived and previously characterized isolates showed that metronidazole-resistant strains were also resistant to ornidazole, and MLCs for all strains tested correlated well with the MICs. The suggested MICs of metronidazole for differentiation of sensitive and resistant isolates are >75 μg/ml in an aerobic 24-h assay and >15 μg/ml in an anaerobic 48-h assay.

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“…Ralph et al . performed a clinical trial in which the efficacy of single 1‐g and 2‐g doses of MTZ was compared; in addition, authors compared the in vitro susceptibility of TV isolates to the clinical response to MTZ treatment 40 . Muller et al evaluated the in vitro susceptibility to MTZ of TV isolates retrieved from a group of women who received 2g of MTZ 24 ; they compared the laboratory testing results with the clinical outcome and proposed breakpoints to define MTZ resistance.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies published between 1988 and 2019 describe anaerobic and aerobic drug susceptibility assays 22–24,26,31,34–37 . The remaining studies only performed MTZ susceptibility testing under aerobic conditions but one 40 …”

Section: Resultsmentioning

confidence: 99%

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Trichomonas vaginalis and growing concern over drug resistance: a systematic review

Marques-Silva

Lisboa

Gomes

et al. 2021

Acad Dermatol Venereol

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In the late 90s, a sharp increase of treatment failures of Trichomonas vaginalis (TV) infections with metronidazole (MTZ) was reported, representing a problem due to limited treatment options. We proposed to review the available evidence on the frequency of MTZ resistance by TV isolates and the relationship between treatment failure and in vitro resistance to MTZ. A systematic review based on the PRISMA guidelines was conducted by searching published studies in three different databases (PubMed, Scopus and Web of Science) up to December 2020. The extracted studies were uploaded to Covidence software; screening was guided based on inclusion and exclusion criteria. Additionally, different articles were included through other sources. For each article, study design, objectives, study population and key outcomes were summarized. We found 403 references from the databases and four extra studies. After duplicate removal and screening of title, abstract and full text, 27 studies were included. The selected studies were published between 1983 and 2019; all except one addressed only vaginal TV infection. We identified four major populations in vitro MTZ resistance: two studies evaluated female adolescents; other two assessed HIV‐positive women. Fifteen studies considered MTZ resistance in newly diagnosed vaginal TV infection. Finally, eight articles studied in vitro susceptibility of isolates from women with clinical resistant trichomoniasis. High level of in vitro MTZ resistance was rare; low‐moderate level was described in most of the cases. Although clinical resistance to MTZ of trichomoniasis was widely reported, there was a paucity of prospective controlled studies. Our review unveiled the need to standardize susceptibility testing, to define breakpoints for detection of MTZ‐resistant isolates and to correlate with clinical outcome. It is important to establish criteria to define clinical resistance to MTZ. Such a consensus would foster the development of surveillance studies about clinical and microbiological response to MTZ treatment.

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Susceptibility of Trichomonas vaginalis Strains to Metronidazole

Cited by 11 publications

References 11 publications

Use of a time-kill technique for susceptibility testing of Trichomonas vaginalis

Use of a time-kill technique for susceptibility testing of Trichomonas vaginalis

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

Trichomonas vaginalis and growing concern over drug resistance: a systematic review

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