Treatment failure in trichomoniasis and persistance of the parasite after Lactobacillus immunotherapy; two case reports

Weiden, R.M.F. van der; Meijden, W I van der; Bogchelman, Dick H.; Polderman, A.M.

doi:10.1016/0028-2243(90)90021-r

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…Since the introduction of 5-nitroimidazoles in the 1960s there have been reports of at least 100 metronidazole-resistant strains of T. vaginalis from the United States (5,9,12,16,21,23,29,31,32,35). Only under 20 metronidazole-resistant strains have been described from Europe (3,7,12,16,19,26,40,41). In addition, some preliminary reports have been published, for example, from Russia (18) and Africa (13).…”

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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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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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“…Evidence that the German vaccine Solco Trichovac induced antibodies that cross-react with trichomonas was not confirmed in vitro 60 and the few case reports of its use have not demonstrated cure. 61,62 However, the vaccine has been shown to return abnormal vaginal microflora, which is associated with increased risk of trichomonal infection, 63 to normal. 64 Therefore, normalization of vaginal flora as a preventive measure for TV may merit further study.…”

Section: Discussionmentioning

confidence: 99%

Recalcitrant Trichomonas vaginalis infection – a case series

et al. 2005

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The objective of this study was (1) to estimate the prevalence of recalcitrant Trichomonas vaginalis (TV) infection in a UK genitourinary medicine clinic; (2) to use a case series and literature review to suggest an algorithm for management of recalcitrant TV (rTV). A retrospective review of laboratory records, case-notes and literature review was conducted. Fifteen patients were studied, representing 1.16% of the cases presenting during the study period. A wide variety of therapeutic agents was used, the treatment regimen differed for each patient. No treatment was universally effective in achieving cure, but the use of acetarsol pessaries vaginally appeared to be the most frequently successful strategy. Based on these results, an algorithm for treatment of rTV is presented, although clinical trials will be needed to elucidate the best clinical approaches to this problem.

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“…The mean number of infections per 6 months was 2.54 ± 1.66 in the control arm and significantly less (0.38 ± 0.51) during the Lactobacillus acidophilis arm (p = 0.001). Two other studies testing L. acidophilus for the prevention of bacterial vaginosis or Trichomonas vaginalis failed to find a protective effect [38,39]. In another small study, Lactobacillus casei GG was given in an open trial to 28 women with recurrent vaginitis.…”

Section: Vaginitismentioning

confidence: 99%