Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity

Muzny, Christina A; Gerwen, Olivia T Van; Kissinger, Patricia

doi:10.1097/qco.0000000000000618

Cited by 20 publications

(12 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5,6,7 Trichomonas vaginalis infection prevalence in pregnant women ranges from 17% to 20% in Africa, 16% to 53% in the United States and 0.8% in Asia. 8 Studies that have been conducted in South African pregnant women have reported prevalence rates of 15.3% 5 and 20.2%. 7 Several risk factors associated with T. vaginalis infection have been reported including older age, co-infection with other STIs, 9,10 sexual behaviour, socioeconomic status and phase of menstrual cycle.…”

Section: Introductionmentioning

confidence: 99%

A review on Trichomonas vaginalis infections in women from Africa

Mabaso

Abbai

2021

Southern African Journal of Infectious Diseases

View full text Add to dashboard Cite

Despite being a highly prevalent infection in the African continent, there is no review article published that solely focusses on Trichomonas vaginalis (T. vaginalis) infections in women from Africa. This review aims to fill this gap in the literature.Method: An electronic search of online databases was used to identify and extract relevant research articles related to the epidemiology, health complications and treatment associated with T. vaginalis in women from Africa.Results: Within the African continent, South Africa has reported the highest prevalence rate for this infection. A combination of sociodemographic, behavioural and biological factors has been shown to be associated with infection. Trichomonas vaginalis infection is associated with the acquisition of HIV, cervical cancer and PIDs in various female populations across the continent. Emerging patterns of resistance to metronidazole have been reported in women from South Africa. Currently, there is no effective vaccine against this pathogen despite efforts at vaccine development. Conclusion:Based on the high prevalence and health consequences associated with T. vaginalis, there is a need for improved screening programmes that will lead to early diagnosis, detection of asymptomatic infections and effective treatment regimens.

show abstract

Section: Introductionmentioning

confidence: 99%

A review on Trichomonas vaginalis infections in women from Africa

Mabaso

Abbai

2021

Southern African Journal of Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Paromomycin is an aminoglycoside with a different mechanism of action (destruction of ribosomal RNA) than 5-nitroimidazoles (inhibition of nucleic acid synthesis by DNA disruption and/or inhibition of enzymes involved in antioxidant defense) (Leitsch et al ., 2009; Van Gerwen and Muzny, 2019); combination use of these medications may provide a synergistic effect. It is important to note that all intra-vaginal formulations need to be made at a compounding pharmacy and may be costly (Muzny et al ., 2020). In addition, intra-vaginal paromomycin can cause vaginal ulceration and should be discontinued if this occurs, at which time ulcerations may spontaneously regress (Van Gerwen and Muzny, 2019).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the literature on mechanisms of 5-nitroimidazole resistance inTrichomonas vaginalis

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Trichomonas vaginalis is the most common non-viral sexually transmitted infection. 5-Nitroimidazoles [metronidazole (MTZ) and tinidazole (TDZ)] are FDA-approved treatments. To better understand treatment failure, we conducted a systematic review on mechanisms of 5-nitroimidazole resistance. Methods PubMed, ScienceDirect and EMBASE databases were searched using keywords Trichomonas vaginalis, trichomoniasis, 5-nitroimidazole, metronidazole, tinidazole and drug resistance. Non-English language articles and articles on other treatments were excluded. Results The search yielded 606 articles, of which 550 were excluded, leaving 58 articles. Trichomonas vaginalis resistance varies and is higher with MTZ (2.2–9.6%) than TDZ (0–2%). Resistance can be aerobic or anaerobic and is relative rather than absolute. Differential expression of enzymes involved in trichomonad energy production and antioxidant defenses affects 5-nitroimidazole drug activation; reduced expression of pyruvate:ferredoxin oxidoreductase, ferredoxin, nitroreductase, hydrogenase, thioredoxin reductase and flavin reductase are implicated in drug resistance. Trichomonas vaginalis infection with Mycoplasma hominis or T. vaginalis virus has also been associated with resistance. Trichomonas vaginalis has two genotypes, with greater resistance seen in type 2 (vs type 1) populations. Discussion 5-Nitroimidazole resistance results from differential expression of enzymes involved in energy production or antioxidant defenses, along with genetic mutations in the T. vaginalis genome. Alternative treatments outside of the 5-nitroimidazole class are needed.

show abstract

“…Trichomonas vaginalis es el protozoario parásito identificado como agente etiológico de la tricomoniasis, responsable de hasta el 30% de las infecciones de transmisión sexual no virales en el mundo 1 . La tricomoniasis se relaciona con cáncer cervical, enfermedades inflamatorias pélvicas atípicas, infertilidad, ruptura prematura de la membrana placentaria y el incremento de transmisión del VIH 2. Su prevalencia mundial en mujeres de 15-49 años es 5.3% y de 0.6% en hombres 3 , sin embargo algunos autores reportan que las frecuencias más altas se encuentran en mujeres de 46 a 55 años de edad 2,4 . En México se reportan prevalencias entre 15-20% 5 .…”

Section: Introductionunclassified

“…En México se reportan prevalencias entre 15-20% 5 . Esta infección es frecuentemente asintomática (85% en mujeres), lo que facilita su transmisión 1,3 ; cuando los síntomas de la infección se presentan, incluyen leucorrea abundante, amarillo verdosa, fétida y espumosa, frecuentemente en mujeres es referida disuria, prurito y dispareunia, a la exploración se observa el llamado "cérvix de fresa" por las hemorragias puntiformes y dilatación de capilares 1 . Los métodos tradicionales para su identificación incluyen microscopía y cultivo, recientemente se han desarrollado métodos moleculares mucho más sensibles 2 .…”

Section: Introductionunclassified

Identificación molecular de Trichomonas vaginalis en muestras cérvico-vaginales de mujeres sexualmente activas de la ciudad de Durango

Silva¹,

Hernández²,

Álamos³

et al. 2021

S. F. J. of Health

View full text Add to dashboard Cite

La tricomoniasis representa el 30% de las infecciones de transmisión sexual no virales en el mundo; su agente etiológico es el protozoario parásito Trichomonas vaginalis. Frecuentemente la infección es asintomática, lo que dificulta su tratamiento y detección y facilita su transmisión. La implementación de pruebas específicas, sensibles y económicamente accesibles que permitan mejorar la capacidad de detección de este patógeno, es importante ya que los métodos de diagnóstico que se utilizan tradicionalmente (examen en fresco, cultivo vaginal, papanicolaou, etc.) no cumplen con estos requisitos. En este proyecto se incluyeron 197 mujeres sexualmente activas entre los 17 y los 67 años; se tomaron muestras cérvicovaginales para realizar examen en fresco, tinción Papanicolaou y para la identificación molecular se amplificó una región conservada en el gen de adhesina AP65 de T. vaginalis. Se obtuvo una prevalencia del 35.5% de Trichomonas vaginalis identificada por de PCR de punto final, confirmando que esta última es la técnica con mayor sensibilidad y especificidad con respecto al examen en fresco y Papanicolaou. Trichomoniasis represents 30% of non-viral sexually transmitted infections worldwide; its etiological agent is the protozoan parasite Trichomonas vaginalis. The infection is often asymptomatic, which makes it difficult to treat and detect and facilitates its transmission. The implementation of specific, sensitive and economically accessible tests to improve the detection capacity of this pathogen is important because the diagnostic methods traditionally used (fresh examination, vaginal culture, pap smears, etc.) do not meet these requirements. 197 sexually active women between 17 and 67 years of age were included in this project; cervicovaginal samples were taken for fresh test, Papanicolaou staining, and for molecular identification, a conserved region in the AP65 adhesin gene of T. vaginalis was amplified. A prevalence of 35.5% of Trichomonas vaginalis identified by end-point PCR was obtained, confirming that the latter is the technique with greater sensitivity and specificity with respect to the fresh test and Papanicolaou.

show abstract

Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity

Cited by 20 publications

References 41 publications

A review on Trichomonas vaginalis infections in women from Africa

A review on Trichomonas vaginalis infections in women from Africa

A systematic review of the literature on mechanisms of 5-nitroimidazole resistance inTrichomonas vaginalis

Identificación molecular de Trichomonas vaginalis en muestras cérvico-vaginales de mujeres sexualmente activas de la ciudad de Durango

Contact Info

Product

Resources

About