Skip to main content
SpringerLink
Log in

Diagnosis and Treatment of Metronidazole-Resistant Trichomonas vaginalis Infection

  • Chapter
  • First Online:
Antimicrobial Drug Resistance

Abstract

Trichomonas vaginalis is the causative agent of trichomoniasis. There is an estimated prevalence of 276.4 million T. vaginalis infections worldwide. Important complications due to T. vaginalis infections are increased transmission of HIV, and infant morbidity due to preterm birth, low birth weight, and vertical transmission. Metronidazole and tinidazole are 5-nitroimidazole drugs used for treatment of T. vaginalis infections. T. vaginalis infections not responding to 5-nitroimidazole drugs used for standard therapy is a concern for adult sexual health due to persistence of infection and its complications as well as the risk for increased spread of disease due to clinical symptom relief following treatment without microbiological cure. At least a low level of metronidazole resistance is likely in 2–6 % of infections globally. Tinidazole resistance is strongly correlated to metronidazole resistance (r = 0.8709, P < 0.0001). Despite significant improvements in diagnostics in the past decade, new treatments are lacking. Alternative treatments tested in vitro rarely progress to clinical trials. So far, no consistently effective, non-nitroimidazole treatments are available to combat metronidazole-resistant T. vaginalis infections.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arroyo R, González‐Robles A, Martínez‐Palomo A, Alderete J. Signalling of Trichomonas vaginalis for amoeboid transformation and adhesin synthesis follows cytoadherence. Mol Microbiol. 1993;7(2):299–309.

    Article  CAS  PubMed  Google Scholar 

  2. Wartoń A, Honigberg B. Structure of trichomonads as revealed by scanning electron microscopy. J Protozool. 1979;26(1):56–62.

    Article  PubMed  Google Scholar 

  3. Honigberg BM, Brugerolle G. Structure. In: Honigberg B, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 5–35.

    Chapter  Google Scholar 

  4. Honigberg BM, King V. Structure of Trichomonas vaginalis Donné. J Parasitol. 1964;50(3):345–64.

    Article  CAS  PubMed  Google Scholar 

  5. Dobell C. The common flagellate of the human mouth, Trichomonas tenax (OFM): its discovery and its nomenclature. Parasitology. 1939;31(01):138–46.

    Article  Google Scholar 

  6. Wenrich D, Saxe L. Trichomonas microti, n. sp. (protozoa, Mastigophora). J Parasitol. 1950;36(3):261–9.

    Article  CAS  PubMed  Google Scholar 

  7. Cleveland L. Tritrichomonas fecalis nov. sp. of man; its ability to grow and multiply indefinitely in faeces diluted with tap water and in frogs and tadpoles. Am J Epidemiol. 1928;8(2):232–55.

    Article  Google Scholar 

  8. Heyworth PG, Gutteridge WE, Ginger CD. Purine metabolism in Trichomonas vaginalis. FEBS Lett. 1982;141(1):106–10.

    Article  CAS  PubMed  Google Scholar 

  9. Heyworth PG, Gutteridge WE, Ginger CD. Pyrimidine metabolism in Trichomonas vaginalis. FEBS Lett. 1984;176(1):55–60.

    Article  CAS  PubMed  Google Scholar 

  10. Beach DH, Holz GG, Singh BN, Lindmark DG. Fatty acid and sterol metabolism of cultured Trichomonas vaginalis and Tritrichomonas foetus. Mol Biochem Parasitol. 1990;38(2):175–90.

    Article  CAS  PubMed  Google Scholar 

  11. Tsukahara T. Respiratory metabolism of Trichomonas vaginalis. Jpn J Microbiol. 1961;5(2):157–69.

    Article  CAS  PubMed  Google Scholar 

  12. Linstead D, Cranshaw MA. The pathway of arginine catabolism in the parasitic flagellate Trichomonas vaginalis. Mol Biochem Parasitol. 1983;8(3):241–52.

    Article  CAS  PubMed  Google Scholar 

  13. Johnson PJ, Lahti CJ, Bradley PJ. Biogenesis of the hydrogenosome in the anaerobic protist Trichomonas vaginalis. J Parasitol. 1993;79(5):664–70.

    Article  CAS  PubMed  Google Scholar 

  14. Lindmark DG, Müller M, Shio H. Hydrogenosomes in Trichomonas vaginalis. J Parasitol. 1975;63(3):552–4.

    Article  Google Scholar 

  15. Kerscher L, Oesterhelt D. Pyruvate: ferredoxin oxidoreductase—new findings on an ancient enzyme. Trends Biochem Sci. 1982;7(10):371–4.

    Article  CAS  Google Scholar 

  16. Mack SR, Müller M. End products of carbohydrate metabolism in Trichomonas vaginalis. Comp Biochem Physiol B Biochem Mol Biol. 1980;67(2):213–6.

    Article  Google Scholar 

  17. Leitsch D, Kolarich D, Binder M, Stadlmann J, Altmann F, Duchêne M. Trichomonas vaginalis: Metronidazole and other nitroimidazole drugs are reduced by the flavin enzyme thioredoxin reductase and disrupt the cellular redox system. Implications for nitroimidazole toxicity and resistance. Mol Microbiol. 2009;72(2):518–36.

    Article  CAS  PubMed  Google Scholar 

  18. Rasoloson D, Tomkova E, Cammack R, Kulda J, Tachezy J. Metronidazole-resistant strains of Trichomonas vaginalis display increased susceptibility to oxygen. Parasitology. 2001;123(01):45–56.

    Article  CAS  PubMed  Google Scholar 

  19. Rowley J, Toskin I, Ndowa F. Global incidence and prevalence of selected curable sexually transmitted infections, 2008. Geneva: World Health Organization; 2012.

    Google Scholar 

  20. Bachmann LH, Hobbs MM, Seña AC, Sobel JD, Schwebke JR, Krieger JN, et al. Trichomonas vaginalis genital infections: progress and challenges. Clin Infect Dis. 2011;53 Suppl 3:S160–72.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia CB, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40(3):187–93.

    Article  PubMed  Google Scholar 

  22. Dunne RL, Linda AD, Upcroft P, O’Donoghue PJ, Upcroft JA. Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis. Cell Res. 2003;13(4):239–49.

    Article  CAS  PubMed  Google Scholar 

  23. Poole DN, McClelland RS. Global epidemiology of Trichomonas vaginalis. Sex Transm Infect. 2013;89(6):418–22.

    Article  PubMed  Google Scholar 

  24. Krieger JN, Jenny C, Verdon M, Siegel N, Springwater R, Critchlow CW, et al. Clinical manifestations of trichomoniasis in men. Ann Intern Med. 1993;118(11):844–9.

    Article  CAS  PubMed  Google Scholar 

  25. Martin DH, Bowie WR. Urethritis in males. In: Holmes KK, Mardh PA, Sparling PF, Weisner PJ, editors. Sexually transmitted diseases. 3rd ed. New York: Mc Graw-Hill; 1999. p. 833–45.

    Google Scholar 

  26. Price MA, Zimba D, Hoffman IF, Kaydos-Daniels SC, Miller WC, Martinson F, et al. Addition of treatment for trichomoniasis to syndromic management of urethritis in Malawi: A randomized clinical trial. Sex Transm Dis. 2003;30(6):516–22.

    Article  CAS  PubMed  Google Scholar 

  27. Rein MF, Müller M. Trichomonas vaginalis and trichomoniasis. In: Holmes KK, Mardh PA, Sparling PF, Weisner PJ, editors. Sexually transmitted diseases. 3rd ed. New York: McGraw-Hill; 1999. p. 481–92.

    Google Scholar 

  28. Lossick JG. Epidemiology of urogenital trichomoniasis. In: Honigberg BM, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 311–23.

    Chapter  Google Scholar 

  29. Weston TE, Nicol CS. Natural history of trichomonal infection in males. Br J Vener Dis. 1963;39(4):251–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Whittington MJ. Epidemiology of infections with Trichomonas vaginalis in the light of improved diagnostic methods. Br J Vener Dis. 1957;33(2):80–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Honigberg BM. Trichomonads of importance in human medicine. In: Krieger JP, editor. Parasitic protozoa, vol. 2. 1st ed. New York: Academic; 1978. p. 275–9.

    Google Scholar 

  32. Gallai Z, Sylvestre L. The present status of urogenital trichomoniasis. A general review of the literature. Appl Ther. 1966;8(9):773–8.

    CAS  PubMed  Google Scholar 

  33. Whittington MJ. The survival of Trichomonas vaginalis at temperatures below 37 °C. J Hyg. 1951;49(4):400–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Jirovec O, Petrů M. Trichomonas vaginalis and trichomoniasis. Adv Parasitol. 1968;6:117–88.

    Article  CAS  PubMed  Google Scholar 

  35. Kozlowska D, Wichrowska B. The effect of chlorine and its compounds used for disinfection of water on Trichomonas vaginalis. Wiad Parazytol. 1976;22(4–5):433–5.

    CAS  PubMed  Google Scholar 

  36. Pereira-Neves A, Benchimol M. Trichomonas vaginalis: In vitro survival in swimming pool water samples. Exp Parasitol. 2008;118(3):438–41.

    Article  PubMed  Google Scholar 

  37. Crucitti T, Jespers V, Mulenga C, Khondowe S, Vandepitte J, Buvé A. Non-sexual transmission of Trichomonas vaginalis in adolescent girls attending school in Ndola, Zambia. PLoS One. 2011;6(1):e16310.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Peterson K, Drame D. Iatrogenic transmission of Trichomonas vaginalis by a traditional healer. Sex Transm Infect. 2010;86(5):353–4.

    Article  PubMed  Google Scholar 

  39. Bruins MJ, Van Straaten ILM, Ruijs GJHM. Respiratory disease and Trichomonas vaginalis in premature newborn twins. Pediatr Infect Dis J. 2013;32(9):1029–30.

    Article  PubMed  Google Scholar 

  40. Carter JE, Whithaus KC. Neonatal respiratory tract involvement by Trichomonas vaginalis: a case report and review of the literature. Am J Trop Med Hyg. 2008;78(1):17–9.

    PubMed  Google Scholar 

  41. Schwandt A, Williams C, Beigi RH. Perinatal transmission of Trichomonas vaginalis: a case report. J Reprod Med. 2008;53(1):59–61.

    PubMed  Google Scholar 

  42. Meysick K, Garber GE. Trichomonas vaginalis. Curr Opin Infect Dis. 1995;8(1):22–5.

    Article  Google Scholar 

  43. Reynolds M, Wilson J. Is Trichomonas vaginalis still a marker for other sexually transmitted infections in women? Int J STD AIDS. 1996;7(2):131–2.

    Article  CAS  PubMed  Google Scholar 

  44. Kissinger P, Adamski A. Trichomoniasis and HIV interactions: a review. Sex Transm Infect. 2013;89(6):426–33.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Hoffmann B, Kazanowska W, Kilczewski W, Krach J. Serological diagnosis of Trichomonas infection. Med Dosw Mikrobiol. 1963;15:91–9.

    CAS  PubMed  Google Scholar 

  46. Smith JD, Garber GE. Trichomonas vaginalis infection induces vaginal CD4 cell infiltration in a mouse model: a vaccine strategy to reduce vaginal infection and HIV transmission. J Infect Dis. 2015;212(2):285–93. doi: http://dx.doi.org/10.1093/infdis/jiv036.

  47. Fastring DR, Amedee A, Gatski M, Clark RA, Mena LA, Levison J, et al. Co-occurrence of Trichomonas vaginalis and bacterial vaginosis and vaginal shedding of HIV-1 RNA. Sex Transm Dis. 2014;41(3):173–9.

    Article  PubMed  Google Scholar 

  48. Hobbs MM, Lapple DM, Lawing LF, Schwebke JR, Cohen MS, Swygard H, et al. Methods for detection of Trichomonas vaginalis in the male partners of infected women: Implications for control of trichomoniasis. J Clin Microbiol. 2006;44(11):3994–9.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Krieger JN. Trichomoniasis in men: old issues and new data. Sex Transm Dis. 1995;22(2):83–96.

    Article  CAS  PubMed  Google Scholar 

  50. Schwebke JR, Hook III EW. High rates of Trichomonas vaginalis among men attending a sexually transmitted diseases clinic: implications for screening and urethritis management. J Infect Dis. 2003;188(3):465–8.

    Article  PubMed  Google Scholar 

  51. Seña AC, Miller WC, Hobbs MM, Schwebke JR, Leone PA, Swygard H, et al. Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clin Infect Dis. 2007;44(1):13–22.

    Article  PubMed  Google Scholar 

  52. Krieger JN. Epidemiology and clinical manifestations of urogenital trichomoniasis in men. In: Honigberg BM, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 235–45.

    Chapter  Google Scholar 

  53. Abdolrasouli A, Croucher A, Roushan A, Gaydos CA. Bilateral conjunctivitis due to Trichomonas vaginalis without genital infection: an unusual presentation in an adult man. J Clin Microbiol. 2013;51(9):3157–9.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Hrbacek J, Urban M, Hamsikova E, Tachezy R, Heracek J. Thirty years of research on infection and prostate cancer: no conclusive evidence for a link. A systematic review. Urol Oncol. 2013;31(7):951–65.

    Article  PubMed  Google Scholar 

  55. Yow MA, Tabrizi SN, Severi G, Bolton DM, Pedersen J, Longano A, et al. Detection of infectious organisms in archival prostate cancer tissues. BMC Cancer. 2014;14(1):579.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  56. Fichorova RN. Impact of T. vaginalis infection on innate immune responses and reproductive outcome. J Reprod Immunol. 2009;83(1–2):185–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Krieger JN. Prostatitis syndromes: pathophysiology, differential diagnosis, and treatment. Sex Transm Dis. 1984;11(2):100–12.

    Article  CAS  PubMed  Google Scholar 

  58. Mitteregger D, Aberle SW, Makristathis A, Walochnik J, Brozek W, Marberger M, et al. High detection rate of Trichomonas vaginalis in benign hyperplastic prostatic tissue. Med Microbiol Immunol. 2012;201(1):113–6.

    Article  PubMed  Google Scholar 

  59. Petrin D, Delgaty K, Bhatt R, Garber G. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. 1998;11(2):300–17.

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Rendón-Maldonado JG, Espinosa-Cantellano M, González-Robles A, Martı́nez-Palomo A. Trichomonas vaginalis: In vitro phagocytosis of lactobacilli, vaginal epithelial cells, leukocytes, and erythrocytes. Exp Parasitol. 1998;89(2):241–50.

    Article  PubMed  Google Scholar 

  61. Lehker MW, Arroyo R, Alderete JF. The regulation by iron of the synthesis of adhesins and cytoadherence levels in the protozoan Trichomonas vaginalis. J Exp Med. 1991;174(2):311–8.

    Article  CAS  PubMed  Google Scholar 

  62. Rein MF. Trichomoniasis in VD clinic women. Paper presented at the annual meeting of the American Public Health Association, Washington DC, November 1; 1977.

    Google Scholar 

  63. Heine P, McGregor JA. Trichomonas vaginalis: a reemerging pathogen. Clin Obstet Gynecol. 1993;36(1):137–44.

    Article  CAS  PubMed  Google Scholar 

  64. Wølner-Hanssen P, Krieger JN, Stevens CE, Kiviat NB, Koutsky L, Critchlow C, et al. Clinical manifestations of vaginal trichomoniasis. JAMA. 1989;261(4):571–6.

    Article  PubMed  Google Scholar 

  65. Rodgerson EB. Vulvovaginal papillomas and Trichomonas vaginalis. Obstet Gynecol. 1972;40(3):327–33.

    CAS  PubMed  Google Scholar 

  66. Gupta PK, Frost JK. Cytopathology and histopathology of the female genital tract in Trichomonas vaginalis infection. In: Honigberg B, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 274–90.

    Chapter  Google Scholar 

  67. Rein MF, Chapel TA. Trichomoniasis, candidiasis, and the minor venereal diseases. Clin Obstet Gynecol. 1975;18(1):73–88.

    Article  CAS  PubMed  Google Scholar 

  68. Silver BJ, Guy RJ, Kaldor JM, Jamil MS, Rumbold AR. Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis. Sex Transm Dis. 2014;41(6):369–76.

    Article  PubMed  Google Scholar 

  69. Rein MF, Holmes K. Non-specific vaginitis, vulvovaginal candidiasis, and trichomoniasis: clinical features, diagnosis and management. In: Remington JS, Swartz MN, editors. Current clinical topics in infectious diseases, vol. 4. 1st ed. New York: McGraw-Hill; 1983. p. 281–315.

    Google Scholar 

  70. Vontver LA, Eschenbach DA. The role of Gardnerella vaginalis in nonspecific vaginitis. Clin Obstet Gynecol. 1981;24(2):439–60.

    Article  CAS  PubMed  Google Scholar 

  71. Chen KC, Amsel R, Eschenbach DA, Holmes KK. Biochemical diagnosis of vaginitis: determination of diamines in vaginal fluid. J Infect Dis. 1982;145(3):337–45.

    Article  CAS  PubMed  Google Scholar 

  72. Hobbs MM, Seña AC. Modern diagnosis of Trichomonas vaginalis infection. Sex Transm Infect. 2013;89(6):434–8.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Fouts AC, Kraus SJ. Trichomonas vaginalis: reevaluation of its clinical presentation and laboratory diagnosis. J Infect Dis. 1980;141(2):137–43.

    Article  CAS  PubMed  Google Scholar 

  74. O’Connor BH, Adler MW. Current approaches to the diagnosis, treatment, and reporting of trichomoniasis and candidosis. Br J Vener Dis. 1979;55(1):52–7.

    PubMed  PubMed Central  Google Scholar 

  75. McMillan A. Laboratory diagnostic methods and cryopreservation of trichomonads. In: Honigberg B, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 297–310.

    Chapter  Google Scholar 

  76. Nielsen R. Trichomonas vaginalis. I. Survival in solid Stuart’s medium. Br J Vener Dis. 1969;45(4):328–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Rayner CF. Comparison of culture media for the growth of Trichomonas vaginalis. Br J Vener Dis. 1968;44(1):63–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Mason PR, Super H, Fripp PJ. Comparison of four techniques for the routine diagnosis of Trichomonas vaginalis infection. J Clin Pathol. 1976;29(2):154–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Hipp SS, Kirkwood MW, Gaafar HA. Screening for Trichomonas vaginalis infection by use of acridine orange fluorescent microscopy. Sex Transm Dis. 1979;6(4):235–8.

    Article  CAS  PubMed  Google Scholar 

  80. Nagesha C, Ananthakrishna N, Sulochana P. Clinical and laboratory studies on vaginal trichomoniasis. Am J Obstet Gynecol. 1970;106(6):933–5.

    Article  CAS  PubMed  Google Scholar 

  81. Werness BA. Cytopathology of sexually transmitted disease. Clin Lab Med. 1989;9(3):559–72.

    CAS  PubMed  Google Scholar 

  82. Weinberger MW, Harger JH. Accuracy of the Papanicolaou smear in the diagnosis of asymptomatic infection with Trichomonas vaginalis. Obstet Gynecol. 1993;82(3):425–9.

    CAS  PubMed  Google Scholar 

  83. Williams JA, Ofner S, Batteiger BE, Fortenberry JD, Van Der Pol B. Duration of polymerase chain reaction-detectable DNA after treatment of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infections in women. Sex Transm Dis. 2014;41(3):215–9.

    Article  CAS  PubMed  Google Scholar 

  84. Peterman TA, Tian LH, Metcalf CA, Malotte CK, Paul SM, Douglas J, et al. Persistent, undetected Trichomonas vaginalis infections? Clin Infect Dis. 2009;48(2):259–60.

    Article  PubMed  Google Scholar 

  85. Gaydos C, Hardick J. Point of care diagnostics for sexually transmitted infections: perspectives and advances. Expert Rev Anti Infect Ther. 2014;12(6):657–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Pearce DM, Styles DN, Hardick JP, Gaydos CA. A new rapid molecular point-of-care assay for Trichomonas vaginalis: Preliminary performance data. Sex Transm Infect. 2013;89(6):495–7.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Alderete JF, Provenzano D. The vagina has reducing environment sufficient for activation of Trichomonas vaginalis cysteine proteinases. Genitourin Med. 1997;73(4):291–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Krieger JN, Rein MF. Zinc sensitivity of Trichomonas vaginalis: in vitro studies and clinical implications. J Infect Dis. 1982;146(3):341–5.

    Article  CAS  PubMed  Google Scholar 

  89. Cosar C, Julou L. The activity of 1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole (R. P. 8823) against experimental Trichomonas vaginalis infections. Ann Inst Pasteur (Paris). 1959;96(2):238–41.

    Google Scholar 

  90. Dubini F, Riviera L, Cocuzza C, Bellotti MG. Antibacterial, antimycotic and trichomonicidal activity of a new nitroimidazole (EU 11100). J Chemother. 1992;4(6):342–6.

    Article  CAS  PubMed  Google Scholar 

  91. Lossick JG. Treatment of sexually transmitted vaginosis/vaginitis. Rev Infect Dis. 1990;12 Suppl 6:S665–81.

    Article  PubMed  Google Scholar 

  92. Sherrard J, Ison C, Moody J, Wainwright E, Wilson J, Sullivan A. United Kingdom national guideline on the management of Trichomonas vaginalis 2014. Int J STD AIDS. 2014;25(8):541–9.

    Article  PubMed  Google Scholar 

  93. Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. Morb Mortal Weekly Rep. 2010;59(12 RR):1–113.

    Google Scholar 

  94. Lewis D. Trichomoniasis. Medicine (United Kingdom). 2014;42(7):369–71.

    Google Scholar 

  95. Seña AC, Bachmann LH, Hobbs MM. Persistent and recurrent Trichomonas vaginalis infections: epidemiology, treatment and management considerations. Expert Rev Anti Infect Ther. 2014;12(6):673–85.

    Article  PubMed  CAS  Google Scholar 

  96. Lushbaugh WB, Cleary JD, Finley RW. Cytotoxicity of hamycin for Trichomonas vaginalis, HeLa and BHK-21. J Antimicrob Chemother. 1995;36(5):795–802.

    Article  CAS  PubMed  Google Scholar 

  97. Alper MM, Barwin BN, McLean WM, McGilveray IJ, Sved S. Systemic absorption of metronidazole by the vaginal route. Obstet Gynecol. 1985;65(6):781–4.

    CAS  PubMed  Google Scholar 

  98. Kane PO, McFadzean JA, Squires S. Absorption and excretion of metronidazole. II. Studies on primary failures. Br J Vener Dis. 1961;37(4):276–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  99. Tidwell BH, Lushbaugh WB, Laughlin MD, Cleary JD, Finley RW. A double-blind placebo-controlled trial of single-dose intravaginal versus single-dose oral metronidazole in the treatment of trichomonal vaginitis. J Infect Dis. 1994;170(1):242–6.

    Article  CAS  PubMed  Google Scholar 

  100. Turgut EH, Özyazici M. Bioavailability file: Metronidazole. FABAD J Pharm Sci. 2004;29(1):39–49.

    CAS  Google Scholar 

  101. Cunningham FE, Kraus DM, Brubaker L, Fischer JH. Pharmacokinetics of intravaginal metronidazole gel. J Clin Pharmacol. 1994;34(11):1060–5.

    Article  CAS  PubMed  Google Scholar 

  102. Schwebke JR, Lensing SY, Sobel J. Intravaginal metronidazole/miconazole for the treatment of vaginal trichomoniasis. Sex Transm Dis. 2013;40(9):710–4.

    Article  CAS  PubMed  Google Scholar 

  103. Adamski A, Clark RA, Mena L, Henderson H, Levison J, Schmidt N, et al. The Influence of ART on the treatment of Trichomonas vaginalis among HIV-infected women. Clin Infect Dis. 2014;59(6):883–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Balkus JE, Richardson BA, Mochache V, Chohan V, Chan JD, Masese L, et al. A prospective cohort study comparing the effect of single-dose 2 g metronidazole on Trichomonas vaginalis infection in HIV-seropositive versus HIV-seronegative women. Sex Transm Dis. 2013;40(6):499–505.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Gatski M, Martin DH, Levison J, Mena L, Clark RA, Murphy M, et al. The influence of bacterial vaginosis on the response to Trichomonas vaginalis treatment among HIV-infected women. Sex Transm Infect. 2011;87(3):205–8.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Kissinger P, Mena L, Levison J, Clark RA, Gatski M, Henderson H, et al. A randomized treatment trial: single versus 7-day dose of metronidazole for the treatment of Trichomonas vaginalis among HIV-infected women. J Acquir Immune Defic Syndr. 2010;55(5):565–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Edwards DI. Nitroimidazole drugs—action and resistance mechanisms. I. Mechanisms of action. J Antimicrob Chemother. 1993;31(1):9–20.

    Article  CAS  PubMed  Google Scholar 

  108. Ellis JE, Yarlett N, Cole D, Humphreys MJ, Lloyd D. Antioxidant defences in the microaerophilic protozoan Trichomonas vaginalis: comparison of metronidazole-resistant and -sensitive strains. Microbiology. 1994;140(Pt 9):2489–94.

    Article  CAS  PubMed  Google Scholar 

  109. Kulda J. Trichomonads, hydrogenosomes and drug resistance. Int J Parasitol. 1999;29(2):199–212.

    Article  CAS  PubMed  Google Scholar 

  110. Kulda J, Tachezy J, Ĉerkasovova A. In vitro induced anaerobic resistance to metronidazole in Trichomonas vaginalis. J Eukaryot Microbiol. 1993;40(3):262–9.

    Article  CAS  PubMed  Google Scholar 

  111. Land KM, Clemens DL, Johnson PJ. Loss of multiple hydrogenosomal proteins associated with organelle metabolism and high-level drug resistance in trichomonads. Exp Parasitol. 2001;97(2):102–10.

    Article  CAS  PubMed  Google Scholar 

  112. Perez-Reyes E, Kalyanaraman B, Mason RP. The reductive metabolism of metronidazole and ronidazole by aerobic liver microsomes. Mol Pharmacol. 1980;17(2):239–44.

    CAS  PubMed  Google Scholar 

  113. Vidakovic M, Crossnoe CR, Neidre C, Kim K, Krause KL, Germanas JP. Reactivity of reduced [2Fe-2S] ferredoxins parallels host susceptibility to nitroimidazoles. Antimicrob Agents Chemother. 2003;47(1):302–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  114. Leitsch D, Kolarich D, Duchêne M. The flavin inhibitor diphenyleneiodonium renders Trichomonas vaginalis resistant to metronidazole, inhibits thioredoxin reductase and flavin reductase, and shuts off hydrogenosomal enzymatic pathways. Mol Biochem Parasitol. 2010;171(1):17–24.

    Article  CAS  PubMed  Google Scholar 

  115. Leitsch D, Drinić M, Kolarich D, Duchêne M. Down-regulation of flavin reductase and alcohol dehydrogenase-1 (ADH1) in metronidazole-resistant isolates of Trichomonas vaginalis. Mol Biochem Parasitol. 2012;183(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  116. Leitsch D, Janssen BD, Kolarich D, Johnson PJ, Duchêne M. Trichomonas vaginalis flavin reductase 1 and its role in metronidazole resistance. Mol Microbiol. 2014;91(1):198–208.

    Article  CAS  PubMed  Google Scholar 

  117. Lloyd D, Kristensen B. Metronidazole inhibition of hydrogen production in vivo in drug-sensitive and resistant strains of Trichomonas vaginalis. J Gen Microbiol. 1985;131(4):849–53.

    CAS  PubMed  Google Scholar 

  118. Moreno SN, Docampo R. Mechanism of toxicity of nitro compounds used in the chemotherapy of trichomoniasis. Environ Health Perspect. 1985;64:199–208.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Ings RM, McFadzean JA, Ormerod WE. The mode of action of metronidazole in Trichomonas vaginalis and other micro-organisms. Biochem Pharmacol. 1974;23(9):1421–9.

    Article  CAS  PubMed  Google Scholar 

  120. Edwards DI. Mechanisms of selective toxicity of metronidazole and other nitroimidazole drugs. Br J Vener Dis. 1980;56(5):285–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  121. Yarlett N, Yarlett NC, Lloyd D. Metronidazole-resistant clinical isolates of Trichomonas vaginalis have lowered oxygen affinities. Mol Biochem Parasitol. 1986;19(2):111–6.

    Article  CAS  PubMed  Google Scholar 

  122. Yarlett N, Yarlett NC, Lloyd D. Ferredoxin-dependent reduction of nitroimidazole derivatives in drug-resistant and susceptible strains of Trichomonas vaginalis. Biochem Pharmacol. 1986;35(10):1703–8.

    Article  CAS  PubMed  Google Scholar 

  123. Land KM, Delgadillo‐Correa MG, Tachezy J, Vanacova S, Hsieh CL, Sutak R, et al. Targeted gene replacement of a ferredoxin gene in Trichomonas vaginalis does not lead to metronidazole resistance. Mol Microbiol. 2004;51(1):115–22.

    Article  CAS  PubMed  Google Scholar 

  124. Wright JM, Webb RI, O'Donoghue P, Upcroft P, Upcroft JA. Hydrogenosomes of laboratory-induced metronidazole-resistant Trichomonas vaginalis lines are downsized while those from clinically metronidazole-resistant isolates are not. J Eukaryot Microbiol. 2010;57(2):171–6.

    Article  CAS  PubMed  Google Scholar 

  125. Mason RP, Holtzman JL. The role of catalytic superoxide formation in the O2 inhibition of nitroreductase. Biochem Biophys Res Commun. 1975;67(4):1267–74.

    Article  CAS  PubMed  Google Scholar 

  126. Hrdy I, Cammack R, Stopka P, Kulda J, Tachezy J. Alternative pathway of metronidazole activation in Trichomonas vaginalis hydrogenosomes. Antimicrob Agents Chemother. 2005;49(12):5033–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Paulish-Miller TE, Augostini P, Schuyler JA, Smith WL, Mordechai E, Adelson ME, et al. Trichomonas vaginalis metronidazole resistance is associated with single nucleotide polymorphisms in the nitroreductase genes ntr4Tv and ntr6Tv. Antimicrob Agents Chemother. 2014;58(5):2938–43.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  128. Smutna T, Pilarova K, Tarabek J, Tachezy J, Hrdy I. Novel functions of an iron-sulfur flavoprotein from Trichomonas vaginalis hydrogenosomes. Antimicrob Agents Chemother. 2014;58(6):3224–32.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  129. Kirkcaldy RD, Augostini P, Asbel LE, Bernstein KT, Kerani RP, Mettenbrink CJ, et al. Trichomonas vaginalis antimicrobial drug resistance in 6 US cities, STD surveillance network, 2009–2010. Emerg Infect Dis. 2012;18(6):939–43.

    Article  PubMed  PubMed Central  Google Scholar 

  130. Meingassner JG, Thurner J. Strain of Trichomonas vaginalis resistant to metronidazole and other 5-nitroimidazoles. Antimicrob Agents Chemother. 1979;15(2):254–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  131. Schmid G, Narcisi E, Mosure D, Secor WE, Higgins J, Moreno H. Prevalence of metronidazole-resistant Trichomonas vaginalis in a gynecology clinic. J Reprod Med. 2001;46(6):545–9.

    CAS  PubMed  Google Scholar 

  132. Schwebke JR, Barrientes FJ. Prevalence of Trichomonas vaginalis isolates with resistance to metronidazole and tinidazole. Antimicrob Agents Chemother. 2006;50(12):4209–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  133. Sobel JD, Nagappan V, Nyirjesy P. Metronidazole-resistant vaginal trichomoniasis—an emerging problem. N Engl J Med. 1999;341(4):292–3.

    Article  CAS  PubMed  Google Scholar 

  134. Upcroft JA, Dunn LA, Wal T, Tabrizi S, Delgadillo-Correa MG, Johnson PJ, et al. Metronidazole resistance in Trichomonas vaginalis from highland women in Papua New Guinea. Sex Health. 2009;6(4):334–8.

    Article  PubMed  Google Scholar 

  135. Müller M. Reductive activation of nitroimidazoles in anaerobic microorganisms. Biochem Pharmacol. 1986;35(1):37–41.

    Article  PubMed  Google Scholar 

  136. Lossick JG, Müller M, Gorrell TE. In vitro drug susceptibility and doses of metronidazole required for cure in cases of refractory vaginal trichomoniasis. J Infect Dis. 1986;153(5):948–55.

    Article  CAS  PubMed  Google Scholar 

  137. Bosserman EA, Helms DJ, Mosure DJ, Secor WE, Workowski KA. Utility of antimicrobial susceptibility testing in Trichomonas vaginalis-infected women with clinical treatment failure. Sex Transm Dis. 2011;38(10):983–7.

    Article  CAS  PubMed  Google Scholar 

  138. Krashin JW, Koumans EH, Bradshaw-Sydnor A, Braxton JR, Evan Secor W, Sawyer MK, et al. Trichomonas vaginalis prevalence, incidence, risk factors and antibiotic-resistance in an adolescent population. Sex Transm Dis. 2010;37(7):440–4.

    PubMed  Google Scholar 

  139. Lossick JG, Kent HL. Trichomoniasis: trends in diagnosis and management. Obstet Gynecol. 1991;165(4):1217–22.

    CAS  Google Scholar 

  140. Grossman 3rd JH, Galask RP. Persistent vaginitis caused by metronidazole-resistant Trichomonas. Obstet Gynecol. 1990;76(3 Pt 2):521–2.

    PubMed  Google Scholar 

  141. Chen MY, Smith NA, Fox EF, Bingham JS, Barlow D. Acetarsol pessaries in the treatment of metronidazole resistant Trichomonas vaginalis. Int J STD AIDS. 1999;10(4):277–80.

    Article  CAS  PubMed  Google Scholar 

  142. Watson PG, Pattman RS. Arsenical pessaries in the successful elimination of metronidazole-resistant Trichomonas vaginalis. Int J STD AIDS. 1996;7(4):296–7.

    Article  CAS  PubMed  Google Scholar 

  143. Narcisi EM, Secor WE. In vitro effect of tinidazole and furazolidone on metronidazole-resistant Trichomonas vaginalis. Antimicrob Agents Chemother. 1996;40(5):1121–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  144. Fung HB, Doan T. Tinidazole: a nitroimidazole antiprotozoal agent. Clin Ther. 2005;27(12):1859–84.

    Article  CAS  PubMed  Google Scholar 

  145. Malla N, Gupta I, Sokhey C, Sehgal R, Ganguly N, Mahajan R. In vitro evaluation of metronidazole and tinidazole on strains of Trichomonas vaginalis. Indian J Med Microbiol. 1988;6(4):297–301.

    Google Scholar 

  146. Nailor MD, Sobel JD. Tinidazole for the treatment of vaginal infections. Expert Opin Investig Drugs. 2007;16(5):743–51.

    Article  CAS  PubMed  Google Scholar 

  147. Mammen-Tobin A, Wilson JD. Management of metronidazole-resistant Trichomonas vaginalis—a new approach. Int J STD AIDS. 2005;16(7):488–90.

    Google Scholar 

  148. Nyirjesy P, Gilbert J, Mulcahy LJ. Resistant trichomoniasis: successful treatment with combination therapy. Sex Transm Dis. 2011;38(10):962–3.

    Article  PubMed  Google Scholar 

  149. Saurina G, DeMeo L, McCormack WM. Cure of metronidazole- and tinidazole-resistant trichomoniasis with use of high-dose oral and intravaginal tinidazole. Clin Infect Dis. 1998;26(5):1238–9.

    Article  CAS  PubMed  Google Scholar 

  150. Sobel JD, Nyirjesy P, Brown W. Tinidazole therapy for metronidazole-resistant vaginal trichomoniasis. Clin Infect Dis. 2001;33(8):1341–6.

    Article  CAS  PubMed  Google Scholar 

  151. Crowell AL, Sanders-Lewis KA, Secor WE. In vitro metronidazole and tinidazole activities against metronidazole-resistant strains of Trichomonas vaginalis. Antimicrob Agents Chemother. 2003;47(4):1407–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  152. Aggarwal A, Shier RM. Recalcitrant Trichomonas vaginalis infections successfully treated with vaginal acidification. J Obstet Gynaecol. 2008;30(1):55–8.

    Google Scholar 

  153. Goldman LM, Upcroft JA, Workowski K, Rapkin A. Treatment of metronidazole-resistant Trichomonas vaginalis. Sex Health. 2009;6(4):345–7.

    Article  PubMed  Google Scholar 

  154. Nyirjesy P, Weitz MV, Gelone SP, Fekete T. Paromomycin for nitroimidazole-resistant trichomonosis. Lancet. 1995;346(8982):1110.

    Article  CAS  PubMed  Google Scholar 

  155. Nyirjesy P, Sobel JD, Weitz MV, Leaman DJ, Gelone SP. Difficult-to-treat trichomoniasis: results with paromomycin cream. Clin Infect Dis. 1998;26(4):986–8.

    Article  CAS  PubMed  Google Scholar 

  156. Tayal SC, Ochogwu SA, Bunce H. Paromomycin treatment of recalcitrant Trichomonas vaginalis. Int J STD AIDS. 2010;21(3):217–8.

    Article  CAS  PubMed  Google Scholar 

  157. Walker PP, Hall RE, Wilson JD. Arsenical pessaries in the treatment of metronidazole-resistant Trichomonas vaginalis. Int J STD AIDS. 1997;8(7):473.

    Article  CAS  PubMed  Google Scholar 

  158. Wood S, Kennedy CM, Galask RP. Prolonged vaginal and oral metronidazole for refractory Trichomonas vaginalis: a case report. J Reprod Med. 2007;52(11):1057–8.

    PubMed  Google Scholar 

  159. Poppe WA. Nitroimidazole-resistant vaginal trichomoniasis treated with paromomycin. Eur J Obstet Gynecol Reprod Biol. 2001;96(1):119–20.

    Article  CAS  PubMed  Google Scholar 

  160. Livengood III CH, Lossick JG. Resolution of resistant vaginal trichomoniasis associated with the use of intravaginal nonoxynol-9. Obstet Gynecol. 1991;78(5 Pt 2):954–6.

    PubMed  Google Scholar 

  161. Pattman RS, Sprott MS, Kearns AM, Earnshaw M. Failure of mebendazole to cure trichomonal vaginitis resistant to metronidazole: case reports. Genitourin Med. 1989;65(4):274–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  162. Waters LJ, Dave SS, Deayton JR, French PD. Recalcitrant Trichomonas vaginalis infection—a case series. Int J STD AIDS. 2005;16(7):505–9.

    Article  CAS  PubMed  Google Scholar 

  163. Wong CA, Wilson PD, Chew TA. Povidone‐iodine in the treatment of metronidazole‐resistant Trichomonas vaginalis. Aust N Z J Obstet Gynaecol. 1990;30(2):169–71.

    Article  CAS  PubMed  Google Scholar 

  164. Muzny C, Barnes A, Mena L. Symptomatic Trichomonas vaginalis infection in the setting of severe nitroimidazole allergy: successful treatment with boric acid. Sex Health. 2012;9(4):389–91.

    Article  PubMed  Google Scholar 

  165. Henderson JN, Tait IB. The use of povidone-iodine (‘Betadine’) pessaries in the treatment of candidal and trichomonal vaginitis. Curr Med Res Opin. 1975;3(3):157–62.

    Article  CAS  PubMed  Google Scholar 

  166. Hamed KA, Studemeister AE. Successful response of metronidazole-resistant trichomonal vaginitis to tinidazole. A case report. Sex Transm Dis. 1992;19(6):339–40.

    Article  CAS  PubMed  Google Scholar 

  167. Antonelli NM, Diehl SJ, Wright JW. A randomized trial of intravaginal nonoxynol 9 versus oral metronidazole in the treatment of vaginal trichomoniasis. Obstet Gynecol. 2000;182(5):1008–10.

    CAS  Google Scholar 

  168. Forna F, Gülmezoglu AM. Interventions for treating trichomoniasis in women. Cochrane Database Syst Rev. 2003;2:CD000218.

    Google Scholar 

  169. Fowler W, Hussain M. Nifuratel (Magmilor) in trichomonal vaginitis. Br J Vener Dis. 1968;44(4):331–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  170. Goodhew EB, Secor WE. Drug library screening against metronidazole-sensitive and metronidazole-resistant Trichomonas vaginalis isolates. Sex Transm Infect. 2013;89(6):479–84.

    Article  PubMed  Google Scholar 

  171. Mendling W, Caserini M, Palmieri R. A randomised, double-blind, controlled study to assess the efficacy and safety of nifuratel in the treatment of trichomoniasis. Sex Transm Infect. 2013;89 Suppl 1:A38.

    Google Scholar 

  172. Evans BA, Catterall RD. Nifuratel compared with metronidazole in the treatment of trichomonal vaginitis. Br Med J. 1970;2(5705):335–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  173. Dan M, Sobel JD. Failure of nitazoxanide to cure trichomoniasis in three women. Sex Transm Dis. 2007;34(10):813–4.

    PubMed  Google Scholar 

  174. Helms DJ, Mosure DJ, Secor WE, Workowski KA. Management of Trichomonas vaginalis in women with suspected metronidazole hypersensitivity. Obstet Gynecol. 2008;198(4):370.e1–370.e7.

    Google Scholar 

  175. De Francesco V, Ierardi E, Hassan C, Zullo A. Is furazolidone therapy for Helicobacter pylori effective and safe? Dig Dis Sci. 2009;54(10):2298–9.

    Article  PubMed  Google Scholar 

  176. Subramanian C, Sobel JD. A case of high-level metronidazole-resistant trichomoniasis in pregnancy successfully treated. J Low Genit Tract Dis. 2011;15(3):248–9.

    Article  PubMed  Google Scholar 

  177. Ackers J. Immunologic aspects of human trichomoniasis. In: Honigberg BM, editor. Trichomonads parasitic in humans. 1st ed. New York: Springer; 1990. p. 36–52.

    Chapter  Google Scholar 

  178. Anderson VR, Curran MP. Nitazoxanide: a review of its use in the treatment of gastrointestinal infections. Drugs. 2007;67(13):1947–67.

    Article  CAS  PubMed  Google Scholar 

  179. Yarlett N, Rowlands C, Yarlett NC, Evans JC, Lloyd D. Reduction of niridazole by metronidazole resistant and susceptible strains of Trichomonas vaginalis. Parasitology. 1987;94(Pt 1):93–9.

    Article  CAS  PubMed  Google Scholar 

  180. Malagoli M, Rossi T, Baggio A, Zandomeneghi G, Zanca A, Casolari C, et al. In vitro study of chemotherapeutic activity of sulphimidazole on some sensitive and metronidazole-resistant Trichomonas vaginalis strains. Pharmacol Res. 2002;46(5):469–72.

    Article  CAS  PubMed  Google Scholar 

  181. duBouchet L, Spence MR, Rein MF, Danzig MR, McCormack WM. Multicenter comparison of clotrimazole vaginal tablets, oral metronidazole, and vaginal suppositories containing sulfanilamide, aminacrine hydrochloride, and allantoin in the treatment of symptomatic trichomoniasis. Sex Transm Dis. 1997;24(3):156–60.

    Article  CAS  PubMed  Google Scholar 

  182. Bouma MJ, Snowdon D, Fairlamb AH, Ackers JP. Activity of disulfiram (bis(diethylthiocarbamoyl)disulphide) and ditiocarb (diethyldithiocarbamate) against metronidazole-sensitive and -resistant Trichomonas vaginalis and Tritrichomonas foetus. J Antimicrob Chemother. 1998;42(6):817–20.

    Article  CAS  PubMed  Google Scholar 

  183. Bramley M, Kinghorn G. Do oral contraceptives inhibit Trichomonas vaginalis? Sex Transm Dis. 1979;6(4):261–3.

    Article  CAS  PubMed  Google Scholar 

  184. Tobian AAR, Kacker S, Quinn TC. Male circumcision: a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections. Annu Rev Med. 2014;65:293–306.

    Article  CAS  PubMed  Google Scholar 

  185. Connor TH, Stoeckel M, Evrard J, Legator MS. The contribution of metronidazole and two metabolites to the mutagenic activity detected in urine of treated humans and mice. Cancer Res. 1977;37(2):629–33.

    CAS  PubMed  Google Scholar 

  186. Lindmark DG, Müller M. Antitrichomonad action, mutagenicity, and reduction of metronidazole and other nitroimidazoles. Antimicrob Agents Chemother. 1976;10(3):476–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  187. Caro‐Patón T, Carvajal A, Martín de Diego I, Martín‐Arias LH, Alvarez Requejo A, Pinilla ER. Is metronidazole teratogenic? A meta‐analysis. Br J Clin Pharmacol. 1997;44(2):179–82.

    Article  PubMed  PubMed Central  Google Scholar 

  188. Czeizel AE, Rockenbauer M. A population based case‐control teratologic study of oral metronidazole treatment during pregnancy. Br J Obstet Gynaecol. 1998;105(3):322–7.

    Article  CAS  PubMed  Google Scholar 

  189. Lamont HF, Blogg HJ, Lamont RF. Safety of antimicrobial treatment during pregnancy: a current review of resistance, immunomodulation and teratogenicity. Expert Opin Drug Saf. 2014;13(12):1569–81.

    Article  CAS  PubMed  Google Scholar 

  190. Rosa FW, Baum C, Shaw M. Pregnancy outcomes after first-trimester vaginitis drug therapy. Obstet Gynecol. 1987;69(5):751–5.

    CAS  PubMed  Google Scholar 

  191. Kigozi GG, Brahmbhatt H, Wabwire-Mangen F, Wawer MJ, Serwadda D, Sewankambo N, et al. Treatment of Trichomonas in pregnancy and adverse outcomes of pregnancy: a subanalysis of a randomized trial in Rakai, Uganda. Obstet Gynecol. 2003;189(5):1398–400.

    Google Scholar 

  192. Klebanoff MA, Carey JC, Hauth JC, Hillier SL, Nugent RP, Thom EA, et al. Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection. N Engl J Med. 2001;345(7):487–93.

    Article  CAS  PubMed  Google Scholar 

  193. Ross SM, van Middelkoop A. Trichomonas infection in pregnancy—does it affect perinatal outcome? S Afr Med J. 1983;63(15):566–7.

    CAS  PubMed  Google Scholar 

  194. Stringer E, Read JS, Hoffman I, Valentine M, Aboud S, Goldenberg RL. Treatment of trichomoniasis in pregnancy in sub-Saharan Africa does not appear to be associated with low birth weight or preterm birth. S Afr Med J. 2010;100(1):58–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  195. Gülmezoglu AM, Azhar M. Interventions for trichomoniasis in pregnancy. Cochrane Database Syst Rev. 2011;5:CD000220.

    Google Scholar 

  196. Klebanoff MA. Counterpoint: screening for trichomoniasis—where’s the evidence of benefit? Clin Chem. 2014;60(1):155–7.

    Article  CAS  PubMed  Google Scholar 

  197. Hoots BE, Peterman TA, Torrone EA, Weinstock H, Meites E, Bolan GA. A Trich-y question: should Trichomonas vaginalis infection be reportable? Sex Transm Dis. 2013;40(2):113–6.

    Article  PubMed  PubMed Central  Google Scholar 

  198. Smith JD, Garber GE. Current status and prospects for development of a vaccine against Trichomonas vaginalis infections. Vaccine. 2014;32(14):1588–94.

    Article  CAS  PubMed  Google Scholar 

  199. McGrory T, Garber GE. Mouse intravaginal infection with Trichomonas vaginalis and role of Lactobacillus acidophilus in sustaining infection. Infect Immun. 1992;60(6):2375–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  200. Campero CM, Hirst R, Ladds P, Vaughan J, Emery D, Watson D. Measurement of antibody in serum and genital fluids of bulls by ELISA after vaccination and challenge with Tritrichomonas foetus. Aust Vet J. 1990;67(5):175–8.

    Article  CAS  PubMed  Google Scholar 

  201. Kvasnicka WG, Hanks D, Huang JC, Hall MR, Sandblom D, Chu HJ, et al. Clinical evaluation of the efficacy of inoculating cattle with a vaccine containing Tritrichomonas foetus. Am J Vet Res. 1992;53(11):2023–7.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Infection Prevention and Control, Public Health Ontario, Ottawa, ON, Canada

    Jeffrey D. Smith M.Sc., Sarah L. Cudmore B.Sc. & Gary E. Garber M.D., F.R.C.P.C., F.A.C.P.

Authors
  1. Jeffrey D. Smith M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah L. Cudmore B.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gary E. Garber M.D., F.R.C.P.C., F.A.C.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gary E. Garber M.D., F.R.C.P.C., F.A.C.P. .

Editor information

Editors and Affiliations

  1. Treiber Therapeutics, Cambridge, Massachusetts, USA

    Douglas L. Mayers

  2. Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA

    Jack D. Sobel

  3. Canada Research Chair in Antimicrobial Resistance, Centre de recherche en Infectiologie, University of Laval, Quebec City, Canada

    Marc Ouellette

  4. Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Keith S. Kaye

  5. Infection Control and Prevention Unit of Infectious Diseases, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Dror Marchaim

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Smith, J.D., Cudmore, S.L., Garber, G.E. (2017). Diagnosis and Treatment of Metronidazole-Resistant Trichomonas vaginalis Infection. In: Mayers, D., Sobel, J., Ouellette, M., Kaye, K., Marchaim, D. (eds) Antimicrobial Drug Resistance. Springer, Cham. https://doi.org/10.1007/978-3-319-47266-9_28

Download citation

Publish with us

Policies and ethics

Search

Navigation