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      Genotyping, Drug Susceptibility and Prevalence Survey of Trichomonas vaginalis among Women Attending Gynecology Clinics in Hamadan, Western Iran, in 2014–2015

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          Abstract

          Background:

          In spite of sufficient knowledge about phenotypic variation of Trichomonas vaginalis, its genetic characteristics are poorly understood. We carried out a molecular epidemiology study in which in vitro metronidazole susceptibility of T. vaginalis isolates was considered.

          Methods:

          This study was conducted on 862 women admitted to Gynecology Clinics in Hamadan, west of Iran, during 2014–2015. After recording the socio-demographic and clinical characteristics of participants, vaginal swab samples were taken and subjected to microscopic examination, culture, in vitro sensitivity testing and PCR-restriction fragment length polymorphism (RFLP) analysis.

          Results:

          T. vaginalis was detected in 1.9% (16/862) of the samples using two parasitological methods. The all T. vaginalis isolates that subjected to drug susceptibility analysis were sensitive to metronidazole with MICs ranged from 0.4 to 12.8 μg/ml. T. vaginalis genotyping by using actin gene and PCR-RFLP analysis identified three actin type; A (9, 56%), I (6, 38%) and E (1, 6%). No significant correlation was observed between actin genotypes and their clinical manifestation ( P>0.05).

          Conclusion:

          The prevalence of T. vaginalis infection is not noticeable in the region and the most of isolates are hypersensitive to metronidazole. Further studies are needed to clarify the efficiency of the actin gene, as a reliable genetic marker, for molecular epidemiology of trichomoniasis.

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          Most cited references25

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          Clinical and microbiological aspects of Trichomonas vaginalis.

          Trichomonas vaginalis, a parasitic protozoan, is the etiologic agent of trichomoniasis, a sexually transmitted disease (STD) of worldwide importance. Trichomoniasis is the most common nonviral STD, and it is associated with many perinatal complications, male and female genitourinary tract infections, and an increased incidence of HIV transmission. Diagnosis is difficult, since the symptoms of trichomoniasis mimic those of other STDs and detection methods lack precision. Although current treatment protocols involving nitroimidazoles are curative, metronidazole resistance is on the rise, outlining the need for research into alternative antibiotics. Vaccine development has been limited by a lack of understanding of the role of the host immune response to T. vaginalis infection. The lack of a good animal model has made it difficult to conduct standardized studies in drug and vaccine development and pathogenesis. Current work on pathogenesis has focused on the host-parasite relationship, in particular the initial events required to establish infection. These studies have illustrated that the pathogenesis of T. vaginalis is indeed very complex and involves adhesion, hemolysis, and soluble factors such as cysteine proteinases and cell-detaching factor. T. vaginalis interaction with the members of the resident vaginal flora, an advanced immune evasion strategy, and certain stress responses enable the organism to survive in its changing environment. Clearly, further research and collaboration will help elucidate these pathogenic mechanisms, and with better knowledge will come improved disease control.
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            Prevalence of Trichomonas vaginalis isolates with resistance to metronidazole and tinidazole.

            Clinical isolates of Trichomonas vaginalis were obtained from women consecutively enrolled in a study of partner notification. Testing of susceptibility to metronidazole and tinidazole was performed. Resistance to metronidazole and tinidazole was present in 17/178 (9.6%) and 1/178 (0.56%) strains, respectively. In vitro resistance was poorly correlated with clinical response to treatment.
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              Centers for Disease Control and Prevention Sexually Transmitted Disease Treatment Guidelines.

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                Author and article information

                Journal
                Iran J Parasitol
                Iran J Parasitol
                IJPA
                IJPA
                Iranian Journal of Parasitology
                Tehran University of Medical Sciences
                1735-7020
                2008-238X
                Jan-Mar 2017
                : 12
                : 1
                : 29-37
                Affiliations
                [1. ] Dept. of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
                [2. ] Dept. of Molecular Medicine and Genetics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
                Author notes
                [* ] Correspondence Email: a.h.maghsood@ 123456umsha.ac.ir
                Article
                ijpa-12-29
                5522696
                50d6b6e5-6507-4ba7-b43e-5d1912ba28b3
                Copyright© Iranian Society of Parasitology & Tehran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 February 2016
                : 25 September 2016
                Categories
                Original Article

                Parasitology
                genotype,parasite,prevalence,trichomonas vaginalis,iran
                Parasitology
                genotype, parasite, prevalence, trichomonas vaginalis, iran

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