Resistance to metronidazole in clinical isolates of Trichomonas vaginalis
DOI:
https://doi.org/10.5902/2236583485538Keywords:
Trichomonas vaginalis, Metronidazole, Drug resistanceAbstract
Trichomoniasis is the most common non-viral Sexually Transmitted Infection (STI) in the world. It is caused by the protozoan, Trichomonas vaginalis and the drug for treatment is metronidazole (MTZ), however, cases of refractory infections are still a challenge for infection control. Despite being a curable infection and its frequency reaching high levels in some regions of the world, this STI has not gained the necessary attention from health authorities. Considering its importance for public health and the need to control resistance to antiparasitic agents, this study proposes to review the literature on the frequency of refractory cases and methodologies for detecting resistance of T. vaginalis to MTZ. The search was performed in three databases using the following descriptors: "Trichomonas vaginalis" AND "resistance" and "trichomoniasis" AND “resistance”. The search resulted in 6,166 texts, after applying the inclusion and exclusion criteria, a total of 20 scientific articles were selected. Most studies showed a percentage of resistance of T. vaginalis to MTZ lower than 11.7% and 30% of the studies showed resistance among 30% and 92%. Many cases refractory to MTZ treatment have been reported in clinical practice. The most frequently used methodology for evaluating the resistance of T. vaginalis to MTZ was the culture of the parasite followed by the determination of the minimum inhibitory or lethal concentration (MIC or MLC). The importance of repeating diagnostic laboratory tests in cases without cessation of clinical signs and symptoms and of carrying out specific tests to identify resistant strains in clinical samples is highlighted. Trichomoniasis is a neglected disease, mainly in developing countries, making its frequency and resistance to antiparasitics underestimated.
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