Abstract
AbstractBackgroundTrichomonas vaginalisis 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.MethodsPubMed, ScienceDirect and EMBASE databases were searched using keywordsTrichomonas vaginalis, trichomoniasis, 5-nitroimidazole, metronidazole, tinidazole and drug resistance. Non-English language articles and articles on other treatments were excluded.ResultsThe search yielded 606 articles, of which 550 were excluded, leaving 58 articles.Trichomonas vaginalisresistance 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 vaginalisinfection withMycoplasma hominisorT. vaginalisvirus has also been associated with resistance.Trichomonas vaginalishas two genotypes, with greater resistance seen in type 2 (vstype 1) populations.Discussion5-Nitroimidazole resistance results from differential expression of enzymes involved in energy production or antioxidant defenses, along with genetic mutations in theT. vaginalisgenome. Alternative treatments outside of the 5-nitroimidazole class are needed.
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Animal Science and Zoology,Parasitology
Reference97 articles.
1. The activity of 1-(2-hydroxyethyl)-2-methyl-5-nitroimidazole (R. P. 8823) against experimental Trichomonas vaginalis infections;Cosar;Annales de l'Institut Pasteur,1959
2. Flagyl (metronidazole);Durel;British Journal of Venereal Diseases,1960
3. A randomized trial comparing mebendazole and secnidazole for the treatment of giardiasis
4. Nitroimidazoles in the treatment of trichomoniasis, giardiasis, and amebiasis;Rossignol;International Journal of Clinical Pharmacology, Therapy, and Toxicology,1984
5. Trichomoniasis: clinical manifestations, diagnosis and management
Cited by
29 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献