Abstract
Trichomoniasis is the most prevalent curable sexually transmitted infection (STI) worldwide and a risk factor for the acquisition of other STIs and adverse pregnancy outcomes. The objectives of this study were to determine the prevalence of T. vaginalis and related coinfections in women attending a third-level hospital of Madrid (Spain). A retrospective study of 24,173 vaginal exudates from women with suspected vaginitis was conducted between 2013 and 2017. Likewise, among T. vaginalis positive samples, co-occurrence with gonorrhea, chlamydia, syphilis, VIH, Mycoplasma hominis, and Ureaplasma urealyticum was checked. Moreover, seven T. vaginalis isolates from 2017 were randomly collected for endobionts, drug resistance, and microsatellite (MS) instability determinations. The prevalence of T. vaginalis was 0.8% between 2013 and 2017. Less than 20% of patients with trichomoniasis were submitted to a complete screening for other genital pathogens. From that, two patients were coinfected with chlamydia and three with syphilis. Surprisingly, 6.4% of positive samples were diagnosed among pregnant women, showing an alarming increase from 3.2% (2014) to 10% (2017). Among the isolates randomly analyzed, five carried T. vaginalis virus, five harbored mycoplasmas, and one was metronidazole-resistant. The molecular genotyping showed a high variability in the three MS evaluated. To our knowledge, this is the first study in Spain that evaluates the prevalence of trichomoniasis in general and pregnant population and includes biomolecular determinations. These results warn about the increasing prevalence and highlight the importance of including T. vaginalis detection in routine gynecological revisions with special emphasis on childbearing age women and patients with previous STIs.
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Acknowledgments
The authors gratefully acknowledge to Professor J.F. Alderete for gently providing the monoclonal Antibody C20A3 for TVV determinations and to all the staff of the Hospital Microbiology Service that collaborated with the sample collecting. The biomolecular characterization was possible thanks to the support of the UCM Research Group “Anti-parasitic Epidemiology, Diagnostics and Therapy” (Ref. 911120 UCM).
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The study protocol was carried out according to the Declaration of Helsinki. The hospital’s ethics committee “Comité Ético de Investigación con Medicamentos del Hospital Universitario Puerta de Hierro Majadahonda-Madrid (CEIm)” granted permission (Acta n° 21.17) to access to medical records and use them for this study.
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Bolumburu, C., Zamora, V., Muñoz-Algarra, M. et al. Trichomoniasis in a tertiary hospital of Madrid, Spain (2013–2017): prevalence and pregnancy rate, coinfections, metronidazole resistance, and endosymbiosis. Parasitol Res 119, 1915–1923 (2020). https://doi.org/10.1007/s00436-020-06688-2
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DOI: https://doi.org/10.1007/s00436-020-06688-2