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The genetic diversity of metronidazole susceptibility in Trichomonas vaginalis clinical isolates in an Egyptian population

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Abstract

Trichomoniasis is the most common curable sexually transmitted disease worldwide. Resistance to metronidazole in treating trichomoniasis is a problematic health issue. We aimed to determine the minimum lethal concentration (MLC) of metronidazole for Trichomonas vaginalis isolates detected in Mansoura, Egypt and studied the genotypic profile of these isolates. Vaginal swab specimens were obtained from 320 symptomatic and 100 asymptomatic females, for whom clinical examination, vaginal discharge wet mount, Giemsa stain, and culture in modified Diamond’s media were performed. Metronidazole susceptibility testing by an aerobic tube assay was performed. Both sensitive and resistant isolates were examined by PCR amplification followed by restriction fragment length polymorphism (RFLP). Trichomonas vaginalis was identified in 49/420 (11.7%) using either culture or PCR, while wet mount and Giemsa stain detected the parasite in 8.1 and 7.6% of participants, respectively. After 48 h incubation, most isolates were sensitive to metronidazole with a minimal lethal concentration (MLC) of 1 μg/ml. Mild resistance was observed in two isolates with MLCs of 64 μg\ml and mild to moderate resistance was observed in an additional two isolates with MLCs of 128 μg/ml. The four isolates that demonstrated low to moderate metronidazole resistance displayed a unique genotype band pattern by RFLP compared to the other 45 samples that were metronidazole sensitive. Our results highlight the presence of in vitro metronidazole tolerance in a few T. vaginalis isolates in Mansoura, Egypt that may lead to the development of drug resistance as well as the possibility of an identifying RFLP pattern in the isolates.

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Authors and Affiliations

  1. Department of Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Aida A. Abdel-Magied, El-Said I. El-Kholya, Marwa M. Hamoudaa & Nora Labeeb El-Tantawy

  2. Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Salwa M. Abou El-Khair

  3. Department of Microbiology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt

    Eman S. Abdelmegeed

  4. Department of Gynecology and Obstetrics, Mansoura University, Mansoura, Egypt

    Sara A. Mohamed

Authors
  1. Aida A. Abdel-Magied
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  2. El-Said I. El-Kholya
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  3. Salwa M. Abou El-Khair
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  4. Eman S. Abdelmegeed
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  5. Marwa M. Hamoudaa
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  6. Sara A. Mohamed
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  7. Nora Labeeb El-Tantawy
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Corresponding author

Correspondence to Nora Labeeb El-Tantawy.

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Ethical approval

This study was approved by the Institutional Review Board of the Faculty of Medicine, Mansoura University, Egypt (IRB reference no: 16.06.83).

Statement of informed consent

Prior to enrollment, informed consent was gained from each participant. Women with confirmed trichomoniasis were treated and followed up.

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Abdel-Magied, A.A., El-Kholya, ES.I., Abou El-Khair, S.M. et al. The genetic diversity of metronidazole susceptibility in Trichomonas vaginalis clinical isolates in an Egyptian population. Parasitol Res 116, 3125–3130 (2017). https://doi.org/10.1007/s00436-017-5627-3

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  • DOI: https://doi.org/10.1007/s00436-017-5627-3

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