Metronidazole resistance in Trichomonas vaginalis from highland women in Papua New Guinea
Jacqueline A. Upcroft A B F , Linda A. Dunn A B , Tilda Wal C , Sepehr Tabrizi D , Maria G. Delgadillo-Correa E , Patricia J. Johnson E , Suzanne Garland D , Peter Siba C and Peter Upcroft A BA Queensland Institute of Medical Research, The Bancroft Centre, 300 Herston Road, Brisbane, Qld 4006, Australia.
B Australian Centre for International and Tropical Health, The University of Queensland, Brisbane, Qld 4029, Australia.
C Papua New Guinea Institute of Medical Research, PO Box 60, Goroka, EHP 441, Papua New Guinea.
D The Royal Women’s Hospital, Department of Microbiology, 132 Grattan Street, Carlton, Melbourne, Vic. 3053, Australia.
E Department of Microbiology, Immunology and Molecular Genetics, University of California Los Angeles School of Medicine, 1602 Molecular Sciences Building, 405 Hilgard Avenue, Los Angeles, CA 90095-1489, USA.
F Corresponding author. Email: Jacqui.Upcroft@qimr.edu.au
Sexual Health 6(4) 334-338 https://doi.org/10.1071/SH09011
Submitted: 3 February 2009 Accepted: 21 May 2009 Published: 13 November 2009
Abstract
Background: The prevalence of the sexually transmissible protozoan parasite Trichomonas vaginalis in the highlands of Papua New Guinea (PNG) has been reported to be as high as 46% and although not previously studied in Papua New Guinea, clinical resistance against metronidazole (Mz), the drug most commonly used to treat trichomoniasis, is well documented worldwide. This study was primarily aimed at assessing resistance to Mz in T. vaginalis strains from the Goroka region. Methods: Consenting patients presenting at the Goroka Base Hospital Sexually Transmitted Diseases (STD) Clinic and local women were asked to provide two vaginal swabs: one for culturing of the parasite; and one for polymerase chain reaction detection of T. vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. T. vaginalis isolates were assayed for Mz susceptibility and a selection was genotyped. Results: The prevalence of T. vaginalis was determined to be 32.9% by culture and polymerase chain reaction of swabs among 82 local women and patients from the STD clinic. An unexpectedly high level of in vitro Mz resistance was determined with 17.4% of isolates displaying unexpectedly high resistance to Mz. The ability to identify isolates of T. vaginalis by genotyping was confirmed and the results revealed a more homogeneous T. vaginalis population in Papua New Guinea compared with isolates from elsewhere. Conclusion: T. vaginalis is highly prevalent in the Goroka region and in vitro Mz resistance data suggest that clinical resistance may become an issue.
Additional keywords: Chlamydia trachomatis, genotyping, Neisseria gonorrhoeae, polymerase chain reaction, vaginal swab.
Acknowledgements
We thank all those involved in the collection of isolates used in this study especially Hannah Nivea of the PNGIMR, and all those from the Goroka Base Hospital. We acknowledge Lynette Corbeil of University of California, San Diego for kindly allowing us to use T. vaginalis isolates from her collection in this study. This work was made possible through the contribution and enthusiasm of the PNGIMR. It was supported by a Winston Churchill Memorial Trust Travel Fellowship to J.A.U. and by the Australian Centre for International and Tropical Health and Nutrition. The work carried out in this study was approved by the Medical Research Advisory Committee of Papua New Guinea. We acknowledge support by an NIH U01 Cooperative Research Agreement AI75527.
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