Susceptibility of clinical isolates of Trichomonas vaginalis to metronidazole and secnidazole--an in vitro study [PublishAheadOfPrint]

Nitroimidazoles (metronidazole [MTZ] and tinidazole [TNZ]) are the only drugs recommended for treating Trichomonas vaginalis (TV) infection. MTZ resistance occurs in 4%–10% of cases of vaginal trichomoniasis (1, 2), and TNZ resistance in 1% of patients (2). Emerging nitroimidazole-resistant trichomoniasis is concerning because few alternatives to standard therapy exist. We assessed the prevalence of in vitro aerobic MTZ and secnidazole resistance among TV isolates from 100 women in Birmingham, AL with positive cultures during the period 2015-2016.. Archived specimens were treated with secnidazole or MTZ (0.2–400 μg/mL) for 48 hours, as per the United States Centers for Disease Control and Prevention protocols. Ninety-six of the 100 clinical trichomonas isolates tested (96%) demonstrated a lower minimal lethal concentration for secnidazole than for MTZ, suggesting that secnidazole has better in vitro activity than MTZ.

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