A Review of Evidence-Based Care of Symptomatic Trichomoniasis and Asymptomatic Trichomonas vaginalis Infections.

Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million women and men in the United States. Health disparities are prominent in the epidemiology of this infection, which affects 11% of women aged ≥40 years and a disproportionately high percentage of black women. Particularly high prevalences have been identified among sexually transmitted disease (STD) clinic patients and incarcerated individuals. This article reviews and updates scientific evidence in key topic areas used for the development of the 2015 STD Treatment Guidelines published by the Centers for Disease Control and Prevention. Current evidence is presented regarding conditions associated with Trichomonas vaginalis infection, including human immunodeficiency virus (HIV) and pregnancy complications such as preterm birth. Nucleic acid amplification tests and point-of-care tests are newly available diagnostic methods that can be conducted on a variety of specimens, potentially allowing highly sensitive testing and screening of both women and men at risk for infection. Usually, trichomoniasis can be cured with single-dose therapy of an appropriate nitroimidazole antibiotic, but women who are also infected with HIV should receive therapy for 7 days. Antimicrobial resistance is an emerging concern.

Atividade citotóxica do extrato de Vitis labrusca em culturas de Trichomonas vaginalis / Cytotoxic activity of Vitis labrusca extract in cultures of Trichomonas vaginalis

Objetivos: Avaliar a atividade anti-Trichomonas vaginalis do extrato de folhas de videira (Vitis labrusca) provenientes de cultivo convencional e orgânico.Métodos: Extratos de folhas secas de videira, orgânico e convencional, foram elaborados com extrator Sohxlet. A composição fenólica total dos extratos foi avaliada por Folin-Cicoalteau e Cromatografia Líquida de Alta Eficiência. A atividade antiparasitária dos extratos foi realizada em cultura de T. vaginalis. Os testes foram realizados em três concentrações finais: 5, 10 e 20 mg/mL. Os trofozoítos foram contados em hemocitômetro e sua densidade foi ajustada em meio de cultura Trypticase-Yeast Extract-Maltose (TYM), de forma a se obter a concentração final de 1×105 trofozoítos/mL. Após incubação com os extratos por 24 horas a 37°C, foi feita a contagem dos trofozoítos com motilidade em hemocitômetro. Os controles do veículo foram realizados, adicionando-se água em substituição aos extratos.Resultados: O extrato de folhas convencionais é rico em catequina e os orgânicos, em resveratrol. Os extratos de V. labrusca não apresentaram atividade anti-T. vaginalis nas concentrações de 5 e 10 mg/mL. Entretanto na concentração de 20 mg/L, o extrato de folhas secas convencionais reduziu em 100% e o extrato orgânico em 48% a sobrevivência dos trofozoítos. Os polifenóis catequina, quercetina e rutina estavam em maior concentração no extrato com maior eficácia, os quais podem ser os responsáveis pela ação anti-T. vaginalis do extrato convencional.Conclusões: O extrato de folha de videira pode ser uma alternativa no combate a T. vaginalis. Estudos pré-clínicos e clínicos são necessários para comprovar eficácia e segurança desta intervenção...

AIMS: To evaluate the anti-Trichomonas vaginalis activity of the extract of organic and conventional leaves of Vitis labrusca.METHODS: Organic and conventional grapevine leaf extracts were prepared with extractor Sohxlet. The total phenolic extracts were evaluated by Folin-Cicoalteau and High-Performace Liquid Chromatography. The antiparasitic activity of the extracts was performed on growth of T. vaginalis. Tests were conducted at three final concentrations of 5, 10 and 20 mg/mL. The trophozoites were counted by hemocytometer and their density was adjusted in Trypticase-Yeast Extract-Maltose (TYM) growth environment in order to obtain a final concentration of 1x105 trophozoites/ml. After incubated with the extracts for 24 hours at 37 �C, the count of motile trophozoites was taken by hemocytometer. The vehicle controls were performed by substituting the extract by water.RESULTS: The conventional leaf extract is rich in catechin and the organic in resveratrol. The extracts of V. labrusca showed no anti-T.vaginalis activity at concentrations of 5 and 10 mg/mL. However in the concentration of 20 mg/L conventional grapevine leaf extracts reduced by 100% and the organic extract by 48% the survival of trophozoites. Catechin polyphenols, quercetin and rutin were in higher concentration in the extract with greater efficacy, which may be the responsible for the anti-T. vaginalis action of the conventional extract.CONCLUSIONS: The vine leaf extract may be an alternative to combat T. vaginalis. Pre-clinical and clinical studies are needed to confirm efficacy and safety of this intervention...

Validation of a modified fluorimetric assay for the screening of trichomonacidal drugs

A fluorimetric microassay that uses a redox dye to determine the viability of the flagellate Trichomonas vaginalis has been optimised to provide a more sensitive method to evaluate potential trichomonacidal compounds. Resazurin has been used in recent years to test drugs against different parasites, including trichomonadid protozoa; however, the reproducibility of these resazurin-based methods in our laboratory has been limited because the flagellate culture medium spontaneously reduces the resazurin. The objective of this work was to refine the fluorimetric microassay method previously developed by other research groups to reduce the fluorescence background generated by the media and increase the sensitivity of the screening assay. The experimental conditions, time of incubation, resazurin concentration and media used in the microtitre plates were adjusted. Different drug sensitivity studies against T. vaginalis were developed using the 5-nitroimidazole reference drugs, new 5-nitroindazolinones and 5-nitroindazole synthetic derivatives. Haemocytometer count results were compared with the resazurin assay using a 10% solution of 3 mM resazurin dissolved in phosphate buffered saline with glucose (1 mg/mL). The fluorimetric assay and the haemocytometer counts resulted in similar percentages of trichomonacidal activity in all the experiments, demonstrating that the fluorimetric microtitre assay has the necessary accuracy for high-throughput screening of new drugs against T. vaginalis.