Abstract
Trichomonas vaginalis is the leading causative agent of non-viral, sexually transmitted infections worldwide. Infection with T. vaginalis is a marker of high-risk sexual behavior as it is frequently seen concomitantly with other STIs. The natural immune response to T. vaginalis infection increases both transmission of and susceptibility to HIV. While often asymptomatic, especially in men, manifestations of infection vary from a characteristic fishy-smelling discharge with pruritus to atypical pelvic inflammatory disease with the potential for pregnancy complications. Given the widespread prevalence of this infection and potential for significant complications; efforts need to be directed toward increased awareness, prevention, diagnosis and treatment. The most common diagnostic test, is a “wet mount”, which consists of simple microscopic examination of vaginal fluid in a saline preparation for organisms with characteristic quivering trichomonad motility. A focus on details of the interrelationship amongst causative agents of sexually transmitted infections has established that Mycoplasma hominis can combine forces with T. vaginalis in a symbiotic co-infection.
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References
Alderete, J., Demes, P., Gombosova, A., et al.: Specific parasitism of purified vaginal epithelial cells by Trichomonas vaginalis. Infect. Immun. 56(10), 2558–2562 (1988)
Alderete, J., Nguyen, J., Mundodi, V., et al.: Heme-iron increases levels of AP65-mediated adherence by Trichomonas vaginalis. Microb. Pathog. 36(5), 263–271 (2003)
Arroyo, R., Martinez-Palomo, A., Gonzales-Robles, A., et al.: Signalling of Trichomonas vaginalis for amoeboid transformation and adhesion synthesis follows cytoadherence. Mol. Microbiol. 7, 299–309 (1993)
Cates, W., and The American Social Health Association Panel: Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. Sex Transm. Dis. 26, 52–57 (1999)
Caliendo, A.M., Jordan, J.A., Green, A.M., et al.: Real-time PCR improves detection of Trichomonas vaginalis infection compared with using culture self-collected vaginal swabs. Infect. Dis. Obstet. Gynecol. 13, 145–150 (2005)
Cotch, M.F., Pastorek, J.G., Nugent, R.P., et al.: Trichomonas vaginalis associated with low birth weight and preterm delivery. Sex. Transm. Dis. 24, 361–362 (1997)
Cudmore, S., Delgaty, K., Hayward, S., et al.: Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin. Microbiol. Rev. 17(4), 783–793 (2004)
Dessi, D., Delogu, G., Emonte, E., et al.: Long-term survival and intracellular replication of Mycoplasma hominis in Trichomonas vaginalis cells: potential role of the protozoan in transmitting bacterial infection. Infect. Immun. 73(2), 1180–1186 (2004)
Fichorova, R., Trifonova, R., Gilbert, R., et al.: Trichomonas vaginalis lipophosphoglycan triggers a selective upregulation of cytokines by human female reproductive tract epithelial cells. Infect. Immun. 74(10), 5773–5779 (2006)
Fiori, P., Rappelli, M.F., Addis, M.F.: The flagellated parasite Trichomonas vaginalis: new insights into cytopathogenicity mechanisms. Microb. Pathog. 1, 149–156 (1999)
Fouts, A.C., Kraus, S.J.: Trichomonas vaginalis: re-evaluation of its clinical presentation and laboratory diagnosis. J. Infect. Dis. 141, 137–143 (1980)
Garcia, A., Chang, T., Benchimol, M., et al.: Iron and contact with host cells induce expression of adhesions on surface of Trichomonas vaginalis. Mol. Microbiol. 47(5), 1207–1224 (2003)
Gerbase, A.C., Rowley, J.T., Mertens, T.E.: Global epidemiology of sexually transmitted diseases. Lancet 351, 2–4 (1998)
Gram, I.T., Macaluso, M., Churchill, J., et al.: Trichomonas vaginalis (TV) and human papillomavirus (HPV) infection and the incidence of cervical intraepithelial neoplasia (CIN) grade III. Cancer Causes Control 3, 231–236 (1992)
Grodstein, F., Goldman, M.B., Cramer, D.W.: Relation of tubal infertility to a history of sexually transmitted diseases. Am. J. Epidemiol. 137, 577–584 (1993)
Guenthner, P., Secor, D., Dezzutti, C.: Trichomonas vaginalis-induced epithelial monolayer disruption and human immunodeficiency virus type 1 (HIV-1) replication: implications for the sexual transmission of HIV-1. Infect. Immun. 73(7), 4155–4160 (2005)
Hardy, P., Hardy, J., Nell, E., et al.: Prevalence of six sexually transmitted disease agents among pregnant inner-city adolescents and pregnancy outcome. Lancet ii, 333–337 (1984)
Heine, P., McGregor, J.A.: Trichomonas vaginalis: a reemerging pathogen. Clin. Obstet. Gynecol. 36, 137–144 (1993)
Hobbs, M., Kazembe, P., Reed, A., et al.: Trichomonas vaginalis as a cause of urethritis in Malawian men. Sex. Transm. Dis. 26, 381–387 (1999)
Jesus, J., Vannier-Santos, M., Britto, C., et al.: Trichomonas vaginalis virulence against epithelial cells and morphological variability: the comparison between a well-established strain and a fresh isolate. Parasitol. Res. 93(5), 369–377 (2004)
Kigozi, G., Brahmbhatt, H., Wabwire-Mangen, F., et al.: Treatment of Trichomonas in pregnancy and adverse outcomes of pregnancy: a subanalysis of a randomized trial in Rakai, Uganda. Am. J. Obstet. Gynecol. 189, 1398–1400 (2003)
Klebanoff, M., Carey, J., Hauth, J., et al.: Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection. N Engl J. Med. 345, 487–493 (2001)
Koumans, E.H., Sternberg, M., Bruce, C., et al.: The prevalence of bacterial vaginosis in the United States, 2001–2004; associations with symptoms, sexual behaviors, and reproductive health. Sex. Transm. Dis. 34(11), 864–869 (2007)
Kucknoor, A., Mundodi, V., Alderete, J.: The proteins secreted by Trichomonas vaginalis and vaginal epithelial cell response to secreted and episomally expressed AP65. J. Cell. Microbiol. 9(11), 2586–2597 (2007)
Laga, M., Manoka, A., Kivuvu, M., et al.: Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS 7, 95–102 (1993)
Leroy, V., De Clercq, A., Ladner, J., et al.: Should screening of genital infections be part of antenatal care in areas of high HIV prevalence? A prospective cohort study from Kigali, Rwanda, 1992–1993. Genitourin. Med. 71, 207–211 (1995)
Levi, M.H., Torres, J., Pina, C., et al.: Comparison of the InPouch TV culture system and Diamond’s modified medium for detection of Trichomonas vaginalis. J. Clin. Microbiol. 35, 3308–3310 (1997)
Madico, G., Quinn, T.C., Rompalo, K.T., et al.: Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. J. Clin. Microbiol. 36, 3205–3210 (1998)
McClelland, R., Sangare, L., Hassan, W., et al.: Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. J. Infect. Dis. 195, 698–702 (2007)
Minkoff, H., Grunebaum, A.N., Schwarz, A.H., et al.: Risk factors for prematurity and premature rupture of membranes: a prospectivestudy of the vaginal flora in pregnancy. Am. J. Obstet. Gynecol. 150, 965–972 (1984)
Mundodi, V., Kucknoor, A., Alderete, J.: Antisense RNA decreases AP33 gene expression and cytoadherence by T. vaginalis. BMC Microbiol. 7, 647 (2007)
Nanda, N., Michel, R.G., Kurdgelashvili, G., et al.: Trichomoniasis and its treatment. Expert Rev. Anti Infect. Ther. 4(1), 125–135 (2006)
Patel, S.R., Wiese, W., Patel, S.C., et al.: Systematic review of diagnostic tests for vaginal trichomoniasis. Infect. Dis. Obstet. Gynecol. 8, 248–257 (2000)
Petrin, D., Delgaty, K., Bhatt, R., et al.: Clinical and microbiological aspects of Trichomonas vaginalis. Clin. Microbiol. Rev. 2, 300–317 (1998)
Price, M., Zimba, D., Hoffman, I.F., et al.: Addition of treatment for trichomoniasis to syndromic management of urethritis in Malawi: a randomized clinical trial. Sex. Transm. Dis. 30, 516–522 (2003)
Provenazo, D., Alderete, J.: Analysis of human immunoglobulin-degrading cysteine proteinases of Trichomonas vaginalis. Infect. Immun. 69(9), 3388–3395 (1995)
Rein, M.F., Muller, M.: Trichomonas vaginalis and trichomoniasis. In Holmes K.K. (ed.), Sexually Transmitted Diseases. New York: McGraw Hill; pp.481–492 (1990)
Ryu, J., Chung, H., Min, Y., et al.: Diagnosis of trichomoniasis by polymerase chain reaction. Yonsei Med. J. 40, 56–60 (1999)
Sanderson, B., White, E., Baldson, M.: Amine content of vaginal fluid from patients with trichomoniasis and gardnerella associated non-specific vaginitis. J.Vener. Dis. 59, 302–305 (1983)
Saurina, G.R., McCormack, W.M.: Trichomoniasis in pregnancy. Sex. Transm. Dis. 24, 361–362 (1997)
Schwebke, J., Burgess, D.: Trichomoniasis. Clin. Microbiol. Rev. 17(4), 794–803 (2004)
Sena, A., Miller, W., Hobbs, M., et al.: Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clin. Infect. Dis. 44, 13–22 (2007)
Shaio, M., Lin, P., Liu, J., et al.: Generation of interleukin-8 from human monocytes in response to Trichomonas vaginalis stimulation. Infect. Immun. 63(10), 3864–3870 (1995)
Solano-Gonzalez, E., Burrola-Barraza, E., Leon-Sicairos, C., et al.: The trichomonad cysteine proteinase TVCP4 transcript contains an iron-reponsive element. J. FEBS Lett. 561(16), 2919–2928 (2007)
Sutcliffe, S., Giovannucci, E., Alderete, J., et al.: Plasma antibodies against Trichomonas vaginalis and subsequent risk of prostate cancer. Cancer Epidemiol. Biomark. Prev. 15, 939–945 (2006)
Torok, M., Miller, W., Hobbs, M., et al.: The association between Trichomonas vaginalis infection and level of vaginal lactobacilli in non-pregnant women. J. Infect. Dis. 196, 1102–1107 (2007)
Upcroft, P., Upcroft, J.A.: Drug targets and mechanisms of resistance in the anaerobic protozoa. Clin. Microbiol. Rev. 14(1), 150–164 (2001)
Vancini, R., Bechimol, M.: Entry and intracellular location of Mycoplasma hominis in Trichomonas vaginalis. Arch. Microbiol. 189(1), 7–18 (2008)
Van der Pol, B., Williams, J., Orr, D., et al.: Prevalence, incidence, natural history and response to treatment of Trichomonas vaginalis infection among adolescent women. J. Infect. Dis. 192, 2039–2044 (2005)
Van der Shee, C., Sluiters, H., Van der Maijden, W.I., et al.: Host and pathogen interaction during vaginal infection by Trichomonas vaginalis and Mycoplasma hominis or Ureaplasma urealyticum. J. Microbiol. Methods 45(1), 61–67 (2001)
Viikki, M., Pukkala, E., Nieminen, P., et al.: Gynaecological infections as risk determinants of subsequent cervical neoplasia. Acta Oncol. 39, 71–75 (2000)
World Health Organization (WHO). Global prevalence and incidence of selected curable sexually transmitted diseases: overview and estimates. WHO, Geneva (1999)
Wiese, W.J., Patel, S.R., Patel, S.C., et al.: A meta-analysis of the Papanicolaou smear and wet mount for the diagnosis of vaginal trichomoniasis. Am. J. Med. 108, 301–308 (2000)
Zhang, Z.F., Begg, C.B.: Is Trichomonas vaginalis a cause of cervical neoplasia? Results from a combined analysis of 24 studies. Int. J. Epidemiol. 23, 682–690 (1994)
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Pellicane, B.L., Moody, M.N. (2011). Trichomonas. In: Gross, G., Tyring, S. (eds) Sexually Transmitted Infections and Sexually Transmitted Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-14663-3_45
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