|
 |
 Home > Available Issues |
|
|
 Original Articles |
| Exploitation of Effective Drugs to Vaginal Trichomoniasis |
| Nam Woong Yang, Seok Jin Chung, Yong Lim |
| Department of Microbiology, Chosun University College of Medicine, Kwang ju, Korea |
Vol.28 Num.4 (p329~341)
|
|
|
Background :Vaginal trichomoniasis is the most prevalent sexually transmitted disease in the world. According to reports, annually 150,000,000 persons have been infected in the whole world. Vaginal trichomoniasis is known to be one of predisposing factors causing low birth weight infant, preterm labor, premature rupture of membranes and bacterial vaginosis. Recently, appearance of resistant strains to 5-nitroimidazoles has been reported frequently by foreign researchers. But in Korea, there are few researchers having interest to Trichomonas vaginalis, and only papers under 10 were reported during 10 years past. We exploited drugs, disinfectants and drug combination usable alternatively to 5-nitroimidazole resistant strains. We also studied effects of several physical conditions to viability and motility of T. vaginalis.
Methods : Metronidazole resistant CHO-3 wild strain isolated in local clinic was used for measurement of minimal lethal concentration(MLC) and combined drug effect were tested by microcentriuge tube dilution method under anaerobic conditions. Motility and viability of T. vaginalis were tested by Neubauer's haemocytometer and slide glass with cover glass on the compound microscope.
Results : MLC of metronidazole to T. vaginalis (CHO-3) was 8μg/mL which has higher than resistant MLC threshold of 3.1μg/mL and 2μg/mL in case of tinidazole. MLCs of gentian violet, doxycycline and quinacrine 2HCl were 62.5, 125, 125μg/mL, respectively. It suggests that these drugs are useful as alternative suppositaries for metronidazole resistant T. vaginalis. MLC of povidone-iodine used as vaginal cleansing agent was 500μg/mL higher than 300μg/mL, the dose recommended by a pharmaceutical company, while the disinfectant, benazalkonium chloride, had strong antitrichomonal effect with the ability to kill all protozoae within 10 minutes in 512x diluent less. MLC of benzalkonium chloride was 1024x diluent equivalent to 1/5 of 200x diluent which is an usual dose in Department of Gynecology. Zine has an antitrichomonal effect, and physiological concentrations of zinc in the prostatic secretions of normal men rante from 4.5 to 7mM with mean value. MLC of zinc to T. vaginalis(CHO-3) was 2.19mM below mean values. In the experiment of combined drug effect by checkerboard tube dilution method, zinc and gentian violet combination showed synergistic effect with FICI(fractional inhibitory concentration index) 0.4 and quinacrine 2HCl and gentian violet combination showed additive effect with FICI 0.8. The motility of T. vaginalis was completely lost in the pH 3.0-modified Diamond's medium after exposure for 3 hours, but the colony counts recovered on agar dilution cultures were little different between pH 3.0 shock group and PBS control group. All of T. vaginalis has maintained their motility for more than 8 hours at 10~15℃. After mixing of distilled water and T. vaginalis pellet washed with PBS, cell membrane rupture of all protozoae took place within 3~6 mins and contents were dicharged. It means that T. vaginalis is very sensitive to the low osmotic pressure.
Conclusion : We found that some drugs and two drug combinations had alternative therapeutic effects to T. vaginalis. Benzalknium chloride used in Department of Gynecology had very strong trichomonacidal effect but povidone-iodine (zinobetadine) was little effective. Low pH(pH 3.0) has trichomonastatic effect but did not have trichomonacidal effect
|
|
|
Keywords : Trichomonas vaginalis, Therapheutic agent, Drug combination, Minimal lethal concentration |
|
|
|
|
|
|
|
|
