Chapter 12 : Trichomoniasis

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Trichomoniasis, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap12-1.gif /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap12-2.gif


Trichomoniasis is the most common nonviral sexually transmitted disease worldwide. It has been estimated that more than 180 million people are infected with . Infection with can be asymptomatic or can be associated with acute vaginitis. infects the squamous epithelium of the lower genital tract almost exclusively, in both women and men. In women, the vagina, exocervix, urethra, and Skene’s glands are the main sites of infection. In men, the infection is urethral and usually without symptoms. Some investigators have found an association between infection and prematurity. After successful therapy, recurrent vaginal infection may occur. However, almost never spreads outside the human genitourinary system. Infection with may elicit an inflammation characterized by discharge. Symptoms of vaginal trichomoniasis include abnormal frothy discharge and genital irritation. Observation of live protozoa in specimens from the vagina or urethra is definitive evidence of genital trichomoniasis. Trichomonas culture is the most sensitive diagnostic procedure but will miss up to 15% of infected cases. Monoclonal antibodies to have been used to identify vaginal trichomoniasis. Metronidazole can produce chromosomal alterations in bacteria and may increase the incidence of tumors in susceptible animals. In summary, is likely to be an important factor in prematurity. Better diagnostic tests (amenable to screening use), better therapy, and appropriate clinical trials are needed to determine whether screening and treatment should be used to prevent prematurity.

Citation: Wölner-Hanssen P. 1999. Trichomoniasis, p 209-221. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch12
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Alderete, J. F. 1984. Enzyme-linked immunosorbent assay for detection of antibody to Trichomonas vaginalis: use of whole cells and aqueous extract as antigen. Br. J. Vener. Dis. 60:160170.
2. Alderete, J. F. 1988. Alternating phenotypic expression of two classes of Trichomonas vaginalis surface markers. Rev. Infect. Dis. 10:408.
3. Alderete, J. F.,, L. Kasmala,, E. Metcalfe,, and G. E. Garza. 1986. Phenotypic variation and diversity among Trichomonas vaginalis isolates and correlation of phenotype with trichomonal virulence determinants. Infect. Immun. 53:285293.
4. Alderete, J. F.,, E. Newton,, C. Dennis,, J. Engbring,, and K. A. Neale. 1991a. Vaginal antibody of patients with trichomoniasis is to a prominent surface immunogen of Trichomonas vaginalis. Genitourin. Med. 67:220225.
5. Alderete, J. F.,, E. Newton,, C. Dennis,, and K. A. Neale . 1991b. Antibody in sera of patients infected with Trichomonas vaginalis to trichomonad proteinases. Genitourin. Med. 67:331334.
6. Alderete, J. F.,, E. Newton,, C. Dennis,, and K. A. Neale. 1991c. The vagina of women infected with Trichomonas vaginalis has numerous proteinases and antibody to trichomonad proteinases. Genitourin. Med. 67:469474.
7. Alper, M. M.,, B. N. Barwin,, W. M. McLean,, I. J. McGilverary,, and S. Sved. 1985. Systemic absorption of metronidazole by the vaginal route. Obstet. Gynecol. 65: 781784.
8. Amon, K.,, I. Amon,, and H. Müller,. 1972. Maternal-fetal passage of metronidazole, p. 113115. In M. Hejzlar,, M. Semonsky,, and S. Masak (ed.), Advances in Antimicrobial Antineoplastic Chemotherapy. University Park Press, Baltimore, Md.
9. Arroyo, R.,, J. Engbring,, and J. F. Alderete. 1992. Molecular basis of host cell recognition by Trichomonas vaginalis. Mol. Microbiol. 6:853862.
10. Borchardt, K. A.,, and R. F. Smith. 1991. An evaluation of an InPouch TV culture method for diagnosing Trichomonas vaginalis infection. Genitourin. Med. 67:149152.
11. Borchardt, K. A.,, V. Hernandez,, S. Miller, et al. 1992. A clinical evaluation of trichomoniasis in San Jose, Costa Rica, using the InPouch TV test. Genitourin. Med. 68: 328330.
12. Briselden, A. M.,, and S. L. Hillier. 1994. Evaluation of Affirm VP Microbial Identification Test for Gardnerella vaginalis and Trichomonas vaginalis. J. Clin. Microbiol. 32:148152.
13. Brown, M. T. 1972. Trichomoniasis. Practitioner 209:639.
14. Buchvald, D.,, P. Demes, , A. Gombos̈ová,, P. Mráz,, M. Valent, , and J. Stefanovic̈. 1992. Vaginal leukocyte characteristics in urogenital trichomoniasis. APMIS 100: 393400.
15. Cassell, G. Personal communication.
16. Cotch, M. F., , J. G. PastorekII,, R. P. Nugent,, D. E. Yerg,, D. H. Martin,, and D. A. Eschenbach. 1991. Demographic and behavioral predictors of Trichomonas vaginalis infection among pregnant women. Obstet. Gynecol. 78:10871092.
17. Cotch, M. F., , J. G. PastorekII,, R. P. Nugent,, S. L. Hillier,, R. S. Gibbs,, D. H. Martin,, D. A. Eschenbach,, R. Edelman,, J. C. Carey,, J. A. Regan,, M. A. Krohn,, M. A. Klebanoff,, A. V. Rao,, and G. G. Rhoads. 1997. Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infection and Prematurity Study Group. Sex. Transm. Dis. 24:361362.
18. DeMeo, L. R.,, D. L. Draper,, J. A. McGregor,, D. F. Moore,, C. R. Peter,, P. S. Kapernick,, and W. M. McCormack. 1996. Evaluation of a deoxyribonucleic acid probe for the detection of Trichomonas vaginalis in vaginal secretions. Am. J. Obstet. Gynecol. 174:13391342.
19. Feinberg, J. G.,, and M. J. A. Whittington. 1957. A culture medium for Trichomonas vaginalis Donne and species of Candida. J. Clin. Pathol. 10:327329.
20. Fouts, A. C.,, and S. J. Kraus. 1980. Trichomonas vaginalis: reevaluation of its clinical presentation and laboratory diagnosis. J. Infect. Dis. 141:137143.
21. Garber, G. E.,, L. T. Lemchuk-Favel,, and W. R. Bowie. 1989. Isolation of a cell-detaching factor of Trichomonas vaginalis. J. Clin. Microbiol. 27:15481553.
22. Hardy, P. H.,, J. B. Hardy,, E. E. Nell,, D. A. Graham,, M. R. Spence,, and R. C. Rosenbaum. 1984. Prevalence of six sexually transmitted agents among pregnant inner-city adolescents and pregnancy outcome. Lancet ii:333337.
23. Hillier, S. L.,, J. Martius,, M. Krohn,, N. Kiviat,, K. K. Holmes,, and D. A. Eschenbach. 1988. A case-control study of chorioaminiotic infection and histologic chorioamnionitis in prematurity. N. Engl. J. Med. 319:972978.
24. Honigberg, B. M.,, and G. Brugerolle,. 1989. Structure, p. 535. In B. M. Honigberg (ed.), Trichomonads Parasitic in Humans. Springer-Verlag, New York, N.Y.
25. Kent, H. L. 1991. Epidemiology of vaginitis. Am. J. Obstet. Gynecol. 165:11681176.
26. Krieger, J. N.,, M. R. Tam,, C. E. Stevens,, I. O. Nielsen,, J. Hale,, N. B. Kiviat, and . K. Holmes. 1988. Diagnosis of trichomoniasis: comparison of conventional wet-mount examination with cytologic studies, cultures, and monoclonal antibody staining of direct specimen. JAMA 259:12231227.
27. Krieger, J. N.,, P. Wölner-Hanssen,, C. Stevens,, and K. K. Holmes . 1990a. Characteristics of Trichomonas vaginalis isolates from women with and without colpitis macularis. J. Infect. Dis. 161:307311.
28. Krieger, J. N.,, B. E. Torian,, J. Hom,, and M. R. Tam . 1990b. Inhibition of Trichomonas aginalis motility by monoclonal antibodies is associated with reduced adherence to HeLa cell monolayers. Infect. Immun. 58:16341639.
29. Lee, N. C.,, G. L. Rubin,, and D. A. Grimes. 1991. Measures of sexual behavior and the risk of pelvic inflammatory disease. Obstet. Gynecol. 77:425430.
30. Legator, M. S.,, T. H. Connor,, and M. Stoekel. 1975. Detection of mutagenic activity of metronidazole and niridazole in body fluid of humans and mice. Science 188: 1181119.
31. Lehker, M. W.,, and J. F. Alderete. 1990. Properties of Trichomonas vaginalis grown under chemostat controlled growth conditions. Genitourin Med. 66:193199.
32. Linstead, D., 1989. Cultivation, p. 91111. In B. M. Honigberg (ed.), Trichomonads Parasitic in Humans. Springer-Verlag, New York, N.Y.
33. Lossick, J. G. 1988. The diagnosis of vaginal trichomoniasis. JAMA 259:1230.
34. Lossick, J. G., 1989. Therapy of urogenital trichomoniasis, p. 324341. In B. M. Honigberg ed.), Trichomonads Parasitic in Humans. Springer-Verlag, New York, N.Y.
35. Mantovani, A.,, N. Polentarutti,, G. Peri,, G. Martinotti,, and F. Landolfo. 1981. Cytotoxicity f human peripheral blood monocytes against Trichomonas vaginalis. lin. Exp. Immunol. 46:391396.
36. Mason, P. R.,, and M. T. Brown. 1980. Trichomonas in pregnancy. Lancet ii:1025.
37. Mason, P. R.,, and L. Forman. 1982. Polymorphonuclear cell chemotaxis to secretions f pathogenic and nonpathogenic Trichomonas vaginalis. J. Parasitol. 68:457462.
38. McGregor, J. A.,, J. I. French,, W. Jones,, R. Parker,, E. Patterson,, and D. Draper. 1992. Association of cervicovaginal infections with increased vaginal fluid phospholipase A2 activity. Am. J. Obstet. Gynecol. 167:15881594.
39. McGregor, J. A.,, J. I. French,, R. Parker,, D. Draper,, E. Patterson,, W. Jones,, K. Thorsgard,, and J. McFee. 1995. Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled valuation. Am. J. Obstet. Gynecol. 173:157167.
40. McLellan, R.,, M. R. Spence,, M. Brockman,, L. Raffel,, and J. L. Smith. 1982. The clinical diagnosis of trichomoniasis. Obstet. Gynecol. 60:3034.
41. Meis, P. J.,, R. L. Goldenberg,, B. Mercer,, A. Moawad,, A. Das,, D. McNellis,, F. Johnson,, J. D. Iams,, E. Thom,, and W. W. Andrews. 1995. The preterm prediction study: significance of vaginal infections. National Institute of Child Health and Human Development Maternal-Fetal Units Network. Am. J. Obstet. Gynecol. 173: 12311235.
42. Minkoff, H.,, A. N. Grunebaum,, R. H. Schwarz,, J. Feldman,, M. Cummings,, W. Crombleholme,, L. Clark,, G. Pringle,, and W. M. McCormack. 1984. Risk factors for prematurity and premature rupture of membranes: a prospective study of the vaginal flora in pregnancy. Am. J. Obstet. Gynecol. 150:965972.
43. Mirhaghani, A.,, and A. Warton. 1996. An electron microscope study of the interaction between Trichomonas vaginalis and epithelial cells of the human amnion membrane. Parasitol. Res. 82:4347.
44. Müller, M.,, J. G. Lossick,, and T. E. Gorrell. 1988. In vitro susceptibility of Trichomonas vaginalis to metronidazole and treatment outcome in vaginal trichomoniasis. Sex. Transm. Dis. 15:1724.
45. Nadisauskiene, R.,, S. Bergström,, I. Stankeviciene,, and T. Spukaite. 1995. Endocervical pathogens in women with preterm and term labour. Gynecol. Obstet. Invest. 40:179182.
46. Narcisi, E. M.,, and W. E. Secor. 1996. In vitro effect of tinidazole and furazolidone on metronidazole-resistant Trichomonas vaginalis. Antimicrob. Agents Chemother. 40: 11211125.
47. Pastorek, J. G.II,, M. F. Cotch,, D. H. Martin, and D. A. Eschenbach for the Vaginal Infection and Prematurity Study Group. 1996. Clinical and microbiological correlates of vaginal trichomoniasis during pregnancy. Clin. Infect. Dis. 23:10751080.
48. Pindak, F. F.,, N. Mora de Pindak,, and W. A. Gardner. 1993. Contact-independent cytotoxocity of Trichomonas vaginalis. Genitourin. Med. 69:3540.
49. Piper, J. M.,, E. F. Mitchel,, and W. A. Ray. 1993. Prenatal use of metronidazole and birth defects: no association. Obstet. Gynecol. 82:348352.
50. Poch, F.,, D. Levin,, S. Levin,, and M. Dan. 1996. Modified thioglycolate medium: a simple and reliable means for detection of Trichomonas vaginalis. J. Clin. Microbiol. 34:26302631.
51. Read, J. S., and M. A. Klebanoff for the Vaginal Infections and Prematurity Study Group. 1993. Sexual intercourse during pregnancy and preterm delivery: effects of vaginal microorganisms. Am. J. Obstet. Gynecol. 168:514519.
52. Rein, M. F.,, J. A. Sullivan,, and G. L. Mandell. 1980. Trichomonacidal activity of human polymorphonuclear neutrophils: killing by disruption. J. Infect. Dis. 142:575585.
53. Ross, S. M.,, and A. V. Middelkoop. 1983. Trichomonas infection in pregnancy—does it affect perinatal outcome? S. Afr. Med. J. 63:566.
54. Rust, J. H., 1976. An assessment of metronidazole tumorigenicity: studies in mouse and rat, p. 138144. In S. Finegold (ed.), Metronidazole. Proceedings of the International Metronidazole Conference. Excerpta Medica, Princeton, N.J.
55. Shaio, M. F.,, P. R. Lin,, J. Y. Liu,, and K. D. Yang. 1995. Generation of interleukin-8 from human monocytes in response to Trichomonas vaginalis stimulation. Infect. Immun. 63:38643870.
56. Street, D. A.,, D. Taylor-Robinson,, J. P. Ackers,, N. F. Hanna,, and A. McMillan. 1982. Evaluation of an enzyme-linked immunosorbent assay for the detection of antibody to Trichomonas vaginalis in sera and vaginal secretions. Br. J. Vener. Dis. 58:330333.
57. Witkin, S. S.,, S. R. Inglis,, and M. Polaneczky. 1996. Detection of Chlamydia trachomatis and Trichomonas vaginalis by polymerase chain reaction in introital specimens from pregnant women. Am J. Obstet. Gynecol. 175:165167.
58. Wölner-Hanssen, P.,, J. N. Krieger,, C. E. Stevens,, N. B. Kiviat,, L. Koutsky,, C. Critchlow,, T. De Rouen,, S. Hillier,, and K. K. Holmes. 1989. Clinical manifestations of vaginal trichomoniasis. JAMA 261:571576.
59. Wölner-Hanssen, P. Unpublished data.
60. Yule, A.,, M. C. A. Gelan,, J. D. Oriel,, and J. P. Ackers. 1987. Detection of Trichomonas vaginalis antigen in women by enzyme immunoassay. J. Clin. Pathol. 40:566568.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error