Today we provide you with an update on the sexually transmitted infection: Trichomonas vaginalis, a protozoan which infects the vagina, urethra and paraurethral glands. It is an uncommon cause of vaginal discharge and penile urethritis and can persist for a long time if left untreated. Up to 50% of people with vaginal infections and especially people with urethral infections remain asymptomatic. Persistent trichomonas infection has been associated with facilitating the transmission of human immunodeficiency virus (HIV) and adverse poor reproductive health outcomes. Dr Christina Muzny, Professor in Infectious Diseases at University of Alabama, Birmingham, USA, will present on published clinical trial data on novel treatment against trichomoniasis.

Relevant publications:

Van Gerwen OT, Aaron KJ, Schroeder J, et al. Spontaneous resolution of Trichomonas vaginalis infection in men. Sexually Transmitted Infections. Published Online First: 27 June 2024. doi: 10.1136/sextrans-2024-056160.

Muzny CA, Van Gerwen OT, Kaufman G, Chavoustie S. Efficacy of single-dose oral secnidazole for the treatment of trichomoniasis in women co-infected with trichomoniasis and bacterial vaginosis: a post hoc subgroup analysis of phase 3 clinical trial data. BMJ Open. 2023;13:e072071

Kissinger PJ, Gaydos CA, Seña AC, McClelland RS, Soper, Secor WE, Legendre D, Workowski KA, Muzny CA, Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines, Clinical Infectious Diseases, Clinical Infectious Diseases, Volume 74, Issue Supplement_2, 15 April 2022

Howe K and Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017; 44: 29–34.

Kissinger P, Muzny CA, Mena LA, et al. Single-dose versus 7- day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018; 18: 1251–1259.

Sherrard J, Pitt R, Hobbs KR, Maynard M, Cochrane E, Wilson J, Tipple C. British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021. Int J STD AIDS. 2022 Jul;33(8):740-750.

STI Guidelines Australia - Trichomoniasis

Host: Dr Fabiola Martin, STI BMJ Podcast editor, a Sexual Health, HIV and HTLV Specialist, Canberra & University of Queensland, Brisbane, Australia

Guest: Dr Christina Muzny, Professor in Infectious Diseases at University of Alabama, Birmingham, USA

You will recall a previous podcast about preventing Neisseria gonorrhoea through an effective vaccine. Neisseria gonorrhoeae is a ubiquitous sexually transmitted bacteria that can cause both localised and systemic disease if left untreated. It may be transmitted to neonates. We also reported on a rise of the gonorrhoea incidence, as well as increasing rates of antibiotic resistance.

Today we will revisit the implementation of vaccinations against gonorrhoea in the UK. Here is an exciting up-date on the advice provided by UK's Joint Committee on Vaccination and Immunisation, JCVI, on using the vaccine 4CMebB OMV against Meningococcus used off-label for the prevention of gonorrhoea infection

• in patients at significant risk of infection with bacterial STIs who

• attend specialist sexual health services. Host:

Dr. Fabiola Martin, Sexual Health HIV, HTLV Specialist, Canberra Sexual Health Services & University of Queensland, Australia

Participants: Dr. Suneeta Soni, Consultant in Sexual Health and HIV, University Hospitals Sussex and Chair of the Bacterial special interest group for BASHH *British Association for Sexual health and HIV)

Dr. Yen Bui, Consultant in Vaccination and Travel Health, Institut national de santé publique du Québec, Canada

A/P. Dr. Kate Seib, NHMRC Leadership Fellow and Associate Director for Research, Institute for Glycomics, Griffith University, Australia

Today we will focus on the alternative treatments of early Syphilis. Worldwide many of us have experienced a shortage of gold standard treatment benzathine benzylpenicillin injections for syphilis. It is time we look for alternative antibiotic treatments and prevention strategies for syphilis. In conversation with Prof Jeffery Klausner, Professor of Medicine, Infectious Diseases and Public Health at the Keck School of Medicine of the University of Southern California, we will discuss a new study published in the Lancet in 2024. Mitja O. et al compared oral linezolid with benzathine penicillin G for treatment of early syphilis in adults (Trep-AB Study) in Spain, which is a prospective, open-label, non-inferiority, randomised controlled trial.

Acknowledgement for his valuable contributions to the content of the podcast: Dr Oriol Mitjà, Skin Neglected Tropical Diseases and Sexually Transmitted Infections Section, Fundació Lluita Contra les Infeccions, Barcelona, Spain.

Related link:

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00683-7/fulltext