Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Antibiotic-resistant bacteria increased after clindamycin use for common vaginal infection

02.11.2004


In the first study to directly compare the emergence of antibiotic resistance following topical treatment between two antibiotics routinely prescribed for a common vaginal infection, researchers from the Magee-Womens Research Institute have found antibiotic-resistant bacteria more likely to develop with the drug clindamycin than metronidazole. The study is being published in the October issue of the American Journal of Obstetrics and Gynecology.



Researchers followed 99 women between the ages of 18 and 45 who were being treated for bacterial vaginosis (BV), a common gynecological complaint that infects up to 50 percent of women in some populations. BV is characterized by an increase in vaginal alkalinity and substitution of certain beneficial bacteria, particularly those that produce hydrogen peroxide, with more toxic bacteria. Among the infection’s more prominent symptoms is a milky, foul-smelling discharge.

"Symptoms of discharge are one of the most common reasons women visit a gynecologist," said Sharon Hillier, Ph.D., professor in the departments of obstetrics, gynecology and reproductive sciences and molecular genetics and biochemistry at the University of Pittsburgh School of Medicine and senior author of the study. "For years, clinicians have thought of BV infection as a minor problem, but studies have shown that women who have BV are more likely to get herpes and other sexually transmitted diseases, including HIV."


For the antibiotic-resistance study, investigators traced the frequency and median concentrations of vaginal microbes from women with BV before and after treatment with vaginal preparations of clindamycin or metronidazole, according to Richard Beigi, M.D., a former fellow in the department of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, who now is with MetroHealth Medical Center in Cleveland, and the study’s first author. Dr. Beigi was part of the Magee program when the antibiotic-resistance study was completed. Vaginal specimens were collected before treatment began and were compared with those collected during three consecutive follow-up visits. Antibiotic resistance testing also was performed.

Specifically examined were 10 groups of bacteria, including Lactobacillus spp, Gardnerella vaginalis, Mycoplasma hominis, Ureaplasma urealyticum, Escherichia coli, Enterococcus spp, Prevotella bivia, Prevotella spp (pigmented and non-pigmented) and Porphyromonas spp. Analysis included data for women in whom therapy failed as well as those whose infection was cured, he said.

While some bacterial concentrations decreased for both groups, women treated with clindamycin experienced more frequent increases in bacterial concentrations of E. coli than those who were treated with metronidazole. In addition, women treated with metronidazole showed more significant decreases in concentrations of other bacteria such as P. bivia, pigmented Prevotella spp and U. urealyticum compared to clindamycin treatment, Dr. Beigi said.

"Fewer than 1 percent of bacterial samples we tested demonstrated resistance to metronidazole," said Dr. Beigi. "In contrast, 12 percent demonstrated baseline clindamycin resistance, and 53 percent demonstrated resistance to clindamycin after therapy."

In addition, women treated with clindamycin (but not metronidazole) showed evidence of clindamycin-resistant bacteria that persisted for 90 days after treatment at rates as high as 80 percent, Dr. Beigi said.

Metronidazole therapy resulted in increased colonization by protective Lactobacillus species in the week following therapy compared to the women treated with clindamycin.

Testing of pigmented Prevotella spp and P. bivia also revealed significant resistance – 75 percent and 57 percent, respectively – to clindamycin following therapy. Metronidazole resistance was far more rare at 0.5 percent and did not increase after treatment.

"Study results suggest that metronidazole and clindamycin differ in their effects on microbes in women with BV," said Dr. Beigi. "Increased bacterial resistance following clindamycin treatment may account for persistence of some pathogens after therapy."

Dr. Hillier said she believes these study results have the possibility to significantly impact standard BV treatment. "I think any time you find out that use of an antibiotic results in a huge antibiotic resistance, it’s important," she said. Treatment decisions, however, remain the province of individual physicians and patients, Dr. Hillier added.

In addition to Drs. Beigi and Hillier, other study authors include Michele Austin, B.S.; Leslie Meyn, M.S.; and Marijane Krohn, Ph.D., all of the University of Pittsburgh. The study was funded by an unrestricted grant from 3M Pharmaceuticals, manufacturer of MetroGel-Vaginal, a metronidazole-containing treatment for bacterial vaginosis, and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.

Michele D. Baum | EurekAlert!
Further information:
http://www.upmc.edu

More articles from Health and Medicine:

nachricht Vanishing capillaries
23.03.2017 | Technische Universität München

nachricht How prenatal maternal infections may affect genetic factors in Autism spectrum disorder
22.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

When Air is in Short Supply - Shedding light on plant stress reactions when oxygen runs short

23.03.2017 | Life Sciences

Researchers use light to remotely control curvature of plastics

23.03.2017 | Power and Electrical Engineering

Sea ice extent sinks to record lows at both poles

23.03.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>