Metronidazole and Giardia: In vitro viability assay under microaerobic conditions indicates a multifactorial basis for metronidazole treatment failure
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F25%3A10504956" target="_blank" >RIV/00216208:11110/25:10504956 - isvavai.cz</a>
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Z9z5OPPR_A" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Z9z5OPPR_A</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.jgar.2025.09.010" target="_blank" >10.1016/j.jgar.2025.09.010</a>
Alternative languages
Result language
angličtina
Original language name
Metronidazole and Giardia: In vitro viability assay under microaerobic conditions indicates a multifactorial basis for metronidazole treatment failure
Original language description
Objectives: Giardiasis, a worldwide intestinal infection caused by the protozoan parasite Giardia intestinalis , is treatable with metronidazole (MTZ). However, MTZ-refractory giardiasis is common. It remains unclear, however, whether MTZ-resistant pathogens cause treatment failure because the natural resistance of Giardia to MTZ has not yet been demonstrated. Methods: We developed a simple 24 h viability assay to assess the MTZ sensitivity of Giardia parasites in vitro under two atmospheric conditions, microaerobic and anaerobic. The results of the assay were statistically evaluated. Results: We tested 18 clinical isolates. Based on the minimum lethal concentration (MLC), hierarchical cluster analysis separated the isolates into three categories: sensitive, intermediate resistant, and resistant. The resistant cluster consisted of two isolates with an MLC of 400 mu g/mL MTZ, which exhibited natural MTZ resistance. Interestingly, this resistance was only manifested under microaerobic conditions. The effect of oxygen on the in vitro drug response was evident in the greater variability of MLC values among the other isolates. Two in vitro-resistant isolates originated from patients with MTZ-refractory giardiasis, suggesting that parasite resistance likely contributes to treatment failure. However, two additional isolates from patients with MTZ-refractory giardiasis showed in vitro susceptibility under both test conditions. This indicates that treatment failure in giardiasis likely stems from multiple factors. Conclusions: Our study highlights the critical importance of oxygen concentration during assessment of Giardia parasite resistance to MTZ. However, it also indicates that MTZ-refractory giardiasis may result from reasons other than parasite resistance.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30303 - Infectious Diseases
Result continuities
Project
<a href="/en/project/NU23-05-00441" target="_blank" >NU23-05-00441: New approaches to addressing giardiasis treatment failure: the employment of next-generation sequencing and digital PCR in the search for markers of parasite drug resistance. e.</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Journal of Global Antimicrobial Resistance
ISSN
2213-7165
e-ISSN
2213-7173
Volume of the periodical
45
Issue of the periodical within the volume
December
Country of publishing house
NL - THE KINGDOM OF THE NETHERLANDS
Number of pages
7
Pages from-to
157-163
UT code for WoS article
001604031000001
EID of the result in the Scopus database
2-s2.0-105019096166