Genetic diversity of Trichomonas Vaginalis isolates in Western Australia, the Northern Territory of Australia and Southern Ghana

Genetic diversity of Trichomonas vaginalis among regional populations has become more evident in studies over the last decade, with increasing cases of treatment failures and variable clinical presentations. We applied next generation-multilocus sequence typing (NG-MLST), comprising seven single-copy housekeeping genes to genetically characterize isolates of T. vaginalis. We examined one hundred and seventy-six archival and recently sampled T. vaginalis isolates from Western Australia, the Northern Territory and female patients visiting selected health care facilities in Southern Ghana, to assess the level of intra- and inter-population genetic diversity of T. vaginalis in these regions. Twenty-two zero-radius operational taxonomic units (ZOTUs) and 106 sequence types (ST) were distinguished among 176 isolates, suggesting diverse T. vaginalis populations within the three geographical regions. Each characterized locus comprised more than one allele and nucleotide diversity for the loci based on pairwise difference averaged 0.0175 differences/site. The number of different alleles for each locus ranged from 2 to 8. Eleven multiple infections with different genotypes were found among 6% of the samples, mostly those from Ghana. ZOTU diversity was greater among isolates from Ghana and one novel T. vaginalis genotype was found in 1% of isolates from Ghana. We discuss how this genetic variation may affect clinical presentation and treatment of T. vaginalis infections