Effects of steroid hormones and immunosuppressant drugs on defences against uterine microbial contamination in the rat

This study used rats as a mammalian model to investigate the effects of steroid hormones and immunosuppressant drugs on uterine microflora. It was shown that prednisolone acetate predisposed to uterine contamination unlike oestradiol, ciclosporin and cyclophosphamide. It therefore appears that the leucocyte component of the immune system does not normally play a role in preventing bacterial colonization of the uterus and that prednisolone is producing its effect via some other mechanism, possibly an effect on cervical mucus.

Predisposition to uterine microbial contamination in the guinea-pig following administration of mucolytic drugs and steroid hormones

Using guinea-pigs as a mammalian model, the effects of bromhexine hydrochloride, ethinyloestradiol, norethisterone acetate and prednisolone acetate on uterine microbial status were determined. Those drugs known to decrease mucus viscoelasticity predisposed to the entry of vaginal bacteria into the uterus, probably due to reduction of the cervical mucus barrier. Norethisterone acetate, which increases cervical mucus viscoelasticity, reduced these effects. The effects produced by the steroid hormones were independent of their immunosuppressive effects. The results also suggest that prednisolone acetate may exert oestrogen-like actions on cervical mucus.

Histopathologic features, environmental factors, and serum estrogen, progesterone, and prolactin values associated with ovarian phase and inflammatory uterine disease in cats

Forty-four female American Shorthair cats with inflammatory uterine disease or infertility were evaluated. Data collected included age, month of diagnosis, housing, reproductive history, results of bacteriologic culture of uterine specimens, serum concentrations of estrogen, progesterone, and prolactin and histopathologic features of the ovaries and uterus. Histologically, the ovaries of 19 cats were dominated by active or cystic follicles, whereas 25 cats had luteal-phase ovaries. Of the 25 cats with active corpora lutea, 20 had either recently weaned litters (n = 11) without subsequent exposure to a male cat, or had been housed individually for lengthy periods (n = 9). The finding of active corpora lutea under these circumstances indicates that in queens, ovulation may occur by mechanisms not involving coitus. Prominent, active corpora lutea on the ovaries were associated with adenomatotic proliferative changes in the superficial and glandular epithelium of the uterus and with myometrial hyperplasia, compared with the uterus of cats with follicular ovaries (P less than 0.01). Serum progesterone concentration greater than or equal to 1.87 ng/ml was consistently associated with luteal-phase ovaries. Serum progesterone values less than or equal to 0.15 ng/ml were consistently associated with follicular-phase ovaries. Escherichia coli was the organism most commonly isolated from uterine contents.

Effect of vaccination with a monovalent Leptospira interrogans serovar hardjo type hardjo-bovis vaccine on type hardjo-bovis infection of cattle

Effectiveness of 2 concentrations of a monovalent vaccine containing Leptospira interrogans serovar hardjo type hardjo-bovis was evaluated for protection of heifers from infection with type hardjo-bovis. Nine heifers were given 2 doses of low-dose vaccine (8.32 x 10(8) cells/dose); 9 heifers were given 2 doses of high-dose vaccine (8.32 x 10(9) cells/dose); and 1 steer and 1 heifer were maintained as nonvaccinated controls. Groups of vaccinated cattle were challenge-exposed with serovar hardjo type hardjo-bovis at 7 (n = 6), 11 (n = 6), or 15 (n = 6) weeks after completion of vaccination. All cattle were challenge-exposed by conjunctival instillation of 1 x 10(5) hardjo-bovis cells on 3 consecutive days. Both control and all vaccinated cattle became infected and shed serovar hardjo type hardjo-bovis in their urine. Leptospires were detected in 15 of 16 (94%) urine samples from control cattle and in 124 of 143 (87%) samples from vaccinated cattle. Leptospires were detected in kidneys of 17 of 18 vaccinated cattle and 2 of 2 control cattle and in the uterus or oviducts of 13 of 18 vaccinates and the 1 control heifer.

[Maternal morbidity after abdominal cesarean section in relation to bacterial amniotic fluid colonization and premature rupture of fetal membranes]

At the time of Caesarean section, amniotic fluid was collected transabdominally from 1025 patients. In 990 patients cultures were performed on the amniotic fluid. The incidence of Caesarean section of all patients was 16.1%, the perinatal mortality in all patients 0.61%, in cases of Caesarean section 1.93%. The influence of bacterial colonisation in the amniotic cavity was analyzed with respect to premature ruptured membranes and frequency of vaginal examinations on the maternal post-operative morbidity (wound-seroma and abscess 2.4%, febrile morbidity 17%, urinary tract infection 19%). Bacterial contamination was present in 33.3% of the amniotic fluid or uterine cavity, after ruptured membranes in 44.3%, without ruptured membranes in 23.35%. There is a significant influence of the positive cultured amniotic fluid on the wound healing and on the febrile morbidity, while the urinary tract infection has been not influenced. The bacterial contamination of the amniotic fluid is correlated to the frequency of vaginal examination and the presence of ruptured membranes. The following microbiologic isolates were found in the amniotic fluids: Staphylococcus epidermidis 36.38%, Streptococcus B 12.23%, Streptococcus D 10.3%, Escherichia coli 8.42%, Staphylococcus aureus 7.88%, Peptococci 3.26%, Streptococcus salivarius 2.99%, Bacteroides 2.4%. According to these data, patients with ruptured membranes of an interval of more than 12 hrs and with more than 7 vaginal examinations could be selected for antibiotic prophylaxis to achieve a reduction in febrile morbidity and in wound infection.

[Postcoital uterine microbe colonization and endometritis in the mare]

In the mare, natural breeding is associated with bacterial contamination of the reproductive tract. The purpose of this study was to examine postcoital bacterial contamination and the resulting inflammatory response of the uterus. Uterine swabs for bacteriological and cytological examination were obtained from 80 mares. Each mare was sampled once between 4 and 69 hours postbreeding. In mares which did not conceive, sampling was repeated at the following estrus. The findings were compared with those obtained prior to breeding and correlated with the breeding outcome. Bacteria were cultured from 72.5% of the postcoital swabs. There was a wide spectrum of organisms which included species known as potential causes of endometritis. Neutrophilic granulocytes were found in varying concentrations in 48.8% of cases. In 16.3% of mares both bacteriological and cytological examinations were negative. Mares with positive bacteriological and/or cytological results at the postcoital examination had better foaling rates compared to the remaining mares (p less than 0.05). The postcoital findings did not correlate with those of the prebreeding examination, or with the interval between breeding and sampling, or with the different stallions.

Early abortion in cattle induced by experimental intrauterine infection with pure cultures of Actinomyces pyogenes

Actinomyces pyogenes from a case of endometritis was used to study the effects of infection of the bovine embryo between days 27 and 41 of pregnancy. From 10(9) to 10(10) washed organisms were introduced into the uterine lumen of four pregnant cows. Two pregnant cows were inoculated with sterile saline and four pregnant cows were treated with cloprostenol. Embryonic death and abortion followed 29 to 144 hours after the inoculation of the live bacteria. The aborted embryos were macerated or clearly degenerating and yielded profuse pure cultures of A pyogenes. Abortion was accompanied by a sustained increase in uterine tone, opening of the cervix, presence of vaginal pus and a vulval discharge and the persistence of the corpus luteum for at least eight days after abortion. Intrauterine inoculation with saline did not affect pregnancy, but embryonic death, abortion and regression of the corpus luteum occurred 66 to 72 hours after the treatment with cloprostenol. The results suggest that A pyogenes is a primary pathogen and is capable of causing embryonic death and abortion.

Immunoglobulin class- and subclass-specific responses to Mycoplasma pulmonis in sera and secretions of naturally infected Sprague-Dawley female rats

Mycoplasma pulmonis causes chronic murine respiratory mycoplasmosis and genital disease in rats. Specific immunoglobulin M (IgM), IgA, and IgG and its subclasses present in sera and tracheal and uterine lavage samples from 36 naturally infected Sprague-Dawley female rats were tested for reactivity with M. pulmonis in an enzyme-linked immunosorbent assay. Ten specific-pathogen-free Sprague-Dawley female rats served as the negative controls. Tracheal and uterine lavage samples were cultured quantitatively for M. pulmonis. M. pulmonis was isolated from the trachea (35 of 36) and uterus (17 of 36) of naturally infected rats; all rats were infected in at least one of the two sites cultured. M. pulmonis was not isolated from any control rat. There was a significant difference in levels of specific antibody of all classes except IgG2c between control and naturally infected animals (P less than 0.001 for IgM, IgG, IgG1, and IgG2a; P less than 0.002 for IgG2b; and P less than 0.02 for IgA). There was no correlation between numbers of M. pulmonis cells isolated and the amount or class of antibody measured in serum or tracheal lavage specimens. The predominant antibodies to M. pulmonis found in the sera of naturally infected rats were IgG and IgM. The IgG2a subclass was responsible for the majority of IgG-positive animals. There were no differences between rats which were positive by culture for M. pulmonis in the uterus (U+) and rats which were negative by culture for M. pulmonis in the uterus (U-) with respect to distribution or amount of antibody classes and subclasses in the serum. However, tracheal wash samples from U+ rats had significantly higher (P less than 0.03) levels of specific IgG1 and IgG2a than those from U- rats. Conversely, IgG2a was present in higher levels in pooled uterine lavage specimens from U- rats than in those from U+ rats.

Characterization of Gardnerella vaginalis and G. vaginalis-like organisms from the reproductive tract of the mare

Gardnerella vaginalis has been isolated from women with bacterial vaginosis, from the genital tracts of asymptomatic women, and from several other infected body sites in humans. However, until recently, it has not been isolated from any other animal species. Between June 1988 and October 1989, 31 isolates identified as G. vaginalis and 70 isolates identified as G. vaginalis-like organisms have been recovered from the genital tracts of 93 mares from Michigan and Ohio. Identification was based on biochemical reactions, hemolysis on media containing blood from various animal sources, and susceptibility to select antimicrobial agents. This report details the characterization of G. vaginalis and G. vaginalis-like organism isolates obtained from the reproductive tracts of these mares and compares the equine isolates with human isolates.

Bacterial flora of the uterus of cows after calving on two hygienically contrasting farms

Intrauterine swabs were obtained from cows after calving on two commercial dairy herds with contrasting hygienic environments and incidence of leucorrhea, and cultured aerobically and anaerobically. Of 26 cows with a normal calving and puerperium, eight of 14 (57 per cent) were sterile on farm B where hygiene was poor, compared with five of 12 (42 per cent) on farm A where hygiene was better. Two cows on farm B retained their placentas and subsequently developed metritis/endometritis. Actinomyces pyogenes was the commonest bacterial isolate and Fusobacterium nucleatum, Proteus mirabilis and Bacteroides melaninogenicus were also frequently observed. Similar isolates were obtained from cows on farm B with parturient or puerperal disorders. The contrasting hygienic environments had no influence on either the quantitative or qualitative uterine bacterial flora. Thus, the difference in the incidence of endometritis must have been due to factors other than hygiene.

[Positive rate of Chlamydia trachomatis antigen detected by the simultaneous sampling of the uterine cervix, uterine cavity and urinary tract and its relation to serum antibody titers]

The presence or absence of Chlamydia trachomatis antigen in the uterine cervix, uterine cavity and urinary tract was investigated by EIA (Chlamydiazyme) in 159 patients, in addition to the measurement of serum antibody titers in 120 of them by indirect enzyme immunoassay (IPAzyme). The results obtained were as follows. 1. The antigen was detected from one of the 3 sites in 13.8%. Patients in their twenties or younger had the highest positive rate (22.2%) and also the highest incidence of multiple lesions. 2. Patients with irregular hemorrhage from the uterine cavity had a high detection rate. 3. Detection rates for the uterine cervix, uterine cavity and urinary tract were 11.9%, 6.9% and 9.4% respectively. 4. As for overlap infection, the antigen was detected from 1, 2 and 3 sites in 7, 7 and 8 of 22 patients, respectively. 5. The incidence of active infection was significantly higher in antigen-positive patients than in antigen-negative patients, while no difference was observed in antibody titers by the increasing number of antigen-positive sites. These results suggested that the examination of the Chlamydia trachomatis antigen in the uterine cervix alone is insufficient, to determine the true actual prevalence of the organism.

A toxic shock syndrome toxin mutant of Staphylococcus aureus isolated by allelic replacement lacks virulence in a rabbit uterine model

The gene coding for toxic shock syndrome toxin-1 in S. aureus was inactivated by allelic replacement in two TSS-associated strains. One mutant derived from FRI1169 (a non-enterotoxigenic strain) lacked virulence in the rabbit uterine chamber infection model. This suggests that TSST-1 is the only determinant produced by this strain that can induce the symptoms of shock in rabbits. A novel method for allelic replacement involving transduction of plasmid integrants is described.

Causative organisms in puerperal infection

Ninety-two postpartum women who had been admitted to Siriraj Hospital from April 1, 1980 to March 1, 1983 were studied for the causative organisms of puerperal infection. Cervical and intrauterine swab & smear-gram stain as well as cultures were performed. Hemocultures were done in some cases. Only 50 per cent of all cases had positive cervical and intrauterine swab smears which showed different kinds of micro-organisms, 78 per cent were gram-positive cocci, gram-negative rod was found in 4 specimens, 2 specimens of gonococcal smears, one for trichomonads. Cervical and intrauterine swab cultures were positive in only 31.5 per cent. E. Coli was the most common and Staphylococci & Streptococci were the second most common.

Effects of chlorhexidine-coated intrauterine device on the bacteriology of the uterine cavity

Twenty-nine women, aged 31-53 years, scheduled for an abdominal hysterectomy, participated in this study. The patients were divided into three groups. The first received a Multiload MLCu250 intrauterine device (IUD); the second group received a chlorhexidine acetate medicated Multiload MLCu250 IUD; the third group acted as a control group receiving no IUD. Bacteriological cultures of the vagina and ectocervix were taken prior to insertion of the IUD. At hysterectomy, some 18 hours later, specimens were taken from the cervical canal, uterine cavity, and the device itself, for culture of anaerobic and aerobic organisms using a standardized previously validated technique. In three of the nine control patients, organisms were cultured from the uterine cavity. There were no differences between the bacteriological results of the two groups with medicated and non-medicated devices, with regard to the cultures from the cervical canal, uterine cavity or the devices themselves. Nor was there any difference between the control and the IUD group.

[The microflora in suppurative-catarrhal endometritis in cattle]

Microflora isolated from cattle with acute postnatal pus-catarrhal endometritis has been studied. It is shown that the given pathology is caused by associations of different bacterial species. 284 strains isolated from the uterus content of 63 sick animals have been identified, their properties being studied. Pathogenic gram-negative bacilli and gram-positive pus-producing cocci are responsible for the studied pathology. Considerable inoculation capacity has been established for conditionally pathogenic microorganisms of different species and genera whose role in pathogenesis is to be found out.

Lactobacillus septicemia, an unusual complication during the treatment of metastatic choriocarcinoma

A case of severe Lactobacillus septicemia in a patient treated with chemotherapy because of metastatic choriocarcinoma is described. Although Lactobacillus is a ubiquitous commensal of the female genital tract, no earlier reference was found in the literature.

Isolation of Mycobacterium paratuberculosis from the uterine flush fluids of cows with clinical paratuberculosis

Mycobacterium paratuberculosis was isolated from the uterine flush fluids obtained from 3 to 4 cows with clinical paratuberculosis. Four cows with clinical paratuberculosis were subjected to uterine lavage, using an established embryo recovery technique, and the recovered fluids were cultured for M paratuberculosis. Mycobacterium paratuberculosis has previously been demonstrated to adhere to bovine ova. Embryos within the uterus of a superovulated cow infected with M paratuberculosis could be exposed to the organism.

Dose-dependent transplacental infection of murine encephalomyelitis virus GDVII in gravid uterus

Intrauterine infection of murine encephalomyelitis virus GDVII was investigated by the indirect immunofluorescence method. Sixty-day-old pregnant mice were inoculated with 5 gradated doses of the virus ranging from 0.001 to 1.5 MLD50 via i.v. route on the 10th day of gestation. The mice exsanguinated on postinfection day 8 showed high incidences of viral antigen in the uterine walls, placentas, and fetal subcutaneous tissues with doses of 0.1-1.5 MLD50, regardless of the presence of maternal symptoms. Incidence of viral antigen-positive cells in fetal brains was high with a dose of 0.1 MLD50, but not by the other doses. However, the brains of the stillborn and newly-born mice derived from females infected by a dose of 0.5 MLD50 brought about still higher detection rates of viral antigen, as well as in the postpartum uteri. In effect, transplacental transmission of the virus was clearly demonstrated, and appeared to be dose-dependent.

Congenital malformations in sheep resulting from in utero inoculation of Cache Valley virus

Serologic evidence indicated that an episode of congenital abnormalities in sheep was caused by Cache Valley virus (CVV), a bunyavirus indigenous to the United States. To determine the teratogenic potential of CVV in sheep, fetuses were infected in utero between 27 and 54 days of gestation with an isolate (CK-102) obtained in 1987 from a sentinel sheep in San Angelo, Texas. The dams of these fetuses were euthanatized between 28 and 75 days after inoculation, and the fetuses were examined for malformations. Twenty-eight of 34 fetuses had congenital abnormalities, including arthrogryposis, hydranencephaly, mummification, reabsorption, and oligohydroamnion. Virus was isolated from the allantoic fluid of 11 of 17 fetuses euthanatized at less than 70 days of gestation. The virus-positive fetuses, which were all negative for CVV-neutralizing antibody, had lesions ranging from none to severe arthrogryposis and hydranencephaly. Virus was not recovered from the allantoic fluid of fetuses after 76 days' gestation when CVV-specific antibody could be detected in 5 of 8 fetuses examined. The 2 fetuses infected on days 50 and 54 of gestation appeared normal and 1 had antibody to CVV.

Isolation of Gardnerella vaginalis from the reproductive tract of four mares

A gram-variable pleomorphic bacillus was isolated from the reproductive tracts of 4 mares during routine prebreeding soundness examinations. Using a commercial bacterial identification system, these organisms were identified as Streptococcus acidominimus. However, colonial and Gram-staining characteristics did not support this identification. Subsequent testing indicated the organism was similar to Gardnerella vaginalis. Additional growth and biochemical analysis performed in our laboratory and at the Michigan Department of Public Health and by the Center for Disease Control, Atlanta, Georgia, confirmed the identification of G. vaginalis.

Bacterial flora of the vagina and uterus of healthy cats

Bacterial culturing was conducted on samples from the reproductive tracts of 53 clinically healthy female cats. Aerobic bacteria were isolated from 52 of 53 vaginal swab samples and from 2 of 29 uterine swab samples. Anaerobic bacteria were detected in 4 of 30 vaginal and 1 of 29 uterine cultures. The aerobic bacteria included species of Acinetobacter, Actinomyces, Corynebacterium, Escherichia, Haemophilus, Klebsiella, Lactobacillus, Staphylococcus, and Streptococcus. Coagulase-negative Staphylococcus, Streptococcus canis, and E coli were the most common organisms and were isolated from 56%, 52%, and 44% of the vaginal samples, respectively. Anaerobes isolated from vaginal samples included 3 species of Bacteroides and 2 isolates of Peptococcus. The single uterine anaerobe isolate was a Lactobacillus sp. The number of bacterial species isolated from each vaginal culture ranged from 1 to 8 (mean, 3). The number of colony forming units tended to vary inversely with the number of bacterial species detected in each sample.