Association of genital mycoplasmas with exudative vaginitis in a 10 year old: a case of misdiagnosis

A 10-year-old girl with a 1-year history of lower genitourinary tract symptoms suggestive of bacterial infection but with numerous negative urine cultures was referred to the University of Alabama urology clinic after empirical treatment with multiple antibiotics failed to resolve her symptoms. An extensive urologic evaluation revealed no structural or physiologic abnormalities, but an exudative vaginitis was noted and large numbers of Ureaplasma urealyticum and Mycoplasma hominis were isolated from the lower genital tract. Cultures for Chlamydia, viruses, and routine bacterial pathogens were negative. After initiation of tetracycline therapy, symptoms resolved and subsequent cultures for mycoplasmas were negative. In addition, a seroconversion was noted for M hominis but not for U urealyticum. Chlamydia serology was negative. It was later learned that the patient had been sexually molested just prior to the onset of symptoms. This case illustrates the necessity of early consideration of a mycoplasmal etiology in the patient with persistent genitourinary symptoms and no obvious bacterial pathogen, or in the patient whose condition is refractory to routine antibiotic therapy.

Measurement of antibody to Ureaplasma urealyticum by an enzyme-linked immunosorbent assay and detection of antibody responses in patients with nongonococcal urethritis

The optimum conditions for the detection of human immunoglobulin G (IgG), IgM, and IgA antibodies to Ureaplasma urealyticum by an enzyme-linked immunosorbent assay (ELISA) were established by using a cell lysate antigen and commercially available alkaline phosphatase conjugates. No significant cross-reactions were observed among rabbit antisera to a variety of mycoplasmas of human origin and ureaplasma antigen, thus demonstrating the specificity of the ELISA. All human sera were assayed at a 1:200 dilution. Antigen was used at 20 mug of protein/ml and conjugates were diluted 1:500. Presence of IgG antibody to U. urealyticum was significantly associated with isolation of U. urealyticum (P < 0.001) in 110 women. Seventeen acute-phase and 19 convalescent-phase sera from male nongonococcal urethritis (NGU) patients were tested for the presence of antibody by both the metabolism inhibition assay and by ELISA, with overall agreements of 82 and 95% for acute- and convalescent-phase sera, respectively. Serum antibody responses were demonstrated to selected serotypes in the metabolism inhibition test, but the response as measured by the ELISA was independent of the serotype of the antigen used. Serum antibody levels in NGU patients were significantly higher (P < 0.002) than the normal serum standard in the IgG, IgM, and IgA classes. Additionally, the magnitude of change between acute- and convalescent-phase sera was greater for NGU patients than for normal asymptomatic ureaplasma-positive male controls. A significant change in antibody levels of one or more antibody classes was detected for 12 of 18 (67%) NGU patients by ELISA. Ten of the 12 (83%) individuals had a change in the IgM class, which is suggestive of an active infectious process. The ELISA is advantageous in that it requires only a single serotype antigen, uses one serum dilution, is class specific, and allows quantitative detection of differences between acute- and convalescent-phase sera.

Incidence of genital mycoplasmas in women at the time of diagnostic laparoscopy

The cervicovaginal and endometrial isolation rates of Ureaplasma urealyticum and Mycoplasma hominis and relevant demographic data were obtained at the time of laparoscopy in 193 women from infertile marriage. For comparative purposes, fertile women undergoing laparoscopy for tubal ligation (n = 56) or other purposes (n = 64) were also cultured. Blacks were more likely than caucasians to be infected with either organism in all population types (p less than or equal to .05); however, no differences were noted in cervicovaginal carriage rates for blacks in different patient populations. M. hominis was isolated more frequently from tubal reanastomosis patients and less often from infertile patients, p less than or equal to .001. No differences were noted among the infertile subpopulations. Although the isolation rate of U. urealyticum from the different patient populations was similar, one subpopulation within the infertile population (male factor) was identified in which the prevalence of ureaplasmal infection of the female's lower genital tract was over twice as high (p less than or equal to .005) as in other infertile women. Yet there were no statistically significant differences in the demographic data of this subpopulation as compared to the population of infertile women as a whole. No other clinical subpopulation with single or multiple diagnoses not including male factor had an increased prevalence of infection. Eighty percent of infected, infertile couples had no clinical evidence of male factor infertility, indicating that only certain individuals are affected. This possibly explains why previous studies involving small numbers of patients without regard to clinical subpopulations have failed to show significant differences between infected and uninfected couples.(ABSTRACT TRUNCATED AT 250 WORDS)

Murine respiratory mycoplasmosis in F344 and LEW rats: evolution of lesions and lung lymphoid cell populations

By comparison of two strains, LEW and F344, which are known to differ in susceptibility to Mycoplasma pulmonis respiratory disease, it was shown that differences in lesion severity and progression were associated with changes in lung lymphocyte populations. Lung lesions in LEW rats developed earlier after infection, became more severe, and were characterized by continued proliferation of all classes of lymphoid cells, T lymphocytes, B lymphocytes, and plasma cells, throughout the 120-day observation period. In contrast, lymphoid proliferation in F344 rats reached a plateau at 28 days and was restricted to an increase in T lymphocytes, immunoglobulin A (IgA)-bearing B lymphocytes, and IgA and IgG plasma cells. Although approximately 10 times as many IgG B cells and 4 times as many IgG plasma cells were found in infected LEW rats as compared with F344 rats, the specific anti-M. pulmonis IgG response in the two strains was roughly parallel. The same relationships held true, although to a lesser extent, for specific IgA antibody responses and cellular responses. Whereas lung lesions showed a tendency to resolve in F344 rats by 120 days, severe lesions persisted in LEW rats. The disparity between the cellular response and specific antibody response, the seemingly uncontrolled lymphocyte proliferation in LEW rats, and the mitogenic potential of M. pulmonis suggest that differences between LEW and F344 rats in lung lesion severity and progression are related to differences in the degree of nonspecific lymphocyte activation in the two strains, an imbalance in regulation of lymphocyte proliferation in LEW rats, or both.

Comparison of methods for detection of Mycoplasma pulmonis in experimentally and naturally infected rats

Isolation, indirect immunofluorescence, an enzyme-linked immunosorbent assay (ELISA), and histopathological examination of tissues for characteristic lesions were evaluated for their efficiency in detecting Mycoplasma pulmonis infection in rats. Whereas all of the methods were efficient in naturally infected Sprague-Dawley rats, none of the methods consistently detected infection in F344 rats experimentally infected with low doses of the organism. In the experimental infections, however, the success rate of any method was directly related (P less than 0.05) to increasing inoculum dose and time postinoculation. Collectively, the data indicated that isolation of M. pulmonis was the most efficient single detection method and the nasopharyngeal duct was the best single site to culture, although sampling of multiple sites within the respiratory tract increased the rate of isolating the organism. The ELISA was understandably the least sensitive method in the low-dose, experimentally infected rats because of the time required for development of a detectable serum antibody response. Although each of the four methods identified a high percentage of naturally infected rats, the ELISA was the most efficient method in these animals as it was uniformly positive. The use of combinations of methods was found to increase the rate of detection of M. pulmonis infection in both experimentally and naturally infected rats.

Detection of natural Mycoplasma pulmonis infection in rats and mice by an enzyme linked immunosorbent assay (ELISA)

A total of 2,194 rats and mice representing 10 rat and nine mouse strains from eight commercial breeding facilities and 19 research institutions were tested for Mycoplasma pulmonis antibodies of the IgG and IgM classes by an enzyme-linked immunosorbent assay (ELISA). Cultural data also were obtained from 1,139 of these animals and histopathological data from 410. Reliability of the IgG ELISA for detection of infection in rats and mice was found to be excellent. Virtually no rat or mouse colony was culturally negative and IgG ELISA positive, or vice versa. However, discrepancies between ELISA and cultural results were observed in individual animals. Discrepancies occurred significantly more often with the IgM than IgG ELISA and more so in mice than in rats, particularly in barrier-maintained animals. Agreement of the IgG and IgM ELISA with culture in barrier-maintained rats was 100% and 94%, respectively and in barrier-maintained mice 87% and 69%, respectively. Available evidence suggested that some of the discrepancies in mice could be due to either active or previous low level infection or failure to culture multiple sites. However, the greatly reduce correlation of the IgM ELISA and culture in mice was incompletely understood, and in the absence of other evidence of infection must be interpreted with caution. Even though the present study was not designed to determine comprehensive incidence figures, the results indicated widespread Mycoplasma pulmonis infection both in conventional and "barrier-maintained" colonies as demonstrated by ELISA a well as cultural isolation.

Transfer effects in feature-positive and feature-negative learning by adult humans

In two experiments, college students performed a feature-positive or a feature-negative discrimination task based on colors or symbols and were then transferred to a feature-positive or feature-negative discrimination based on the other stimulus dimension (symbols-colors, colors-symbols). Initial task results yielded a substantial feature-positive effect and indicated that the color task was easier than the symbol task. Transfer task results indicated that the feature-positive effect was maintained and showed that consistent transfer (positive-positive, negative-negative) led to superior performance on the transfer task. These results were obtained when the correct solution to the initial task was provided to the subject prior to transfer (Experiment 1) and when it was not (Experiment 2). These results systematically replicated the existence of the feature-positive effect in adult humans and showed that both feature-positive and feature-negative discrimination learning were facilitated by consistent examples of these problems.

Infant pneumonitis associated with cytomegalovirus, Chlamydia, Pneumocystis, and Ureaplasma: a prospective study

In a prospective study of 104 infants between 1 and 3 months of age hospitalized with pneumonitis, 65 (63%) had evidence of infection with one or more potential respiratory pathogens. Single infections were noted in 48 (74%) whereas mixed infections occurred in 17 (26%) of 65 infected infants. The four most common infections were Chlamydia trachomatis (15/59, 25%), Ureaplasma urealyticum (8/38, 21%), cytomegalovirus (21/104, 20%), and Pneumocystis carinii (19/104, 18%). In sharp contrast, the incidence of these infections in control infants was 0% (0/25), 4% (2/49), 3% (3/97), and 0% (0/64), respectively. The clinical, radiologic, and laboratory characteristics of the pneumonitis syndrome associated with Chlamydia, cytomegalovirus, and Pneumocystis were indistinguishable from each other. Patients with mixed infections had a more severe pneumonitis as measured by the occurrence of apnea and the need of oxygen therapy an mechanical ventilation. The patients enrolled in this study are being followed-up to determine the longitudinal course of these infections.

Strategies for the selection of log-linear models

In a multidimensional contingency table strategies have been proposed to build log-linear models using either stepwise methods or standardized estimates of the parameters of the saturated model. Brown (1976) proposed a two-step procedure to screen effects and then test a subset of models. Alternate methods of model building are discussed with respect to the final choice of model and with respect to intermediate information available to the data analyst during the selection process.

Paternity tests in multisired beef herds by blood grouping

The number of offspring sired by individual bulls in multisired beef herds was determined by blood grouping. Six series of tests, each having from 3 to 18 bulls as possible sires,, yielded from 35 to 114 dam-offspring pairs. The paternity was established for 45 to 90 % of the calves tested in each series. The rest were cases with either more than 1 bull not being excluded as the possible sire, or all bulls excluded from being the sire. The causes for the non-established paternities are discussed. Highly significant differences were found in the number of offspring sired by each bull. In each series, bulls ranking in the top third of the siring order sired 65–100 % of the calves with established paternities. Since a minority of the bulls sired the majority of the calf-crop, the generally recomended number of bulls for herds on the range can perhaps be reduced.

Accumulation of some secretory enzymes in venom glands of Vipera palaestinae

Secretion of venom in the venom glands of Vipera palaestinae was studied by measuring the protein content and enzymatic activities of L-amino acid oxidase (LAO), phosphodiesterase (PDE), and benzoylarginine ethyl esterase (BAEE). These were tested in the accumulating venom and gland homogenates at 0, 2, 3, 4,6, and 15 days after an intitial emptying of the venom glands by milking. Changes in the total activities of the enzymes and in the protein concentration were found in the venom samples, but not in the homogenates, at the different intervals after milking. In the venom the total activities of LAO, PDE, and BAEE were higher the longer the time intervals from the initial milking. When the data were fit by a straight line, the fluctuations from the line were of opposite signs for LAO and PDE at the 3- and the 4-day intervals. There were no significant correlations between the specific activities or between the changes in the specific activities of any two of the enzymes at any time interval. It is concluded that each of the enzymes is secreted at a rate independent of the other two; this pattern of secretion can best be described as nonparallel.