Augmentin in the combined therapy of puerperal diseases]

Augmentin was used in treatment of mild forms of postnatal endometritis and serous mastitis. Augmentin tablets proved to be efficient in endometritis due to enterobacteria and obligate nonsporulating anaerobes and mastitis due to Staphylococcus aureus strains sensitive to the preparation. No adverse events were recorded. It was shown that in the treatment of mild postnatal infections the augmentin tablets were not inferior by their activity of combinations of antibiotics against aerobic and anaerobic microflora.     

Endometritis in the mare: A comparison between reproductive history and uterine biopsy as techniques for predicting susceptibility of mares to uterine infection

Thirty mares with no clinical signs of endometritis were categorized as being susceptible or resistant to uterine infection depending on whether or not they had a history of recurrent endometritis. The same mares were then independently classified as susceptible or resistant on the basis of their uterine biopsies; those with significant endometrial degeneration were considered to be susceptible to endometritis. The mares then received an intrauterine inoculation of pathogenic Streptococcus zooepidemicus . Those mares which eliminated bacteria by 10 d after inoculation were considered truly resistant to endometritis, whereas those still infected at 10 d were considered susceptible. The original classifications based on history or biopsy were compared to the inoculation results. A history of recurrent endometritis provided a more sensitive (0.90) and specific (0.95) indication of susceptibility to uterine infection than a uterine biopsy with significant endometrial degeneration (sensitivity 0.5, specificity 0.75).     

The detection of endometrial tuberculosis in cases of infertility by uterine aspiration cytology

The cytology and histopathology of tuberculous endometritis are described in eight cases found among 200 women who presented with primary or secondary infertility. Because tuberculous endometritis is considered a possible cause of such sterility, the combination of endometrial aspiration and biopsy is recommended as an outpatient screening technique in such cases in areas where the rate of endometrial tuberculosis is high.     

患子宫内膜炎母猪产道致病菌谱分析及卟啉单胞菌的分离鉴定

【背景】子宫内膜炎是规模化养殖场母猪常患的生殖道疾病之一,对养殖业造成的经济损失较大,细菌感染是常见的病因之一,但具体病原及致病机制尚未完全明确。【目的】探究产道菌群对母猪子宫内膜炎的影响。【方法】采用第三代细菌16S rRNA基因全长高通量测序技术进行对比,研究健康和患有子宫内膜炎母猪产道菌群差异,并依据菌群分析结果对子宫内膜炎母猪产道分泌物进行细菌分离。建立荧光定量PCR计数方法测定母猪产道样品中的卟啉单胞菌数。【结果】健康和患子宫内膜炎母猪产道菌群的丰富度和多样性差异显著;与健康组母猪相比,患子宫内膜炎母猪产道菌群变形菌门(Proteobacteria)、拟杆菌门相对丰度显著增加(P<0.05)。在属分类水平上,健康母猪产道的主要优势菌属为金黄杆菌属、芽孢杆菌属、毛螺菌属等,这些优势属在患子宫内膜炎母猪产道丰度降低,患子宫内膜炎母猪产道丰度最高的菌属为埃希氏菌属(Escherichia)、Rodentibacter和卟啉单胞菌属(Porphyromonas)。在种水平上,Porphyromonas somerae是患子宫内膜炎母猪产道的主要条件性致病菌。依据菌群分析结果,本研究从子宫内膜炎母猪产道分泌物中分离到一株卟啉单胞菌,经鉴定该菌16S rRNA基因与Porphyromonas somerae DSM 23386 strain JCM 13867(NR_113090.1)相似性达99.04%。荧光定量PCR计数方法测定,子宫内膜炎母猪产道卟啉单胞菌数量显著高于健康母猪(P<0.05),推测卟啉单胞菌与该批次母猪子宫内膜炎病因有关。【结论】本研究为子宫内膜炎母猪的病因和发病机制奠定基础,并为其治疗提供理论依据。     

Clinical evaluation of postpartum vaginal mucus reflects uterine bacterial infection and the immune response in cattle

Bacteria contaminate the uterus of most dairy cattle after parturition and endometritis causes infertility. An endometritis score can be ascribed based on the vaginal mucus character and odour but it is not clear if the clinical score reflects the number of uterine bacteria or the inflammatory response. The present study tested the hypothesis that clinical evaluation of endometritis reflects the number of bacteria present in the uterus, and the acute phase protein response. Swabs (n = 328) were collected from the uterine lumen of dairy cattle, 21 and 28 days postpartum, vaginal mucus was scored for character and odour, and blood samples collected for acute phase protein measurement. Bacteria were identified following aerobic and anaerobic culture, and the bacterial growth density was scored semi-quantitatively. When bacteria were categorised by their expected pathogenic potential in the uterus, purulent or fetid odour vaginal mucus was associated with the growth density of pathogenic bacteria but not opportunist contaminants. When bacteria were analysed independently, Arcanobacterium pyogenes, Proteus and Fusobacterium necrophorum growth densities were associated with mucopurulent or purulent vaginal mucus. The bacterial growth densities for A. pyogenes, Escherichia coli, non-hemolytic Streptococci, and Mannheimia haemolytica were associated with a fetid mucus odour. Peripheral plasma concentrations of alpha(1)-acid glycoprotein were higher if there was a fetid compared with a normal vaginal mucus odour (1.50 +/- 0.09 mg/mL versus 1.05 +/- 0.02 mg/mL, P < 0.001), but did not differ significantly between vaginal mucus character scores. The evaluation of the character and odour of vaginal mucus reflects the number of bacteria in the uterus, and the acute phase protein response.     

Endometritis treatment with a PGF2alpha analog does not improve reproductive performance in a large dairy herd in Argentina

In Argentina, most dairy cows with endometritis are treated with prostaglandin (PGF(2alpha) or its analogs) and insemination is withheld until there are no signs of endometritis. The objective of the present study was to evaluate if this method of managing endometritis enhances reproductive performance. Three experiments were conducted over 4 years in a large farm in the west of Buenos Aires province. In Experiment 1, half of the cows diagnosed with endometritis (>1.5-fold difference in diameter of uterine horns, as determined by rectal palpation) received standard endometritis management (treatment with tiaprost, a PGF(2alpha) analog, rectal palpation every 20 days, and withholding of AI until endometritis apparently resolved) and the other half was untreated, with AI at the first estrus after the voluntary waiting period. Untreated cows were inseminated and conceived 20 days earlier than treated cows, and the pregnancy rate by Day 90 postpartum was higher in the untreated group. In Experiment 2, cows with endometritis were divided into four groups according to the severity of symptoms; within each group, cows were allocated to treatment or control, as in Experiment 1. Although first service conception rate decreased as endometritis severity increased, reproductive performance in treated versus control cows was similar to that of Experiment 1 (with no interaction due to degree of endometritis). Re-evaluation of the treated cow (to confirm uterine "normality") may have been responsible for the delay in conception in both experiments. The objective of Experiment 3 was to determine the effects of tiaprost treatment on clinically normal postpartum cows (no evidence of endometritis). Tiaprost treatment reduced the interval from calving to conception in multiparous cows, but it delayed conception and reduced the conception rate in primiparous cows. In conclusion, treatment with tiaprost impaired reproductive performance in primiparous cows (in the absence of endometritis). Furthermore, the standard treatment for endometritis (treatment with a prostaglandin analog and withholding insemination until clinical signs abated) impaired reproductive performance and increased costs.     

凝固酶阴性葡萄球菌致新生儿败血症临床分析

目的了解本地区凝固酶阴性葡萄球菌（CNS）致新生儿败血症的病原学及耐药性状况,用以指导临床治疗。方法回顾性分析64株CNS致新生儿败血症血培养的病原学及耐药性。结果64株CNS中以表皮葡萄球菌和溶血葡萄球菌为主;耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）39株,分离率为60．9％,β-内酰胺酶检出率达100％,MRCNS对青霉素、红霉素、苯唑西林耐药率最高,对利福平、呋西地酸、替考拉宁、喹奴普汀／达福普汀等耐药率均较低;甲氧西林敏感凝固酶阴性葡萄球菌（MSCNS）25株,分离率为39．1％,13-内酰胺酶检出率为44％,MSCNS对大多数抗生素敏感;64株CNS中未检测到万古霉素耐药株。结论新生儿败血症中CNS以表皮葡萄球菌和溶血葡萄球菌为主,MRCNS检出率高且呈多重耐药,应重视对其监测与控制。     

奶牛阴道嗜酸乳杆菌生物学特性的研究

通过生长曲线、最适培养温度、最适培养方式、体外抑制奶牛子宫内膜炎常见病原菌的效果及其与奶牛子宫内膜上皮细胞黏附性等一系列实验,对1株分离自健康奶牛阴道的嗜酸乳杆菌进行生物学特性的研究。结果表明该菌最适培养温度为39℃,在偏于厌氧的环境下生长最佳,在培养18~20 h后收获最佳,对奶牛子宫内膜炎常见病原菌具有一定的抑制作用,并与奶牛子宫内膜上皮细胞具有一定的黏附作用。     

Association between endometritis diagnosis using a novel intravaginal device and reproductive performance in dairy cattle

Endometritis reduces reproductive performance in dairy cattle. Diagnosis of endometritis is undertaken using a variety of techniques including vaginoscopy, manual examination, cytology and ultrasonography. The current studies compared a novel test device ("metricheck") that is inserted into the vagina with vaginoscopy and then examined the relationship between the metricheck test score at 35 days before the start of the seasonal breeding programme and subsequent reproductive performance. Cows (n = 191; Study 1) with a history of a peripartum disease were examined by both vaginoscopy and the metricheck device and any material viewed within the vagina (using vaginoscopy) or retrieved (by the metricheck device) was scored on a 0 (no material) to 5 (grossly purulent and with an odour) scale. Within each herd the order of examination was randomized with sequentially presented pairs of cows. All cows (n = 2793; Study 2) from nine herds were examined and scored using the metricheck device 35 days before the start of the seasonal breeding programme. All cows were pregnancy tested to determine date of conception. In Study 1, more cows were defined as infected (i.e. score > 1) following metricheck than vaginoscopic examination (60% versus 43%, respectively; P < 0.05) and the level of agreement between the two tests was moderate (kappa = 0.45). The metricheck device had a higher sensitivity, but lower specificity, than vaginoscopy. Endometritis (i.e. score > 1) was detected in 21.2% of cows examined in Study 2. The prevalence of endometritis varied among herds, declined with time postpartum (P < 0.05) and was higher in cows recorded as having a peripartum disease (P < 0.01). Cows diagnosed with endometritis were at higher risk of not being detected in oestrus before the start of breeding (P < 0.01), took longer to be inseminated after the start of the seasonal breeding programme (P < 0.01), had a lower first service conception rate (P < 0.01), had lower 56-day and final pregnancy rates (P < 0.05) and took longer to conceive than cows without endometritis (P < 0.05). It is concluded that examination with the metricheck device is more sensitive in detecting endometritis than vaginoscopy. Diagnosis of endometritis with the metricheck device was associated with poorer subsequent reproductive performance.     

Effect of presence of clinical and subclinical endometritis at the initiation of Presynch-Ovsynch program on the first service pregnancy in dairy cows

The present study examined the effect of presence of clinical or subclinical endometritis at the initiation of Presynch-Ovsynch estrous synchronization program on the first service pregnancy rate in dairy cows. Lactating Holstein cows (N=275) were given a thorough reproductive examination at 32-38 days in milk, 3 days prior to the scheduled start of Presynch-Ovsynch program. Based on the reproductive exam findings the cows were diagnosed and classified into three groups as clinical endometritis, subclinical endometritis and normal. All cows received two set-up injections of 25mg PGF(2alpha) (Lutalyse((R)), Pfizer Animal Health, New York, NY, USA) i.m., 14 days apart starting at 35-42 days in milk (DIM). All cows received 75microg of GnRH (Cystorelin, Merial, Iselin, NJ, USA) i.m. 14 days after the second pre-synchronization injection of PGF(2alpha), followed by a third injection of 25mg PGF(2alpha) i.m. 7 days later. Cows received a second injection of 75microg of GnRH i.m. 54h after the third PGF(2alpha), and received timed artificial insemination at the time of the second GnRH injection or 24h later. Multivariate logistic regression was used to analyze the odds of pregnancy at the first service. Variables included in the model were endometritis status (clinical endometritis, subclinical endometritis and normal), farm (two), presence of corpus luteum (CL, yes or no), timing of second GnRH in relation to AI (0 or 24h), sire fertility (bulls with greater compared with lesser estimated relative conception rates), parity (primiparous and multiparous) and their interactions. Of all variable included in the model, cows with corpus letuem (OR=1.83 versus OR=1.00; P=0.05) 3 days prior to the scheduled start of Presynch-Ovsynch program and primiparous cows (OR=1.00 versus OR=0.55; P=0.04) had increased odds of becoming pregnant at the first service. No differences were found in the odds of first service pregnancy among clinical, subclinical endometritis and normal cows (P>0.1). In summary, presence of clinical or subclinical endometritis at the initiation of Presynch-Ovsynch estrous synchronization program does not harm the first service pregnancy rate in dairy cows.     

Exosome-derived uterine microRNAs isolated from cows with endometritis impede blastocyst development

As a common disease of cows occurring during their perinatal period, endometritis is known to affect fertility. At present, the studies on endometritis mainly focus on preventing microbial invasion. However, the mechanism that uterine inflammation affects embryo activity and implantation is unclear. Mainly containing lipids, proteins, mRNAs, and microRNAs, exosomes widely exist in various tissues and body fluids. Exosome extractions were used by commercial kits and confirmed through morphological examinations and Western blot. After exosomes’ mRNA profiles were generated using RNA sequencing, it was investigated how uterine cavity fluid exosomes affect the developmental competence of in vitro fertilization (IVF) embryos in case of endometritis. In this study, the isolated exosomes were spherical particles with a diameter of 30–150 nm according to the transmission electron microscopy. Identified with Western blotting, positive CD63 and CD9 expressions showed that the isolated exosomes could be used for the subsequent tests. We found 118 differentially expressed miRNAs in the exosomes of the uterine cavity fluid in healthy cows and those with endometritis, among which, 52 miRNAs were down regulated and 66 up regulated. Furthermore, the qRT-PCR results confirmed the up-regulation of three miRNAs and down-regulation of six miRNAs, which were consistent with the deep sequencing results. IVF embryos co-incubated with the endometritis exosomes significantly decreased the blastocyst formation rate in comparison with those co-incubated with the healthy exosomes (21.84+3.17 vs. 32.37+2.69). Therefore, exosome miRNAs may be a cause of infertility in cows with endometritis.     

Microbial diversity of genital ulcer disease in men enrolled in a randomized trial of male circumcision in kisumu, kenya

Background

Medical male circumcision (MMC) reduces the risk of genital ulcer disease (GUD) in men by 50%. In Ugandan and Kenyan trials, a sexually transmissible agent was not identified in 50–60% of GUD specimens by polymerase chain reaction (PCR) assay. We sought to better define the etiology of GUD in men participating in the Kenyan trial and examine how MMC affects GUD etiology.

Methods

We defined GUD of unknown etiology as negative for HSV (type 1 and type 2), T. pallidum, and H. ducreyi by PCR, and negative for HSV-2 and T. pallidum by serology. We identified bacterial microbiota in a subset of 59 GUD specimens using multitag pyrosequencing of the 16S rRNA gene, and compared results by unknown vs. STI-associated etiology. Statistical analysis employed Bray-Curtis similarity measure of bacterial community by etiology, hierarchical clustering and logistic regression.

Results

In 59 GUD specimens from 59 men, 23 (39%) had unknown etiology. Bacterial diversity was greater in GUD of unknown than STI etiology (p = 0.01). Fusobacteria (Fusobacterium spp. and Sneathia spp.) were more commonly detected in men with GUD of unknown etiology [adjusted OR = 5.67; 95% CI: 1.63–19.8] as were Oxobacter spp. and Anaerovorax spp. [adjusted OR = 3.12; 95% CI: 0.83–11.7]. Sequences from these four anaerobic bacterial taxa were more often detected in uncircumcised men than circumcised men (p<0.05).

Conclusions

Anaerobic bacteria are more common in genital ulcers of uncircumcised men. The specific anaerobic bacteria associated with GUD of unknown etiology have cytotoxic properties that can exacerbate epithelial disruptions leading to ulcer-like appearance. MMC may reduce GUD through a reduction in these anaerobic bacteria.     

The place of molecular genetic methods in the diagnostics of human pathogenic anaerobic bacteria. A minireview

Anaerobic infections are common and can cause diseases associated with severe morbidity, but are easily overlooked in clinical settings. Both the relatively small number of infections due to exogenous anaerobes and the much larger number of infections involving anaerobic species that are originally members of the normal flora, may lead to a life-threatening situation unless appropriate treatment is instituted. Special laboratory procedures are needed for the isolation, identification and susceptibility testing of this diverse group of bacteria. Since many anaerobes grow more slowly than the facultative or aerobic bacteria, and particularly since clinical specimens yielding anaerobic bacteria commonly contain several organisms and often very complex mixtures of aerobic and anaerobic bacteria, considerable time may elapse before the laboratory is able to provide a final report. Species definition based on phenotypic features is often time-consuming and is not always easy to carry out. Molecular genetic methods may help in the everyday clinical microbiological practice in laboratories dealing with the diagnostics of anaerobic infections. Methods have been introduced for species diagnostics, such as 16S rRNA PCR-RFLP profile determination, which can help to distinguish species of Bacteroides, Prevotella, Actinomyces, etc. that are otherwise difficult to differentiate. The use of DNA-DNA hybridization and the sequencing of special regions of the 16S rRNA have revealed fundamental taxonomic changes among anaerobic bacteria. Some anaerobic bacteria are extremely slow growing or not cultivatable at all. To detect them in special infections involving flora changes due to oral malignancy or periodontitis, for instance, a PCR-based hybridization technique is used. Molecular methods have demonstrated the spread of specific resistance genes among the most important anaerobic bacteria, the members of the Bacteroides genus. Their detection and investigation of the IS elements involved in their expression may facilitate following of the spread of antibiotic resistance among anaerobic bacteria involved in infections and in the normal flora members. Molecular methods (a search for toxin genes and ribotyping) may promote a better understanding of the pathogenic features of some anaerobic infections, such as the nosocomial diarrhoea caused by C. difficile and its spread in the hospital environment and the community. The investigation of toxin production at a molecular level helps in the detection of new toxin types. This mini-review surveys some of the results obtained by our group and others using molecular genetic methods in anaerobic diagnostics.     

Risk factors for clinical endometritis in postpartum dairy cattle

Bacterial contamination of the uterine lumen after parturition occurs in most dairy cattle. The presence of clinical endometritis beyond three weeks post partum depends on the balance between microbes, host immunity, and other environmental or animal factors. The present study tested the hypothesis that clinical endometritis is associated with animal factors, such as retained fetal membranes, assisted calving and twins, as well as fecal contamination of the environment. The association between selected risk factors and the lactational incidence risk of clinical endometritis was examined in 293 animals from four dairy herds. Multivariate analysis was used to identify risk factors and quantify their relative risk (RR) and population attributable fraction (PAF) based on the proportion of cows exposed to each factor. The lactational incidence of clinical endometritis was 27% and significant risk factors for clinical endometritis were retained fetal membranes (RR = 3.6), assisted calving (RR = 1.7), stillbirth (RR = 3.1), vulval angle (RR = 1.3), primparity (RR = 1.8), and male offspring (RR = 1.5) but not the cleanliness of the environment or the animal. The highest PAF was associated with male offspring (0.6) so the use of sexed semen has the greatest potential to reduce the incidence of clinical endometritis. The dominant association between retained fetal membranes and clinical endometritis was supported by an expert panel of clinicians. The risk factors for clinical endometritis appear to be associated with trauma of the female genital tract and disruption of the physical barriers to infection rather than fecal contamination.     

厌氧真菌和甲烷菌共培养的研究进展

厌氧真菌是自然界中降解植物纤维素类物质最高效的微生物之一.近年来,大量厌氧真菌和甲烷菌共培养菌株被分离.共培养中,甲烷菌通过对厌氧真菌代谢产物的利用显著提高厌氧真菌对木质纤维素的降解;厌氧真菌通过为甲烷菌提供能量和营养物质使甲烷菌快速生成大量甲烷.全面深入地了解共培养中两者的互作关系以及共培养降解木质纤维素产甲烷的特性...     

The characteristics of the microflora isolated in bovine endometritis]

117 pure bacterial cultures of numerous species isolated by the authors at acute postnatal pyo-catarrhal cattle endometritis have been studied for their virulence and resistance to 18 antibiotics with the aim to determine their etiologic role in the development of the given pathology and to make a prediction estimation of possible therapeutic and preventive efficiency of the antibiotics. The experiments on white mice have revealed pathogenic properties and virulence in most studied strains of bacteria of different species. The studied microflora is, mainly, resistant practically to all 18 tested antibiotics. A direct dependence is established between virulence of the microflora, isolated in case of endometritis, and its resistance to antibiotics.     

Sensitivity of Escherichia coli to proline analogues during osmotic stress and anaerobiosis

L.M. REESE, K.O. CUTLER AND C.E. DEUTCH. 1996. The sensitivity of wild-type Escherichia coli K-12 to a series of proline analogues was determined in cultures containing increasing concentrations of NaCl under both aerobic and anaerobic conditions. The bacteria were most sensitive to L-azetidine-2–carboxylate and L-thiazolidine-4–carboxylate. The minimum inhibitory concentrations for these compounds decreased progressively during osmotic stress, but the bacteria were much more sensitive to these proline analogues under aerobic conditions than during anaerobiosis. The reduced sensitivity under anaerobic conditions did not reflect degradation of the compounds in the culture medium. Since both urine and medullary renal tissue contain relatively low oxygen concentrations, these results raise doubts about the potential use of proline or glycine betaine analogues in treating urinary tract infections.     

Spontaneous recovery or persistence of postpartum endometritis and risk factors for its persistence in Holstein cows

It has been stated that postpartum endometritis in dairy cows has a tendency to cure without intervention. The objectives of this field study, therefore, were to determine the proportions of cows with spontaneous clinical recovery or persistence of postpartum endometritis and to determine some risk factors for its persistency in dairy cows (Bos taurus). Holstein-Friesian cows (n = 441 lactations) from seven dairy herds were examined monthly by vaginoscopy and transrectal palpation. A cow was considered to have “postpartum endometritis” if it had pus in the cervico-vaginal discharge at the first postpartum examination during Days 15 to 60 (Day 0 = day of calving); this was classified as mild, mucopurulent, or purulent endometritis, or endometritis with fluid in uterus. Furthermore, a cow with evidence of endometritis at least once during Days 61 to 150 was considered to have “persistence (or recurrence) of endometritis.” A total of 104 (23.6%) lactations had postpartum endometritis, of which 25.3% had persistence or recurrence of clinical endometritis. Cows with persistence or recurrence of endometritis became pregnant at a slower rate (hazard ratio [HR] = 0.28; P < 0.001) than those with no endometritis until Day 150. Calving in summer (odds ratio [OR] = 7.00; P = 0.04), early postpartum complications (OR = 6.58; P = 0.05), moderate (OR = 4.03; P = 0.08) and severe (OR = 30.99; P = 004) degrees of urovagina, and mucopurulent (OR = 9.54; P = 0.02) and purulent (OR = 5.70; P = 0.04) endometritis were risk factors for the persistence or recurrence of endometritis. Furthermore, 10.6% of cows that had not shown signs of postpartum endometritis had a new diagnosis of endometritis during Days 61 to 150. Some risk factors for the new diagnosis of endometritis beyond Day 60 were early postpartum complications (OR = 2.82; P = 0.03) and moderate (OR = 5.00; P = 0.001) or severe (OR = 12.63; P < 0.001) degrees of urovagina. In conclusion, approximately one quarter of cows with postpartum endometritis had persistence of endometritis until or beyond the breeding period. Risk factors for the persistence of clinical endometritis were summer calving, early postpartum complications, clinically relevant urovagina, and clinically relevant endometritis within 2 mo postpartum.     

The effects of EDTA-Tris infusion on the equine endometrium

Four groups of five pony mares each were used to determine if the intrauterine infusion of EDTA-Tris solution caused adverse effects on the endometrium. The uteri of mares were infused with either saline or EDTA-Tris solution or biopsied or sham-biopsied without infusion. Acute endometritis developed in one (20%) to three (60%) mares in each group during the seven days following treatment, but there were no differences (P > 0.05) in the incidence of endometritis among the groups. Endometrial fibrosis was not evident in biopsies taken on days 14, 30 and 60 following infusion of saline or EDTA-Tris. It was concluded that the endometrial response to saline and EDTA-Tris was not different and that EDTA-Tris may be a useful adjunct to treatment of uterine infections in the mare.