Tumor necrosis factor in peritoneal fluid from asymptomatic infertile women.

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) is a cytokine that can be found in the peritoneal fluid (PF) of patients with endometriosis and pelvic inflammatory disease (PID) as a response to inflammatory disorders and infections. The cytotoxic effect of this cytokine could be a factor participating in the pathology of various gynecological diseases, and could also be accountable for the high immunological response and damage to the tubal epithelium. The objective of this study was to establish the presence of TNF-alpha in asymptomatic infertility and its association with various isolated bacteria. METHODS: Ten milliliters of PF were collected from each of 73 patients by means of laparoscopy and cultured in synthetic medium and McCoy cells for the isolation of aerobic and anaerobic bacteria, as well as for Chlamydia trachomatis. The activity of TNF-alpha was determined by means of a bioassay using L-929 cells. RESULTS: Forty-three percent of the PFs showed positive TNF-alpha activity, while the laparoscopic evaluation showed that 32 patients had Fallopian tube occlusion (FTO), 7 had endometriosis, 30 had PID, and 4 had myomas and adhesions. TNF-alpha activity was found to be high in FTO patients (p < 0.05). Positive cultures were found in 50.7% of patients; of these, 31.5% had PID (p < 0.05), and only 20.5% of positive cultures were TNF-alpha positive. Chlamydia trachomatis (16%) was the most frequently isolated bacteria in these patients. CONCLUSIONS: The detection of TNF-alpha could be useful in the diagnosis of active infectious and inflammatory diseases in asymptomatic infertile patients.

[Determination of the tumor necrosis factor in the peritoneal fluid of gynecologic patients with intraperitoneal infections and endometriosis]. / Determinación del factor de necrosis tumoral en líquido peritoneal de pacientes ginecológicas con infecciones intraperitoneales y endometriosis.

Tumor necrosis factor (TNF-alpha) is a cytokine which can be found in peritoneal fluid (PF) of patients with endometriosis and pelvic inflammatory disease (PID) as a response of inflammatory disorder and infections diseases. The cytotoxic effect of this cytokine could be participating in the pathology of different gynecologic problem and be accountable of the high immunological response and damage on the tubal epithelium. The objective of this study was determinate the presence of TNF-alpha in PF of endometriosis patients, fallopian tube occlusion (FTO) and PID and their correlation with different isolated bacteria. Ten mililiter PF were collected and cultured in antificial medium and Mc Coy culture cells for isolation of acrobic, and anaerobic bacteria and Chlamydia trachomatis from 73 patients by laparoscopy. The TNF-alpha activity was determined by L-929 cells endometriosis, 30 PID and 4 had miomas and adherences. The 50.7% of patients were cultive positive, fom these, 31.5% were PID. Chlamydia trachomatis (16%) was the most frecuenty isolated bacteria in these patients. 59.4% of FTO patients displayed TNF-alpha activity. However, only 4% showed positive isolation, in conclusion the detection of TNF-alpha could be useful in active infectious and inflammatory diseases in patients which not present simptomatologic characteristic of these illnesses and plus being attended at for sterility clinical as a result of their incapacity to get pregnant.

[Evaluation of sensitivity and specificity of 3 reagents of direct immunofluorescence in the diagnosis of Chlamydia trachomatis]. / Evaluación de la sensibilidad y especificidad de tres reactivos de inmunofluorescencia directa para el diagnóstico de Chlamydia trachomatis.

The sensitivity, specificity, positive and negative predictive values and positive and negative false percentage of three monoclonal immunofluorescence reagents for direct diagnosis of Chlamydia trachomatis infections were evaluated, 150 cervical specimens and 50 samples of peritoneal liquid of patients with pelvic inflammatory disease, were studied. The results showed that the reagents against the main protein of external membrane of Chlamydia introduced high sensitivity but minor specificity than the reagent of immunofluorescence direct against then chlamydial lipopolysaccharide.

Neonatal septicaemia due to K. pneumoniae. Septicaemia due to Klebsiella pneumoniae in newborn infants. Nosocomial outbreak in an intensive care unit.

The authors report a nosocomial infection outbreak by Klebsiella pneumoniae, observed in neonates at a gyneco-obstetrical hospital from Mexico City. Forty six newborns presented one or more infections due to K. pneumoniae during their stay in neonatal care units, between October 3 and November 12, 1988. Sepsis was documented in 41 cases by clinical picture and routine laboratory exams, including one positive, blood culture at least. The most frequent invasive procedures practiced in these patients were catheterization and ventilatory support. K. pneumoniae was isolated as well from several environmental sources that could have led to infection of patients. Treatment of cases was initiated with ampicillin-amikacin, however, therapeutic failure with a lethality rate of 50% (14/28) and results of antimicrobial susceptibility conducted to treatment with cefotaxime. Fifteen out of 19 patients receiving the cephalosporin survived. To prevent outbreaks like the one presented here, we concluded that appropriate measures dealing with hygiene and education of personnel plus monitoring of bacterial susceptibility to antimicrobials, should prove successful in our environment.