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2.
mBio ; 15(6): e0102724, 2024 Jun 12.
Article En | MEDLINE | ID: mdl-38742889

Escherichia coli has been attributed to playing a major role in a cascade of events that affect the prevalence and severity of uterine disease in cattle. The objectives of this project were to (i) define the association between the prevalence of specific antimicrobial resistance and virulence factor genes in E. coli with the clinical status related to uterine infection, (ii) identify the genetic relationship between E. coli isolates from cows with diarrhea, with mastitis, and with and without metritis, and (iii) determine the association between the phenotypic and genotypic antimicrobial resistance identified on the E. coli isolated from postpartum cattle. Bacterial isolates (n = 148) were obtained from a larger cross-sectional study. Cows were categorized into one of three clinical groups before enrollment: metritis, cows with purulent discharge, and control cows. For genomic comparison, public genomes (n = 130) from cows with diarrhea, mastitis, and metritis were included in a genome-wide association study, to evaluate differences between the drug classes or the virulence factor category among clinical groups. A distinct E. coli genotype associated with metritis could not be identified. Instead, a high genetic diversity among the isolates from uterine sources was present. A virulence factor previously associated with metritis (fimH) using PCR was not associated with metritis. There was moderate accuracy for whole-genome sequencing to predict phenotypic resistance, which varied depending on the antimicrobial tested. Findings from this study contradict the traditional pathotype classification and the unique intrauterine E. coli genotype associated with metritis in dairy cows.IMPORTANCEMetritis is a common infectious disease in dairy cattle and the second most common reason for treating a cow with antimicrobials. The pathophysiology of the disease is complex and is not completely understood. Specific endometrial pathogenic Escherichia coli have been reported to be adapted to the endometrium and sometimes lead to uterine disease. Unfortunately, the specific genomic details of the endometrial-adapted isolates have not been investigated using enough genomes to represent the genomic diversity of this organism to identify specific virulence genes that are consistently associated with disease development and severity. Results from this study provide key microbial ecological advances by elucidating and challenging accepted concepts for the role of Intrauterine E. coli in metritis in dairy cattle, especially contradicting the existence of a unique intrauterine E. coli genotype associated with metritis in dairy cows, which was not found in our study.


Cattle Diseases , Escherichia coli Infections , Escherichia coli , Genotype , Postpartum Period , Virulence Factors , Cattle , Animals , Female , Virulence Factors/genetics , Escherichia coli Infections/veterinary , Escherichia coli Infections/microbiology , Escherichia coli/genetics , Escherichia coli/pathogenicity , Escherichia coli/isolation & purification , Escherichia coli/classification , Cattle Diseases/microbiology , Cross-Sectional Studies , Whole Genome Sequencing , Uterine Diseases/microbiology , Uterine Diseases/veterinary , Uterine Diseases/genetics , Genome, Bacterial , Uterus/microbiology , Anti-Bacterial Agents/pharmacology , Genome-Wide Association Study , Drug Resistance, Bacterial/genetics
3.
Front Cell Infect Microbiol ; 14: 1351329, 2024.
Article En | MEDLINE | ID: mdl-38655283

Introduction: The potential role of the endometrial microbiota in the pathogenesis of endometrial polyps (EPs) warrants further investigation, given the current landscape of limited and inconclusive research findings. We aimed to explore the microecological characteristics of the uterine cavity in patients with EPs and investigate the potential of endometrial microbiota species as novel biomarkers for identifying EPs. Methods: Endometrial samples were collected from 225 patients who underwent hysteroscopies, of whom 167 had EPs, whereas 58 had non- hyperproliferative endometrium status. The endometrial microbiota was assessed using 16S rRNA gene sequencing. We characterized the endometrial microbiota and identified microbial biomarkers for predicting EPs. Results: The endometrial microbial diversity and composition were significantly different between the EP and control groups. Predictive functional analyses of the endometrial microbiota demonstrated significant alterations in pathways involved in sphingolipid metabolism, steroid hormone biosynthesis, and apoptosis between the two groups. Moreover, a classification model based on endometrial microbial ASV-based biomarkers along with the presence of abnormal uterine bleeding symptoms achieved powerful classification potential in identifying EPs in both the discovery and validation cohorts. Conclusion: Our study indicates a potential association between altered endometrial microbiota and EPs. Endometrial microbiota-based biomarkers may prove valuable for the diagnosis of EPs. Clinical trial registration: Chinese Clinical Trial Registry (ChiCTR2100052746).


Endometrium , Microbiota , Polyps , RNA, Ribosomal, 16S , Humans , Female , RNA, Ribosomal, 16S/genetics , Endometrium/microbiology , Endometrium/pathology , Microbiota/genetics , Polyps/microbiology , Middle Aged , Adult , Biomarkers , Uterine Diseases/microbiology , Bacteria/classification , Bacteria/genetics , Bacteria/isolation & purification
4.
Genes (Basel) ; 15(4)2024 03 30.
Article En | MEDLINE | ID: mdl-38674374

The metritis complex (MC), a group of post-partum uterine diseases, is associated with increased treatment costs and reduced milk yield and fertility. The goal of this study was to identify genetic variants, genes, or genomic regions that modulate MC disease. A genome-wide association study was performed using a single-locus mixed linear model of 1967 genotypes (624,460 SNPs) and metritis complex records. Then, in-silico functional analyses were performed to detect biological mechanisms and pathways associated with the development of MC. The ATP8A2, COX16, AMN, and TRAF3 genes, located on chromosomes 12, 10, and 21, were associated with MC at p ≤ 0.0001. These genes are involved in the regulation of cholesterol metabolism in the stromal tissue of the uterus, which can be directly associated with the mode of transmission for pathogens causing the metritis complex. The modulation of cholesterol abundance alters the efficiency of virulence factors and may affect the susceptibility of the host to infection. The SIPA1L1, DEPDC5, and RNF122 genes were also significantly associated with MC at p ≤ 0.0001 and are involved in the PI3k-Akt pathway, responsible for activating the autophagic processes. Thus, the dysregulation of these genes allows for unhindered bacterial invasion, replication, and survival within the endometrium.


Cattle Diseases , Genome-Wide Association Study , Polymorphism, Single Nucleotide , Animals , Female , Cattle , Cattle Diseases/genetics , Cattle Diseases/microbiology , Genetic Predisposition to Disease , Endometritis/genetics , Endometritis/microbiology , Endometritis/veterinary , Endometritis/pathology , Uterine Diseases/genetics , Uterine Diseases/microbiology , Uterine Diseases/pathology
5.
AJR Am J Roentgenol ; 216(3): 812-823, 2021 03.
Article En | MEDLINE | ID: mdl-33439049

OBJECTIVE. The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. CONCLUSION. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement.


Emphysema/diagnostic imaging , Gases , Tomography, X-Ray Computed , Abdominal Wall/diagnostic imaging , Abdominal Wall/microbiology , Abscess/diagnostic imaging , Abscess/microbiology , Aortitis/diagnostic imaging , Aortitis/microbiology , Cystitis/diagnostic imaging , Cystitis/microbiology , Emphysema/microbiology , Emphysematous Cholecystitis/diagnostic imaging , Emphysematous Cholecystitis/microbiology , Female , Fournier Gangrene/diagnostic imaging , Fournier Gangrene/microbiology , Gas Gangrene/diagnostic imaging , Gas Gangrene/microbiology , Gastritis/diagnostic imaging , Gastritis/microbiology , Hepatitis/diagnostic imaging , Hepatitis/microbiology , Humans , Male , Pancreatitis/diagnostic imaging , Pancreatitis/microbiology , Prostatic Diseases/diagnostic imaging , Prostatic Diseases/microbiology , Psoas Abscess/diagnostic imaging , Psoas Abscess/microbiology , Pyelitis/diagnostic imaging , Pyelitis/microbiology , Pyelonephritis/diagnostic imaging , Pyelonephritis/microbiology , Uterine Diseases/diagnostic imaging , Uterine Diseases/microbiology
6.
Am J Obstet Gynecol ; 224(5): 530.e1-530.e17, 2021 05.
Article En | MEDLINE | ID: mdl-33248136

BACKGROUND: Group B Streptococcus is a common vaginal bacterium and the leading cause of invasive fetoplacental infections. Group B Streptococcus in the vagina can invade through the cervix to cause ascending uteroplacental infections or can be transmitted to the neonate during vaginal delivery. Some studies have found that women with a "dysbiotic" polymicrobial or Lactobacillus-depleted vaginal microbiota are more likely to harbor group B Streptococcus. Gardnerella vaginalis is often the most abundant bacteria in the vaginas of women with dysbiosis, while being detected at lower levels in most other women, and has been linked with several adverse pregnancy outcomes. Mouse models of group B Streptococcus and Gardnerella vaginalis colonization have been reported but, to the best of our knowledge, the two have not been studied together. The overarching idea driving this study is that certain members of the dysbiotic vaginal microbiota, such as Gardnerella vaginalis, may directly contribute to the increased rate of group B Streptococcus vaginal colonization observed in women with vaginal dysbiosis. OBJECTIVE: We used a mouse model to test the hypothesis that vaginal exposure to Gardnerella vaginalis may facilitate colonization and/or invasive infection of the upper reproductive tract by group B Streptococcus during pregnancy. STUDY DESIGN: Timed-pregnant mice were generated using an allogeneic mating strategy with BALB/c males and C57Bl/6 females. Dams were vaginally inoculated at gestational day 14 with group B Streptococcus alone (using a 10-fold lower dose than previously reported models) or coinoculated with group B Streptococcus and Gardnerella vaginalis. Bacterial titers were enumerated in vaginal, uterine horn, and placental tissues at gestational day 17. The presence (Fisher exact tests) and levels (Mann-Whitney U tests) of bacterial titers were compared between mono- and coinoculated dams in each compartment. Relative risks were calculated for outcomes that occurred in both groups. Tissue samples were also examined for evidence of pathophysiology. RESULTS: Inoculation of pregnant mice with 107 group B Streptococcus alone did not result in vaginal colonization or ascending infection. In contrast, coinoculation of group B Streptococcus with Gardnerella vaginalis in pregnant mice resulted in a 10-fold higher risk of group B Streptococcus vaginal colonization (relative risk, 10.31; 95% confidence interval, 2.710-59.04; P=.0006 [Fisher exact test]). Ascending group B Streptococcus infection of the uterus and placenta occurred in approximately 40% of coinoculated animals, whereas none of those receiving group B Streptococcus alone developed uterine or placental infections. Immunofluorescence microscopy revealed group B Streptococcus in both the maternal and fetal sides of the placenta. Histologic inflammation and increased proinflammatory cytokines were evident in the setting of group B Streptococcus placental infection. Interestingly, placentas from dams exposed to group B Streptococcus and Gardnerella vaginalis, but without recoverable vaginal or placental bacteria, displayed distinct histopathologic features and cytokine signatures. CONCLUSION: These data suggest that Gardnerella vaginalis vaginal exposure can promote group B Streptococcus vaginal colonization, resulting in a greater likelihood of invasive perinatal group B Streptococcus infections. These findings suggest that future clinical studies should examine whether the presence of Gardnerella vaginalis is a risk factor for group B Streptococcus vaginal colonization in women. Because Gardnerella vaginalis can also be present in women without bacterial vaginosis, these findings may be relevant both inside and outside of the context of vaginal dysbiosis.


Coinfection/complications , Gardnerella vaginalis , Placenta Diseases/microbiology , Streptococcal Infections/microbiology , Streptococcus agalactiae , Uterine Diseases/microbiology , Vaginosis, Bacterial/microbiology , Animals , Cytokines/metabolism , Dysbiosis/microbiology , Female , Mice , Microbial Interactions , Microbiota , Placenta/microbiology , Placenta Diseases/metabolism , Placenta Diseases/pathology , Pregnancy , Vagina/microbiology
8.
Article De | MEDLINE | ID: mdl-32823330

Postpartum uterine diseases, such as puerperal metritis and clinical endometritis may affect over 40 % of cows in dairy farms. Regardless of their severity, these diseases are one of the main reasons for impaired fertility, causing declines in dairy cow productivity and hence, resulting in economic losses. Although uterine diseases have been the topic of scientific discussion for many years, until now it was not possible to agree on uniform definitions for the different kinds of manifestation. By including technical innovations and testing procedures, enormous scientific progress and a deeper knowledge of the physiology as well as the pathologic mechanisms have been achieved. Bovine metritis and endometritis may be regarded as multifactorial diseases caused by a combination of microbial infection, the dysregulation of the immune system, and additional risk factors. These interactions have been analyzed on microbial and molecular biological levels as well as by the use of bioinformatics and molecular genetics. As a result, new species of bacteria and inflammatory mediators possibly contributing to the development of uterine diseases have recently been described. Additionally, metabolic and genetic risk factors and their roles in leading to fertility impairment have been evaluated. In conclusion, it was possible to identify new approaches for possible therapeutic and preventive methods, a subset of which may already be implemented into daily practical routine. This article provides an overview of recent scientific results concerning bovine metritis and endometritis with a focus on microbial, microbiological and immunological studies.


Cattle Diseases , Uterine Diseases , Animals , Cattle , Cattle Diseases/diagnosis , Cattle Diseases/genetics , Cattle Diseases/microbiology , Computational Biology , Female , Puerperal Infection/diagnosis , Puerperal Infection/genetics , Puerperal Infection/microbiology , Puerperal Infection/veterinary , Risk Factors , Uterine Diseases/diagnosis , Uterine Diseases/genetics , Uterine Diseases/microbiology , Uterine Diseases/veterinary
9.
PLoS One ; 15(6): e0228294, 2020.
Article En | MEDLINE | ID: mdl-32479536

Even though Escherichia coli are common bacteria of the bovine vaginal microbiota, they represent an important pathogen that causes diseases in the reproductive tract and subfertility. However, the actual endometrial virulence profile of E. coli is poorly understood. The present study aims to characterize the phylogenetic structure and virulence potential of native vaginal populations of E. coli from healthy heifers (H), and cows with postpartum uterine diseases (PUD), such as metritis/endometritis (MT) or repeat breeder cows (RB). To this end, the virulence repertoire of 97 E. coli isolates was genotypically and phenotypically assessed. Most of them were assigned to phylogenetic group A (74%), followed by B1 (17%) and D (9%); RB strains were significantly (p < 0.05) more represented by B1. Seven of the 15 evaluated virulence genes (VFG) were detected and the most prevalent were fimH (87%), agn43 (41%) and csgA (35%); while traT (27%), fyuA (11%), hlyA (5%) and kpsMT II (5%) were observed in a lower proportion. Particularly, fyuA was significantly higher (p < 0.05) in MT cows whereas csgA showed the same behavior in PUD animals (p < 0.05). When comparing H and PUD strains, these last ones were associated to positive expression of biofilm, fimbriae curli/cellulose and motility; yet RB strains did not show motility. Vaginal B1 E. coli populations, that possess VFG (fyuA and csgA) as well as the expression of motility, curli fimbriae/cellulose and biofilm, may represent risk factors for endometrial disorders; specifically, those that also, have kpsMT II may have a pathogenic potential for causing the RB syndrome. Future research focusing on the detection of these strains in the vaginal microbiota of cows with postpartum uterine diseases should be done since the control of their presence in vagina could reduce the risk that they access the uterus during the postpartum period.


Cattle Diseases/microbiology , Escherichia coli/isolation & purification , Uterine Diseases/veterinary , Vagina/microbiology , Animals , Biofilms/growth & development , Cattle , Escherichia coli/genetics , Escherichia coli/physiology , Female , Gene Expression Regulation, Bacterial , Genetic Variation , Intestines/microbiology , Phylogeny , Uterine Diseases/microbiology
10.
J Gynecol Obstet Hum Reprod ; 49(8): 101745, 2020 Oct.
Article En | MEDLINE | ID: mdl-32422363

OBJECTIVE: To evaluate the use of the intracervical balloon compared with locally applied prostaglandins for cervical ripening for induction in patients with preterm premature rupture of membranes. METHODS: Monocentric, retrospective (from 2002 to 2017) observational cohort study of singleton pregnancies complicated by preterm premature rupture of membranes and induced between 34 and 37 weeks. The primary outcome measure was balloon catheter efficiency evaluated by Cesarean section rate. Secondary outcomes were : interval from induction to delivery, labor duration, oxytocin use, intrauterine infection rate, maternal complications (i.e., postpartum hemorrhage and endometritis), and neonatal complications. RESULTS: 60 patients had cervical ripening with prostaglandins alone and 58 had balloon catheter. Demographic characteristics were similar between the groups, except for induction term and neonatal weight. There was not a significant difference in occurrence of Cesarean section rate (p = 0.14). Nor were there significant differences in time from induction to birth (p = 0.32) or in intrauterine infection rate (p = 0.95). Labor duration was shorter (p = 0.006) and total oxytocin dose lower (p = 0.005) in patients induced by prostaglandins alone. Concerning neonatal outcomes, there were more transfers to intensive care (p = 0.008) and more respiratory distress (p = 0.005) among newborns induced by prostaglandins. CONCLUSION: Compared with locally applied prostaglandins, balloon catheter induction is not associated with an increase of Cesarean section rate in patients with preterm premature rupture of membranes.


Cervical Ripening/physiology , Fetal Membranes, Premature Rupture , Labor, Induced/instrumentation , Labor, Induced/methods , Adult , Catheterization/instrumentation , Catheterization/methods , Cesarean Section/statistics & numerical data , Cohort Studies , Female , Gestational Age , Humans , Infant, Newborn , Labor, Induced/adverse effects , Oxytocin/administration & dosage , Pregnancy , Prostaglandins/administration & dosage , Prostaglandins/adverse effects , Reproductive Tract Infections/epidemiology , Retrospective Studies , Uterine Diseases/microbiology
11.
Biol Reprod ; 103(3): 508-520, 2020 08 21.
Article En | MEDLINE | ID: mdl-32401311

Uterine infection is associated with infertility in women and dairy cows, even after the resolution of infection. However, the mechanisms causing this persistent infertility are unclear. Here, we hypothesized that induced endometritis in non-lactating dairy cows would reduce the developmental competence of oocytes. Non-lactating Holstein cows received an intrauterine infusion of endometrial pathogenic bacteria (Escherichia coli and Trueperella pyogenes; n = 12) or vehicle control (n = 11) on day 2 of the estrous cycle. Bacterial infusion increased expression of endometrial inflammatory mediators, and a mucopurulent discharge in the vagina confirmed the establishment of endometritis. Oocytes were collected by transvaginal ultrasound-guided ovum pickup on days 2, 24, 45, and 66 following infusion and subjected to in vitro fertilization and embryo culture. Bacterial infusion resulted in fewer cleaved oocytes developing to morulae compared to vehicle-infused controls (30.7 versus 45.0%), with the greatest effect observed in oocytes collected on day 24. Development to morula was inversely correlated with endometrial expression of IL6 on day 6. The expression of genes associated with embryo quality did not differ significantly between morulae from bacteria-infused and control cows. Artificial insemination 130 days after intrauterine infusion resulted in normal, filamentous embryos that produced interferon tau 16 days after conception in both infusion groups. This model of experimentally induced uterine infection successfully resulted in endometritis and a reduction in the proportion of oocytes that developed to morulae following in vitro fertilization. In conclusion, endometritis reduced the capacity of oocytes to develop to morulae.


Cattle Diseases/pathology , Endometritis/pathology , Endometritis/veterinary , Oocytes/growth & development , Oocytes/pathology , Uterine Diseases/pathology , Uterine Diseases/veterinary , Actinomycetales Infections/pathology , Animals , Cattle , Cattle Diseases/microbiology , Embryo Culture Techniques , Endometritis/microbiology , Escherichia coli Infections/pathology , Estrous Cycle , Female , Fertilization in Vitro , Inflammation Mediators/metabolism , Insemination, Artificial , Interferon Type I/metabolism , Pregnancy , Pregnancy Proteins/metabolism , Uterine Diseases/microbiology , Vagina/metabolism , Vagina/pathology
12.
Biomolecules ; 10(4)2020 04 11.
Article En | MEDLINE | ID: mdl-32290428

Current knowledge suggests that the uterus harbours its own microbiota, where the microbes could influence the uterine functions in health and disease; however, the core uterine microbial composition and the host-microbial relationships remain to be fully elucidated. Different studies are indicating, based on next-generation sequencing techniques, that microbial dysbiosis could be associated with several gynaecological disorders, such as endometriosis, chronic endometritis, dysfunctional menstrual bleeding, endometrial cancer, and infertility. Treatments using antibiotics and probiotics and/or prebiotics for endometrial microbial dysbiosis are being applied. Nevertheless there is no unified protocol for assessing the endometrial dysbiosis and no optimal treatment protocol for the established dysbiosis. With this review we outline the microbes (mostly bacteria) identified in the endometrial microbiome studies, the current treatments offered for bacterial dysbiosis in the clinical setting, and the future possibilities such as pro- and prebiotics and microbial transplants for modifying uterine microbial composition.


Endometrium/microbiology , Uterus/microbiology , Disease , Female , Humans , Microbiota , Uterine Diseases/microbiology , Uterine Diseases/pathology , Uterine Diseases/therapy
13.
Theriogenology ; 150: 158-165, 2020 Jul 01.
Article En | MEDLINE | ID: mdl-31973964

Up to forty percent of dairy cows develop metritis or endometritis when pathogenic bacteria infect the uterus after parturition. However, resilient cows remain healthy even when exposed to the same pathogens. Here, we provide a perspective on the mechanisms that dairy cows use to prevent postpartum uterine disease. We suggest that resilient cows prevent the development of uterine disease using the three complementary defensive strategies of avoiding, tolerating and resisting infection with pathogenic bacteria. Avoidance maintains health by limiting the exposure to pathogens. Avoidance mechanisms include intrinsic behaviors to reduce the risk of infection by avoiding pathogens or infected animals, perhaps signaled by the fetid odor of uterine disease. Tolerance improves health by limiting the tissue damage caused by the pathogens. Tolerance mechanisms include neutralizing bacterial toxins, protecting cells against damage, enhancing tissue repair, and reprogramming metabolism. Resistance improves health by limiting the pathogen burden. Resistance mechanisms include inflammation driven by innate immunity and adaptive immunity, with the aim of killing and eliminating pathogenic bacteria. Farmers can also help cows prevent the development of postpartum uterine disease by avoiding trauma to the genital tract, reducing stress, and feeding animals appropriately during the transition period. Understanding the mechanisms of avoidance, tolerance and resistance to pathogens will inform strategies to generate resilient animals and prevent uterine disease.


Cattle Diseases/microbiology , Uterine Diseases/veterinary , Animals , Cattle , Cattle Diseases/immunology , Disease Susceptibility/veterinary , Female , Postpartum Period , Uterine Diseases/immunology , Uterine Diseases/microbiology
14.
Gynecol Obstet Fertil Senol ; 48(1): 24-34, 2020 01.
Article Fr | MEDLINE | ID: mdl-31669523

OBJECTIVE: To evaluate safety of home care, clinical and biological initial examination and effectiveness of prophylactic antibiotic in preventing maternal and neonatal infectious complications in women with term prelabor rupture of membranes. MATERIALS AND METHODS: The MedLine database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In case of expectant management and low rate of antibiotic prophylaxis coverage, home care compared to hospitalization could be associated with an increase in neonatal infections (LE3), especially when colonized with Group B Streptococcus (GBS) (LE3). Home care is therefore not recommended (Grade C). Studies investigating the initial clinical-biological examination are sparse. The initial examination should search for signs of intra-uterine infection. Repeated digital examination before and during labor is associated with an increased risk of intra-uterine infection (LE3). It is therefore recommended to limit the number of digital examinations before and during labor (Grade C). A GBS-positive vaginal swab is strongly associated with the risk of intra-uterine and neonatal infection (LE3) independently of the type management (induction vs. expectant management) and the mode of induction (oxytocin or prostaglandin) (LE3). When the GBS-positive vaginal swab has not been performed between 34 and 38 weeks, it is recommended to perform it on admission (Professional consensus). The diagnostic performance of the CRP and white blood cell count for the prediction of neonatal infection is low (LE3). If these tests are used, the negative predictive value of the CRP should be preferred (Professional consensus). In case of term prelabor rupture of membranes after 12hours, prophylactic antibiotics could reduce the rate of intra-uterine infection without reducing the risk of neonatal infection (LE3). Their use in term prelabor rupture of membranes after 12hours is therefore recommended (Grade C). When prophylactic antibiotics are indicated, intravenous beta-lactamine is the preferred option (Grade C). CONCLUSION: Overall, the current data on initial management of term prelabor rupture of membranes are of low evidence level.


Fetal Membranes, Premature Rupture/therapy , Antibiotic Prophylaxis , Female , France , Home Care Services , Hospitalization , Humans , Infant, Newborn , Infection Control , Infections/etiology , MEDLINE , Pregnancy , Retrospective Studies , Streptococcal Infections/prevention & control , Streptococcus agalactiae/isolation & purification , Uterine Diseases/microbiology
15.
J Dairy Sci ; 102(12): 11786-11797, 2019 Dec.
Article En | MEDLINE | ID: mdl-31587913

Until 2010, our knowledge of the uterine microbiome in cows that developed uterine disease relied almost exclusively on culture-dependent studies and mostly included cows with clinical endometritis (i.e., with purulent uterine discharge). Those studies consistently found a strong positive correlation between Trueperella pyogenes and clinical endometritis, whereas other pathogens such as Escherichia coli, Fusobacterium necrophorum, Prevotella melaninogenica, and Bacteroides spp. were also commonly cocultured. In contrast, Streptococcus spp., Staphylococcus spp., and Bacillus spp. were usually isolated from healthy cows. Starting in 2010, culture-independent studies using PCR explored the microbiome of cows with metritis and clinical endometritis, and observed that E. coli was a pioneer pathogen that predisposed cows to infection with F. necrophorum, which was strongly associated with metritis, and to infection with T. pyogenes, which was strongly associated with clinical endometritis. Starting in 2011, culture-independent studies using metagenomic sequencing expanded our knowledge of the uterine microbiome. It has been shown that cows have bacteria in the uterus even before calving, they have an established uterine microbiome within 20 min of calving, and that the microbiome structure is identical between cows that develop metritis and healthy cows until 2 d postpartum, after which the bacterial structure of cows that developed metritis deviates in favor of greater relative abundance of Bacteroidetes and Fusobacteria and lesser relative abundance of Proteobacteria and Tenericutes. The shift in the uterine microbiome in cows that develop metritis is characterized by a loss of heterogeneity and a decrease in bacterial richness. At the genus level, Bacteroides, Porphyromonas, and Fusobacterium have the strongest association with metritis. At the species level, we observed that Bacteroides pyogenes, Porphyromonas levii, and Helcococcus ovis were potential emerging uterine pathogens. Finally, we have shown that the hematogenous route is a viable route of uterine infection with uterine pathogens. Herein, we propose that metritis is associated with a dysbiosis of the uterine microbiota characterized by decreased richness, and an increase in Bacteroidetes and Fusobacteria, particularly Bacteroides, Porphyromonas, and Fusobacterium.


Bacteria/isolation & purification , Cattle Diseases/microbiology , Endometritis/veterinary , Microbiota , Uterine Diseases/veterinary , Animals , Bacteria/genetics , Bacteroidetes/genetics , Bacteroidetes/isolation & purification , Cattle , Cattle Diseases/pathology , Dysbiosis/microbiology , Dysbiosis/veterinary , Endometritis/microbiology , Female , Fusobacteria/genetics , Fusobacteria/isolation & purification , Polymerase Chain Reaction , Postpartum Period , Uterine Diseases/microbiology , Uterine Diseases/pathology , Uterus/microbiology
16.
BMC Infect Dis ; 19(1): 791, 2019 Sep 09.
Article En | MEDLINE | ID: mdl-31500570

BACKGROUND: Infections by Streptococcus gallolyticus subsp. pasteurianus (SGSP) is often underestimated. Herein, the epidemiological features and resistant characteristics of SGSP in mainland China are characterized to enable a better understanding of its role in clinical infections. METHODS: In the present work, 45 SGSP isolates were collected from the samples of bloodstream, urine, aseptic body fluid, and fetal membrane/placenta from patients in 8 tertiary general hospitals of 6 cities/provinces in China from 2011 to 2017. The identification of all isolates was performed using traditional biochemical methods, 16S rRNA and gyrB sequencing, followed by the characterization of their antibiotic resistance profiling and involved genes. RESULTS: Among 34 non-pregnancy-related patients, 4 (4/34,11.8%) patients had gastrointestinal cancer, 10 (10/34, 29.4%) patients had diabetes, and one patient had infective endocarditis. Moreover, 11 cases of pregnant women were associated with intrauterine infection (9/11, 81.2%) and urinary tract infection (1/11, 9.1%), respectively. Except one, all other SGSP isolates were correctly identified by the BD Phoenix automated system. We found that all SGSP isolates were phenotypically susceptible to penicillin, ampicillin, cefotaxime, meropenem, and vancomycin. Forty strains (40/45, 88.9%) were both erythromycin and clindamycin-resistant, belonging to the cMLSB phenotype, and the majority of them carried erm(B) gene (39/40, 97.5%). Although the cMLSB/erm(B) constituted the most frequently identified phenotype/genotype combination (25/40, 62.5%) among all erythromycin-resistant cMLSB isolates, erm(B)/erm(A), erm(B)/mef(A/E), and erm(B)/erm(T) was detected in 7, 4, and 3 isolates, respectively. Furthermore, 43 strains (43/45, 95.6%) were tetracycline-resistant, and out of these, 39 strains (39/45, 86.7%) carried tet(L), 27(27/45, 60.0%) strains carried tet(O), and 7 (7/45, 15.6%) strains carried tet(M), alone or combined, respectively. All erythromycin-resistant isolates were also resistant to tetracycline. CONCLUSIONS: It is important to study and draw attention on SGSP, an underreported opportunistic pathogen targeting immunodeficient populations, notably elderly subjects, pregnant women and neonates.


Bacteremia/pathology , Streptococcal Infections/pathology , Streptococcus gallolyticus/genetics , Uterine Diseases/pathology , Adult , Anti-Bacterial Agents/pharmacology , Bacteremia/microbiology , Bacterial Proteins/genetics , China , Drug Resistance, Bacterial/genetics , Female , Humans , Infant, Newborn , Male , Microbial Sensitivity Tests , Middle Aged , Phenotype , Phylogeny , Pregnancy , RNA, Ribosomal, 16S/chemistry , RNA, Ribosomal, 16S/isolation & purification , RNA, Ribosomal, 16S/metabolism , Streptococcal Infections/microbiology , Streptococcus gallolyticus/classification , Streptococcus gallolyticus/drug effects , Streptococcus gallolyticus/isolation & purification , Uterine Diseases/microbiology , Young Adult
17.
Pan Afr Med J ; 33: 45, 2019.
Article Fr | MEDLINE | ID: mdl-31448008

Tuberculosis is a public health problem, especially in the developing countries. Bacillary pulmonary tuberculosis is the most common form of tuberculosis while genital tuberculosis is rare and underdiagnosed. We here report a case of endometrial tuberculosis. The study involved a 72-year old female patient with SC hemoglobinopathy consulting her gynecologist because of chronic leukorrhea. Cytobacteriologic assessment of vaginal swabs showed Streptococcus agalactatiae. Despite suitable antibiotic therapy, the evolution was marked by the persistence of leukorrhea. Pelvic ultrasonography objectified thickened endometrium, appearing as hyperechoic at the base of the uterus. This was suggestive of endometrial cancer. Anatomo-pathological examination of endometrial curettage samples showed granulomatous endometritis suggesting follicular tuberculosis. Outcome was favorable under antituberculosis treatment. In TB endemic areas, genital tuberculosis is not exceptional and should be suspected in patients with chronic leukorrhea despite suitable treatment.


Antitubercular Agents/administration & dosage , Endometritis/diagnosis , Endometrium/pathology , Tuberculosis, Female Genital/diagnosis , Aged , Endometrial Neoplasms/diagnosis , Endometritis/microbiology , Endometrium/microbiology , Female , Humans , Tuberculosis, Female Genital/drug therapy , Tuberculosis, Female Genital/pathology , Uterine Diseases/diagnosis , Uterine Diseases/drug therapy , Uterine Diseases/microbiology
18.
PLoS One ; 14(7): e0219941, 2019.
Article En | MEDLINE | ID: mdl-31329630

Escherichia coli infection of the female reproductive tract is a significant cause of disease in humans and animals, but simple animal models are lacking. Here we report that vaginal inoculation of uropathogenic E. coli strains UTI89 and CFT073 in non-pregnant, estrogen-treated mice resulted in robust colonization of the vagina and uterine horns, whereas titers of the lab strain MG1655 were significantly lower. Non-estrogenized mice also became colonized, but there was more variation in titers. A dose of 104 colony-forming units (CFU) UTI89 was sufficient to result in colonization in all estrogenized mice, and we also observed bacterial transfer between inoculated and uninoculated estrogenized cage mates. UTI89 infection led to inflammation and leukocyte infiltration into the uterine horns as evidenced by tissue histology. Flow cytometry experiments revealed that neutrophil, monocyte and eosinophil populations were significantly increased in infected uterine horns. This model is a simple way to study host-pathogen interactions in E. coli vaginal colonization and uterine infection. There are immediate implications for investigators studying urinary tract infection using mouse models, as few E. coli are required to achieve reproductive colonization, resulting in an additional, underappreciated mucosal reservoir.


Escherichia coli Infections/microbiology , Extraintestinal Pathogenic Escherichia coli/pathogenicity , Uterine Diseases/microbiology , Animals , Colony Count, Microbial , Escherichia coli Infections/pathology , Female , Mice , Mice, Inbred C57BL , Uterine Diseases/pathology , Uterus/microbiology , Uterus/pathology
19.
Pol J Vet Sci ; 22(2): 377-384, 2019 Jun.
Article En | MEDLINE | ID: mdl-31269356

Early embryonic death (EED) is one of the causes of infertility in the mare. We compared endometrial environment in 9 mares with EED and 13 mares in diestrus phase. Cotton swab (CS), cytobrush (CB) and uterine biopsy (B) samples were obtained for the cytological, bacteriological and histopathological examinations. In the first step we compared CS and CB methods to biopsy as a reference method, as B revealed the highest number of positive results in cytological and bacteriological examinations in both groups. In turn, we also compared cytological, bacteriological and histopathological findings between EED and control animals using the B sampling. Although the differences between these groups were not statistically significant (p≥0.05), there was a tendency to a higher prevalence of subclinical endometritis in the control group, than in the EED group (62% vs 22%). In general, positive bacteriological results were similar in both groups (62% vs 55%), whereas positive cytological results were higher in the control group (62% vs 22%; p≥0.05). In histopathological examination in EED mares endometrial degeneration was better expressed (all mares were with grades IIB and III on the Kenney-Doig scale); however, the differences between both groups were not statistically significant (p≥0.05). We could not confirm a clear difference in uterine environment between the two groups. Moreover, the uterine biopsy seemed to be the most reasonable sampling method for diagnosis of endometrial state.


Abortion, Veterinary , Endometrium/pathology , Horse Diseases/pathology , Uterine Diseases/veterinary , Animals , Endometrium/cytology , Endometrium/microbiology , Female , Horses , Uterine Diseases/microbiology , Uterine Diseases/pathology
20.
J Vet Med Sci ; 81(9): 1313-1317, 2019 Sep 18.
Article En | MEDLINE | ID: mdl-31341113

We investigated the association among endometrial hyperemia, uterine bacterial infection, and features of the large ovarian follicles in dairy cows. Genital organs were collected in a complete set at a slaughterhouse, and the degree of endometrial hyperemia was examined for the direct evaluation of uterine inflammation. The rate of bacterial infection in the uterus was higher in cows with endometrial hyperemia regardless of the severity of hyperemia, compared with cows without hyperemia. Moreover, the characteristics of the follicular fluid were changed in cows with uterine bacterial infection and included high concentrations of lipopolysaccharide and malondialdehyde (lipid peroxidation marker). These findings can be utilized as the basic information for the direct evaluation of the uterine inflammatory status in dairy cows.


Cattle Diseases/microbiology , Ovarian Follicle/physiopathology , Uterine Diseases/veterinary , Animals , Bacteria/isolation & purification , Cattle , Endometritis/veterinary , Female , Follicular Fluid/chemistry , Hyperemia/veterinary , Inflammation , Lipopolysaccharides/analysis , Malondialdehyde/analysis , Uterine Diseases/microbiology
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