Streptococcus equi subsp. zooepidemicus isolates from equine infectious endometritis belong to a distinct genetic group.

Streptococcus equi subsp. zooepidemicus is the pathogen most commonly isolated from the uterus of mares. S. zooepidemicus is an opportunistic pathogen and part of the resident flora in the caudal reproductive tract. The aim of this study was to investigate whether a genotypically distinct subpopulation of S. zooepidemicus is associated with endometritis in the mare, by genotyping and comparing uterine S. zooepidemicus strains with isolates from the vagina and clitoral fossa. Mares with (n=18) or without (n=11) clinical symptoms of endometritis were included. Uterine samples were obtained using a guarded endometrial biopsy punch, whereas a swab was used to recover samples from the cranial vagina and the clitoral fossa. If S. zooepidemicus was present, up to three colonies were selected from each anatomical location (max. 9 isolates per mare). Bacterial isolates were characterized by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). S. zooepidemicus was isolated from the endometrium of 12 mares. A total of 88 isolates were analyzed by PFGE: 31 from the endometrium, 26 from the cranial vagina and 31 isolates from the clitoral fossa. For MLST 21 isolates were chosen. Results demonstrated a higher genetic similarity of the isolates obtained from infectious endometritis compared to isolates obtained from the caudal reproductive tract. In conclusion, we demonstrate for the first time that a genetically distinct group of S. zooepidemicus is associated with infectious endometritis in the mare.

Gynecologic rarities: a case of periclitoral abscess and review of the literature.

Periclitoral abscess is a rare entity, with publications limited to case reports. We present here a case of periclitoral abscess in a 17 year old patient, which was treated with incision and drainage. We also review all the similar cases that have been reported in the English literature until now.

Absceso de clítoris / No disponible

Se presenta un caso de absceso de clítoris en una mujer de 24 años. Se produjo drenaje espontáneo del absceso tras tratamiento médico con ciprofloxacino e ibuprofeno, con curación completa (AU)

We present a case of clitoral abscess in a 24-yearoldwoman. Spontaneous drainage of the abscess occurred after medical treatment with ciprofloxacin and ibuprofen, with complete resolution (AU)

Development of a PCR test for rapid diagnosis of contagious equine metritis.

In order to establish a rapid diagnostic method for contagious equine metritis (CEM), we developed and evaluated a polymerase chain reaction (PCR) test. Species-specific PCR primer sets were derived from the DNA sequence of a cloned DNA fragment of Taylorella equigenitalis that did not hybridize with the genome of a taxomonically related species, Oligella urethralis. Single step PCR with primer set P1-N2 and two-step semi-nested PCR with primer sets P1-N2 and P2-N2 detected as low as 100 and 10 CFU of the bacteria, respectively. Single-step PCR detected T. equigenitalis from genital swabs of experimentally infected mares with sensitivity comparable to that of bacterial isolation. Furthermore, two-step PCR was more sensitive than the culture method. Upon examination of field samples, 12 out of 3,123 samples were positive by single-step PCR while only 2 were positive by bacterial culture. The 12 PCR-positive samples originated from 5 mares, of which 3 animals were considered to be carriers based on previous bacteriologic and serologic diagnoses for CEM. The PCR test described in this study would provide a specific and highly sensitive tool for the rapid diagnosis of CEM.

Evaluation of progesterone treatment to create a model for equine endometritis.

To investigate a model for equine endometritis, 12 mares with normal reproductive tracts were divided into 2 groups. All mares received progesterone in oil, 250 mg im, daily. At 5 days after initiation of progesterone administration, the uteri were inoculated with 10(6) colony forming units of Pseudomonas aeruginosa. The day of inoculation was designated Day 0. On Day 6, endometrial swab samples yielded P. aeruginosa in 5 mares; samples from the other 7 mares yielded heavy growth of Escherichia coli, Streptococcus zooepidemicus, Klebsiella pneumoniae, Enterobacter spp., Citrobacter diversus, Staphylococcus epidermidis and Streptococcus morbillorum. On Days 6, 7 and 8, Group A mares received intrauterine infusions of 6 g ticarcillin disodium and 0.2 g clavulanate potassium in 100 ml sterile saline. Group B mares received infusions of saline only. The incidence of swab specimens yielding no bacterial growth was significantly higher in Group A than Group B mares on Days 8 and 13 (4/6 vs 0/6). Swab samples from 5 of the 6 mares in Group A yielded growth of fungi on Days 13 and 19. Mares in Group B were then similarly treated with ticarcillin/clavulanate infusions, on Days 19, 20 and 21. The incidence of swab specimens yielding no bacterial growth was 2/6 and 1/6 on Days 21 and 26, respectively; fungi were not recovered from these mares at any time. The incidence of no-growth swabs after antibiotic treatment tended to be higher in Group A and incidence of fungal recovery after antibiotic treatment was significantly higher in Group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification of anatomic features of the equine clitoris as potential growth sites for Taylorella equigenitalis.

A median clitoral sinus, as a space canalized from epithelial cells, was distinguishable developmentally in equine fetuses from 33-mm crown-rump length (CRL) to 500-mm CRL (including a mule of 21-mm CRL). In saggital sections of the clitoris of a 480-mm CRL fetus, indentations under the transverse frenular fold were identified as lateral sinuses of the clitoris. Unlike the median sinus, they were shallow; it therefore could not be anatomically substantiated that the lateral sinuses were of sufficient depth to support the growth of the partial anaerobe Taylorella equigenitalis, the organism of contagious equine metritis. This study indicated excision of the lateral clitoral sinuses was unnecessary for treatment of contagious equine metritis.

Clinical significance of aerobic bacterial flora of the uterus, vagina, vestibule, and clitoral fossa of clinically normal mares.

Swab specimens for bacterial culture were obtained from the uterus, vagina, vestibule, and clitoral fossa of 48 mares that had normal reproductive tracts, no history of reproductive problems, and no inflammation on evaluation of endometrial biopsy. The mares were predominantly Thoroughbred and Standardbred. Swab specimens of the vagina were obtained through a sterile speculum; swab specimens of the uterus were obtained by use of a double-guarded, occluded culture instrument. Fifteen (31%) of the uterine swab specimens and 20 (42%) of the vaginal swab specimens yielded growth on aerobic culture; however, only 2 (4%) of the uterine swab specimens and 4 (8%) of the vaginal swab specimens yielded growth of more than 10 colonies. In contrast, 21 (44%) of the vestibular swab specimens and 45 (94%) of the clitoral fossa swab specimens had moderate (greater than 10 colonies in 1 quadrant) to heavy (colonies in 2 or 3 quadrants) growth of organisms on culture. Of organisms considered to be potential pathogens, Streptococcus zooepidemicus and Escherichia coli were found on bacteriologic culture of several clitoral fossa swab specimens and of some vestibular swab specimens. We did not isolate any potential pathogens from uterine or vaginal swab specimens. It appears that 1 to 10 colonies of nonpathogenic organisms could be recovered from the uterus in a substantial number of clinically normal mares even when double-guarded swabbing techniques are used, and we suggest that prebreeding culture requirements be modified to reflect this. Also, our findings indicate that the vulvovaginal fold, rather than the cervix, might be the major barrier to ascending bacterial contamination of the reproductive tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of sample freezing on the isolation of Mycoplasma spp. from the clitoral fossa of the mare.

The growth of Mycoplasma equigenitalium and Mycoplasma subdolum from specimens collected from the clitoral fossa of each of four Standardbred mares was not diminished by freezing of the specimens in liquid nitrogen (-196 degrees C) for up to 30 days when compared to samples cultured immediately.

Recovery of contagious equine metritis organisms and development of lesions in experimental infection of mares.

Twenty-three of 24 mares were infected experimentally with contagious equine metritis organisms by intrauterine inoculation, and killed 2-116 days later. From mares killed within 14 days after infection the organism could be recovered from many sites in the uterus, and most sites in the cervix, a few sites in the vagina and oviduct and from one clitoral sinus. At this time the endometrial folds were swollen and there were 10-20 ml of fluid in the uterus. In mares killed after 14 days, the organism was recovered from the ovarian surface (1 mare), oviduct (4 mares), uterus (2 mares) and the clitoral sinus (3 mares). Severe diffuse endometritis and cervicitis was initially acute, and became more severe subacute and predominantly plasmacytic by 14 days, then declined but persisted throughout the experiment.

Contagious equine metritis: effect of intrauterine inoculation of contagious equine metritis agent in pony mares.

Actively growing culture of contagious equine metritis (CEM) bacteria or infective exudate (or both) were inoculated intrauterine in pony mares. A direct relationship was observed between (i) appearance and duration of cervicitis and vaginitis and (ii) vaginal exudate. Clinical signs appeared 1 to 3 days after mares were inoculated and lasted 7 to 23 days. In the acute phase of infection, all uterine and cervical samples yielded CEM bacteria. In the asymptomatic stage of infection, CEM bacteria were not isolated from uterine and cervical samples; however, in 33%, 28%, and 20% of the pony mares, CEM bacteria were present in clitoral fossa, clitoral sinus, and urethral vestibule, respectively, Sampling during early estrus increased the bacterial isolation rate to 57% in mares that were previously negative; however, 3 days later, CEM bacteria could not be isolated from 62% of the positive mares. The results of repeated exposure experiments indicated the presence of local antibodies, as no CEM bacteria could be recovered at 2, 7, and 15 days after reexposure with a small number of bacterial cells (8.4 x 10(5) cells). The CEM bacteria were isolated from all mares reexposed with a large number of bacterial cells (7.2 x 10(8)) at 2 days after second inoculation and from 50% at 7 days. However, all of the mares were negative by day 15 after reexposure, indicating increased resistance to CEM bacteria.

Contagious equine metritis: the present situation reviewed and a revised code of practice for its control.

This report contains details of the code of practice for the control of contagious equine metritis (CEM) during the 1979 breeding season. It was prepared under the guidance of a scientific committee established by the Horserace Betting Levy Board under the chairmanship of Sir David Evans, FRS. The code is similar to the one introduced for the 1978 breeding season but takes into account the experience gained during the past 12 months. Following discussions with colleagues in Ireland it has been agreed that a similar code of practice will be introduced in the United Kingdom and Ireland so as to facilitate a uniform policy for the control of CEM. A summary of this report will be circulated to thoroughbred mare and stallion owners.

The experimental infection of ponies with contagious equine metritis.

Four pony mares were readily infected with the organism of contagious equine metritis by intracervical inoculation and one by coitus with an infected stallion. Infected mares developed an acute endometritis with local destruction of the endometrial epithelium. In 2 experimentally infected mares, infection appeared to have been spontaneously eliminated from the genital tract within 3 to 4 weeks. A third mare however remained persistently infected in the clitoral fossa over a long period and was a symptomless carrier. Four pony stallions were readily infected in the urethral fossa and the organism survived for varying periods without giving rise to any signs of infection. From 2 of these animals it appeared eventually to have been eliminated spontaneously. An experimentally infected stallion transmitted infection to a healthy mare by coitus. Bacteriological examination of infected pony stallions may occassionally give false negative results and fail to reveal the organism in the external genitalia. Repeated bacteriological examinations need to be undertaken before it can be concluded that a stallion is free of infection.