Detection of Novel Organisms Associated with Salpingitis, by Use of 16S rDNA Polymerase Chain Reaction

Hebb, Jennifer K.; Cohen, Craig R.; Astete, Sabina G.; Bukusi, Elizabeth A.; Totten, Patricia A.

doi:10.1086/425929

Cited by 71 publications

(52 citation statements)

References 47 publications

(49 reference statements)

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“…Antibodies against chsp60 were significantly higher in women suffering from perihepatitis-salpingitis and did not have distinctive clinical or microbiologic findings of C. trachomatis infection (43). Several other organisms have been associated with PID, which may subsequently result in the development of salpingitis and EP (10,20,38,64). Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum have been isolated from the fallopian tubes or peritoneal fluid from women with PID, supporting a possible role of these organisms in the development of tubal pathology and subsequent EP or infertility (10,64).…”

Section: Vol 16 2009 Activin and Inos In C Trachomatis-infected Womentioning

confidence: 96%

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

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Al-Azemi

Geary

et al. 2009

Clin Vaccine Immunol

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Chlamydia trachomatis infection can lead to pelvic inflammatory disease, ectopic pregnancy (EP), infertility, and chronic pelvic pain in women. Activins and inducible nitric oxide synthase (iNOS) are produced by the human fallopian tube, and we speculate that tubal activins and iNOS may be involved in the immune response to C. trachomatis in humans and their pathological alteration may result in tubal pathology and the development of EP. Blood and fallopian tubes were collected from 14 women with EP. Sera were analyzed by enzyme-linked immunosorbent assay to detect antibodies against chlamydial heat shock protein 60 (chsp60) and the major outer membrane protein of C. trachomatis. Confirmation of C. trachomatis serology was made using the microimmunofluorescence test. The patients were classified into three groups according to their serological results, and immunohistochemistry and quantitative reverse transcription-PCR were performed to investigate the expression of candidate molecules by tubal epithelial cells among the three groups. This is the first study to show an increase in the expression of activin ␤A subunit, type II receptors, follistatin, and iNOS within the human fallopian tube of EP patients who were serologically positive for C. trachomatis. A similar expression profile was observed in the fallopian tubes with detectable antibodies only against chsp60. These results were shown at the mRNA and protein levels. We suggest that tubal activin A, its type II receptors, follistatin, and NO could be involved in the microbial-mediated immune response within the fallopian tube, and their pathological expression may lead to tubal damage and the development of EP.

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Section: Vol 16 2009 Activin and Inos In C Trachomatis-infected Womentioning

confidence: 96%

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Refaat

Al-Azemi

Geary

et al. 2009

Clin Vaccine Immunol

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“…Inflammation ascending beyond the cervix, i.e., pelvic inflammatory disease (PID), like most genital tract diseases, does not have a single cause (72,183) and is more difficult to diagnose than cervicitis. Clinical examination alone may give a false impression, but laparoscopy is helpful in providing a more accurate diagnosis and in enabling upper tract specimens to be taken.…”

Section: Pelvic Inflammatory Diseasementioning

confidence: 99%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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SUMMARY The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis , the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium , together with the treatment and possible prevention of mycoplasmal disease, are discussed.

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“…In the remainder, detection was enabled by the application of 16S rRNA gene amplification and sequencing techniques. The above cases demonstrate the value of using molecular methods for the detection and identification of fastidious or uncultivable organisms in clinical specimens (6,11,16), illustrating the importance of such methods as a future direction for clinical detection. At present, L. amnionii can be identified only by sequence analysis.…”

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confidence: 90%

Leptotrichia amnionii, an Emerging Pathogen of the Female Urogenital Tract

et al. 2007

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Leptotrichia amnionii, a recently described, very fastidious, gram-negative anaerobic bacterium, is an opportunistic pathogen of the female urogenital tract. We report a case of second-trimester abortion in a patient with chorioamnionitis and L. amnionii bacteremia and a case of renal abscess in a female 5 weeks postpartum. CASE REPORTS Case 1.A 33-year-old, previously healthy female presented in the second trimester of pregnancy with a 2-to 3-day history of vaginal bleeding, lower back pain, fatigue, and fever. On admission, her blood pressure was 95/50, her pulse was 80/min, and her temperature was 39.6°C. Abdominal examination revealed tenderness in the lower right and left quadrants on palpation. There was no guarding or rebound tenderness. There was no vaginal discharge. Ultrasound examination showed a viable normal fetus of approximately 13 weeks gestation. Initial laboratory values showed a normal white blood cell count and differential, a hemoglobin level of 11.1 g/dl, and a C-reactive protein level (CRP) of 88 mg/liter. Urinalysis results were positive for nitrites, ketones, leukocytes, and blood. Urosepsis was suspected. Three sets of blood cultures from peripheral veins (BACTEC Plus aerobic/F and anaerobic/F culture vials) and a urine sample for culture were obtained prior to initiating treatment with intravenous mecillinam (an amidinopenicillin). On the second day of admission, an ultrasound of the urinary tract was reported as normal, urine culture yielded no significant bacterial growth, and the CRP peaked at 178 mg/liter. Gram-negative bacteria were detected in the blood cultures. Chorioamnionitis was suspected. The antibiotic regimen was changed to cefotaxime and metronidazole, after which the patient became afebrile and the CRP fell to 42 mg/liter. The episodes of vaginal bleeding continued, however, and a spontaneous abortion occurred on day 9. Curettage was performed. None of the products were sent for culture, but chorioamnionitis was diagnosed on the basis of the histopathology of the placenta. The patient was discharged from the hospital 2 days later on amoxicillin therapy and made a full recovery. She delivered a healthy baby 1 year later after an uncomplicated pregnancy.Microbiological findings. Two anaerobic and two aerobic BACTEC Plus blood culture vials were flagged as positive after 2 and 3 days, respectively, of incubation. Gram staining showed gram-negative/gram-variable pleomorphic rods and coccobacilli. After 48 to 72 h of incubation of the chocolate agar plates under anaerobic conditions, gray convex colonies of less than 1 mm in size were seen. In comparison, there was less growth on the anaerobic blood agar plates. Under aerobic conditions (37°C, 5% CO 2 ), growth was detected on chocolate agar plates only after 48 to 72 h of incubation. Catalase and indole spot tests were negative. The isolate was sensitive to kanamycin, brilliant green, and oxgall (Diatabs; Rosco). Antimicrobial susceptibility was determined by Etest (AB Biodisk, Solna, Sweden) on Isosensitest chocolate agar ...

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Detection of Novel Organisms Associated with Salpingitis, by Use of 16S rDNA Polymerase Chain Reaction

Cited by 71 publications

References 47 publications

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Role of Activins and Inducible Nitric Oxide in the Pathogenesis of Ectopic Pregnancy in Patients with or withoutChlamydia trachomatisInfection

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Leptotrichia amnionii, an Emerging Pathogen of the Female Urogenital Tract

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