The ability of a microbial invader to acquire iron from its vertebrate host has been recognized as an important virulence mechanism in some pathogenic bacteria. We examined the involvement of similar mechanisms in an experimental infection of mice by a protozoan pathogen of cattle, Tritrichomonas foetus. In a series of experiments, outbred ICR mice were inoculated intraperitoneally with two strains of T. foetus, the moderately virulent KV-1 (approximately 5% mortality rate) and the highly virulent LUB-1MIP (approximately 80% mortality rate). Treatment of mice with ferric ammonium citrate (FeAC) (100 mg/kg per day intraperitoneally) increased the mortality rate caused by the KV-1 infection up to the level determined for the highly virulent strain. The treatment effect was dose dependent and required early administration of FeAC after inoculation of parasites and its continued supply for at least 3 subsequent days. Daily sampling of peritoneal exudate showed that the infection-enhancing effect of iron overload was associated with a stimulation of parasite multiplication, which in the case of KV-1 infection was strongly suppressed in untreated mice. Consistent with these findings, the strain of lower virulence (KV-1) showed considerably lower efficiency accumulating radiolabeled iron from transferrin and a low-molecular source [Fe(III)nitrilotriacetic acid] in vitro. The results indicate an involvement of iron uptake mechanisms by the parasite as a virulence factor in T. foetus infection.
R e c e i ve d Ju ly 2 , 2 0 1 2 ; A c c e p t e d A p r i l 8 , 2 0 1 3 . Key words: Febrile morbidity -Pelvic organ prolapse -Postoperative infectionsSepsis -Synthetic polypropylene meshAbstract: New mesh-related complications such as erosion, etc., can result from abnormal postoperative healing due to surgical site infection. The aim of our study was to compare systemic inflammatory responses and the incidence of early infectious complications after reconstructive surgery using synthetic mesh and after traditional vaginal wall repair. In this prospective observational study 99 women with symptomatic pelvic organ prolapse were included; 55 women underwent traditional repair and 44 repair using mesh. After the procedure infectious complications were monitored. The patients who underwent reconstructive Republic, and surgery using mesh material were more likely to have febrile morbidity in the postoperative period than the patients who had been treated with traditional repair (p=0.031); there was a higher incidence of combination febrile morbidity with elevated C-reactive protein (CRP) > 50 mg/l; p=0.046, and a higher incidence of CRP increase over 30 mg/l; p=0.005. Reconstructive procedures using synthetic mesh are accompanied by a higher incidence of early post-operative infectious complications. This study was supported by the Grant Agency of the Ministry of Health of the Czech IntroductionPelvic organ prolapse is a common problem affecting up to 50% of parous women (Subak et al., 2001). Not all of them are symptomatic (Olsen et al., 1997;Baessler and Maher, 2006), and the risk of requiring surgery for prolapse is 11-12% in women reaching 79 years of age (Olsen et al., 1997). For a long time traditional pelvic reconstruction surgical procedures were the only ones available. The longterm efficiency of those procedures varied, and re-operation rates of nearly 30% have been reported by Olsen et al. (1997), with a risk of recurrence of up to 45% according to Valaitis and Stanton (1994) and Kohli et al. (1998). This may be one of the reasons why synthetic meshes were introduced to pelvic reconstructive surgery. However, these new surgical procedure have brought with them new mesh-related complications such as erosion, pain syndrome, etc. as described by Bako and Dhar (2009). Some of these complications -erosion, shrinkage and abnormal pain -can result from abnormal postoperative healing due to surgical site infection.The vagina contains more microorganisms than any other site in the body except the bowel (Lamont and Haynes, 2008). Surgical procedures resulting in the opening of the vagina will result in contamination of normally sterile sites by bacteria that are normally resident in the vagina. Infection and inflammation depends on a mixture of surgical and host-related factors. When mesh material is used this decreases the size of the bacterial inoculum, which can induce postoperative infection.The aim of our study was to compare immediate inflammatory reaction and the incidence of infectious complications afte...
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