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      Prevalence of Bacteremia in Dairy Cattle with Acute Puerperal Metritis

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          Abstract

          Background

          Acute puerperal metritis ( APM) affects 30% of postpartum dairy cattle. Bacteremia negatively impacts survival in cattle with coliform mastitis. However, the prevalence of bacteremia in dairy cattle with APM is unknown.

          Hypothesis

          Bacteremia is detectable in a large proportion of cattle with APM.

          Animals

          Seventeen dairy cows with APM and 17 healthy dairy cattle.

          Methods

          Prospective case‐control study. Cases were identified by daily monitoring of cattle in the first 10 days after calving. Controls were matched to cases by parity and days in milk. Cows were examined at the time of identification of APM. A complete blood count, serum biochemical analysis, and bacteriologic culture of blood and lochial fluid were performed on each animal at the time of diagnosis. The same samples were collected from healthy herdmates of a similar parity and days in milk. Blood culture results and clinicopathologic variables were compared between groups. Conditional logistic regression was used to evaluate factors associated with APM, whereas multivariate logistic regression was used to evaluate factors associated with bacteremia.

          Results

          Bacteremia occurred in 53% (9/17) of cattle with APM and 53% (8/15) controls. Bacillus spp. was the organism most commonly isolated from the bloodstream in cattle of both groups. Bacteremic cattle in both groups were significantly less likely to have basophils in the peripheral circulation ( P = .02) and more likely to have higher serum globulin concentrations ( P = .02).

          Conclusions and Clinical Importance

          Bacteremia is a common occurrence in postpartum dairy cattle. Further study is warranted to investigate the modes by which bacteria colonize the bloodstream in this population of animals and the importance of bacteremia on health and productivity of affected animals.

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          Most cited references27

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          Defining postpartum uterine disease in cattle.

          Uterine function is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist, causing uterine disease, a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies among research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Puerperal metritis should be defined as an animal with an abnormally enlarged uterus and a fetid watery red-brown uterine discharge, associated with signs of systemic illness (decreased milk yield, dullness or other signs of toxemia) and fever > 39.5 degrees C, within 21 days after parturition. Animals that are not systemically ill, but have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina, within 21 days post partum, may be classified as having clinical metritis. Clinical endometritis is characterised by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 days or more after parturition, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 days post partum. In the absence of clinical endometritis, a cow with subclinical endometritis is defined by > 18% neutrophils in uterine cytology samples collected 21-33 days post partum, or > 10% neutrophils at 34-47 days. Pyometra is defined as the accumulation of purulent material within the uterine lumen in the presence of a persistent corpus luteum and a closed cervix. In conclusion, we have suggested definitions for common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.
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            Defining postpartum uterine disease and the mechanisms of infection and immunity in the female reproductive tract in cattle.

            Uterine microbial disease affects half of all dairy cattle after parturition, causing infertility by disrupting uterine and ovarian function. Infection with Escherichia coli, Arcanobacterium pyogenes, and bovine herpesvirus 4 causes endometrial tissue damage. Toll-like receptors on endometrial cells detect pathogen-associated molecules such as bacterial DNA, lipids, and lipopolysaccharide (LPS), leading to secretion of cytokines, chemokines, and antimicrobial peptides. Chemokines attract neutrophils and macrophages to eliminate the bacteria, although persistence of neutrophils is associated with subclinical endometritis and infertility. Cows with uterine infections are less likely to ovulate because they have slower growth of the postpartum dominant follicle in the ovary, lower peripheral plasma estradiol concentrations, and perturbation of hypothalamic and pituitary function. The follicular fluid of animals with endometritis contains LPS, which is detected by the TLR4/CD14/LY96 (MD2) receptor complex on granulosa cells, leading to lower aromatase expression and reduced estradiol secretion. If cows with uterine disease ovulate, the peripheral plasma concentrations of progesterone are lower than those in normal animals. However, luteal phases are often extended in animals with uterine disease, probably because infection switches the endometrial epithelial secretion of prostaglandins from the F series to the E series by a phospholipase A2-mediated mechanism, which would disrupt luteolysis. The regulation of endometrial immunity depends on steroid hormones, somatotrophins, and local regulatory proteins. Advances in knowledge about infection and immunity in the female genital tract should be exploited to develop new therapeutics for uterine disease.
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              Evaluation of peripartal calcium status, energetic profile, and neutrophil function in dairy cows at low or high risk of developing uterine disease.

              In this prospective cohort study, Holstein cows considered to be at high risk of developing metritis (dystocia, twins, stillbirth, retained placenta, or their combination) were matched with herdmates at low risk of developing metritis (normal calving) and monitored daily for rectal temperature and uterine discharge during the first 12 d in milk (DIM). Blood was sampled on d 0, 1, and 3 postpartum for assessment of neutrophil phagocytic and oxidative burst activities. Blood was also sampled at 0, 1, 2, 3, 4, 7, and 12 DIM for determination of serum concentrations of Ca, K, Mg, nonesterified fatty acids, β-hydroxybutyrate, and glucose. On the basis of receiver operator characteristic curves, subclinical hypocalcemia (SCH) was defined as a serum Ca concentration ≤8.59 mg/dL in at least 1 sample in the first 3 DIM. The overall incidences of metritis and puerperal metritis were 47.3 and 30%, respectively. Concentration in blood and percentages of neutrophils undergoing phagocytosis and oxidative burst were all reduced in cows with SCH compared with normocalcemic cows. Cows with SCH were at a greater risk of developing fever, metritis, and puerperal metritis compared with normocalcemic cows. Among cows at low risk of developing metritis, those with SCH had a greater incidence of metritis (40.7%) compared with normocalcemic cows (14.3%). Similarly, among cows at high risk of developing metritis, cows with SCH had a greater incidence of metritis (77.8%) compared with normocalcemic cows (20.0%). Cows with SCH had elevated concentrations of nonesterified fatty acids and β-hydroxybutyrate compared with normocalcemic cows. The relative risk of developing metritis decreased by 22% for every 1mg/dL increase in serum Ca. Neither metritis nor SCH influenced the resumption of estrous cyclicity by 38 DIM, but cows with SCH had a reduced pregnancy rate and a longer interval to pregnancy compared with normocalcemic cows. Finally, the population risk to develop uterine diseases attributable to SCH was 66.6% for metritis and 91.3% for puerperal metritis in the present study. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                J Vet Intern Med
                J. Vet. Intern. Med
                10.1111/(ISSN)1939-1676
                JVIM
                Journal of Veterinary Internal Medicine
                John Wiley and Sons Inc. (Hoboken )
                0891-6640
                1939-1676
                07 August 2014
                Sep-Oct 2014
                : 28
                : 5 ( doiID: 10.1111/jvim.2014.28.issue-5 )
                : 1606-1612
                Affiliations
                [ 1 ] Department of Population HealthCollege of Veterinary Medicine University of Georgia Athens GA
                [ 2 ] Department of Large Animal Medicine and SurgeryCollege of Veterinary Medicine University of Georgia Athens GA
                [ 3 ] Department of Physiology and Pharmacology College of Veterinary Medicine University of Georgia Athens GA
                Author notes
                [*] [* ]Corresponding author: B.C. Credille, DVM, PhD, DACVIM, Department of Population Health, College of Veterinary Medicine, University of Georgia, 425 River Road, Athens, GA 30602; e‐mail: bc24@ 123456uga.edu .
                Article
                JVIM12418
                10.1111/jvim.12418
                4895591
                25103694
                6dd2de5b-b5c6-402f-ae70-77115a0a9f0d
                Copyright © 2014 by the American College of Veterinary Internal Medicine
                History
                : 15 April 2014
                : 21 May 2014
                : 17 June 2014
                Page count
                Pages: 7
                Categories
                Standard Article
                Standard Articles
                Custom metadata
                2.0
                jvim12418
                September/October 2014
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.8.9 mode:remove_FC converted:06.05.2016

                Veterinary medicine
                dairy cattle,inflammation,postpartum,sepsis,uterine
                Veterinary medicine
                dairy cattle, inflammation, postpartum, sepsis, uterine

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