Examinations on penicillin resistant, serologically homogeneous staphylococci isolated from human mastitis.
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Although subclinical mastitis is associated with increased HIV load in breast milk, it is not known whether empirical treatment with antibiotics will reduce breast milk HIV load. We examined the effect of antibiotic treatment for subclinical mastitis on HIV load in breast milk. Seventy-five HIV-infected post-partum women in Malawi with subclinical mastitis were treated with oral amoxicillin/clavulanic acid and were followed between 1 and 24 weeks later. Breastmilk HIV-1 load and sodium concentration were measured and microbiological studies were performed at presentation. At 1 week (n = 34), the proportion of women with elevated breast milk leukocyte counts decreased significantly to 41.2% (p < 0.0001) and there was a nonsignificant increase in breast milk HIV-1 RNA load (p = 0.9264) and sodium concentration (p = 0.08) in the affected breast. At 4 to 12 weeks (n = 63), breast milk HIV-1 RNA load and sodium concentration decreased significantly (p < 0.05) and 17.5% had elevated breast milk leukocyte counts. Treatment with amoxicillin/clavulanic acid was associated with a significant decrease in inflammation of the breast, but breast milk HIV load remained elevated despite a significant decrease from baseline. These findings have important implications regarding how mothers should be counselled on safety of resuming breastfeeding after resolution of subclinical mastitis.
Intrapapillary deposition of 5-30 CFU of 6 separate human strains of Group B streptococci into 7 lactating quarters of 6 cows resulted in clinical mastitis in all. Identical streptococci were subsequently recovered from 6 of the affected quarters. Details of milk somatic cell counts, bacterial isolations and clinical findings are tabulated. The role of GBS in human medicine and the implications of proof that the bovine udder is susceptible to small numbers of GBS from human sources, are discussed.
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INTRODUCTION: Lactational mastitis is common in lactating women, with Staphylococcus aureus as the most commonly isolated agent associated with infectious lactational mastitis. Currently, there are no evidence-based guidelines for antimicrobial treatment due to barriers in obtaining pharmacokinetic data from lactating women. To overcome this barrier, a suitable large animal model is needed. Goats are an ideal translational model for human mastitis due to their anatomical and physiological similarity to humans. The objective of this pilot study was to assess if goats would develop clinical mastitis following intramammary inoculation with a clinical human isolate of S. aureus with the goal of establishing an alternative in vivo model for future research. The hypothesis was that the infected mammary gland half would show similar clinical signs to women with mastitis and demonstrate a similar local immune response when compared to the control mammary gland half. METHODS: One half of the mammary gland of two healthy lactating does was inoculated with a clinical human isolate of S. aureus. The other half of the mammary gland was sham inoculated with sterile buffered saline. Physical examinations, mammary gland assessments, and sterile milk samples were collected every 12 hours post inoculation. At 96 hours post inoculation, the goats were euthanized, and the mammary glands were examined for pathological changes. RESULTS: Goats did not develop systemic signs of disease following inoculation. Focal infected mammary gland changes included warmth, swelling, redness, discoloration, and reduced milk production; the other mammary gland half remained normal throughout the study period. S. aureus was enumerated from only the infected mammary gland half. The microscopic findings of the infected half showed neutrophilic inflammation and cell necrosis consistent with acute mastitis. DISCUSSION: This pilot study demonstrated lactating does can develop clinical signs like those observed in women. Goats have the potential to be a promising animal model to study infectious lactational mastitis.
The aim of the present study was to characterize genotypically 45 Staphylococcus aureus strains isolated from humans, bovine subclinical mastitis and food samples in Argentina by rep-PCR and PCR amplification of virulence genes. Resistances to various antibiotics could be observed for the human S. aureus, less pronounced for the bovine strains, but not for the eight S. aureus isolated from food samples. The strains could be classified genotypically by rep-PCR and by amplification of the genes encoding protein A, coagulase, clumping factor, the collagen adhesin domains A and B, capsular polysaccharide 5 and 8, the accessory gene regulator agr classes I to III, and the S. aureus gene regulator sae. rep-PCR analyses and the different gene patterns revealed that the strains could be divided into seven groups mostly matching with the origin of the isolates. The present study describes genotypic variations of S. aureus strains isolated from different origins in Argentina. The study provides a valuable insight into molecular specificities of this important pathogen.
Twenty isolates of group B streptococcus (GBS) were recovered from the milk of cows with bovine mastitis on three farms located in the south and south-east of Brazil between 1987 and 1988. These isolates were characterised by molecular methods and compared with a collection of 103 human GBS isolates from colonised and infected patients in the same region between 1980 and 2003. Some of the bovine isolates shared identical or similar pulsed-field gel electrophoresis (PFGE) patterns with a PFGE clone of human GBS type V. In addition, these bovine and human isolates also possessed the same ribotype. Multilocus sequence typing (MLST) of representative isolates confirmed the genetic relationship between the human and bovine GBS isolates with identical PFGE patterns, which clustered in the same ST-26 clonal complex. These data support the hypothesis that some bovine GBS strains are related closely to human isolates and may infect humans, or vice versa. Further comparative genomic analyses of GBS isolates from bovine and human origins are required to investigate this hypothesis further.
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Intramammary infections with Group-B streptococci of human and bovine origin were produced experimentally in cows. The initial cytological response was more rapid to the human than to the bovine strain (Table I), while at later stages the pathological changes induced by the two infections were much the same (Fig. 1). The initial clinical reaction was more acute to the "human" than to the "bovine" infections and the average daily loss of milk was greater in cases of "human" infection than in cases of "bovine" infection (Table II). In contrast to the "bovine" infections the "human" infections showed a pronounced tendency to spontaneous clearance. The rate of excretion of Group-B streptococci with the milk was lower for the "human" than for the "bovine" infections (Table III). The special mode of reaction of the bovine udder against infections with Group-B streptococci of human origin may, in part, explain why such infections have a lower tendency to spread within a herd than infections with bovine strains of B-streptococci.
Although hemagglutination by Staphylococcus aureus has been associated with the pathogenesis of bovine mastitis, this trait has not been characterized with regard to human disease. In this study, the prevalence of hemagglutination in 100 strains of S. aureus responsible for bovine mastitis or human bacteremia, was characterized. Under optimum conditions hemagglutination was noted in 23% of the bovine strains, but only 13% of human strains, leading us to conclude that this trait is not a significant virulence determinant in human systemic infection. Additional studies indicate the hemagglutinin of S. aureus strains responsible for human bacteremia is proteinaceous in character.
Mastitis, an inflammation in the breast, has recently been linked with higher human immunodeficiency virus (HIV) load in breast milk and higher risk of mother-to-child transmission of HIV. Among 334 HIV-infected women in Malawi who were breastfeeding, the prevalence of mastitis, as indicated by elevated breast milk sodium, was 16.4% at six weeks and 2.8% at six months postpartum. Mastitis is associated with significantly higher concentrations of immunological and inflammatory mediators in breast milk, including lactoferrin, lysozyme, secretory leukocyte protease inhibitor, interleukin-8, and RANTES. Mastitis is potentially preventable by improving micronutrient status of breastfeeding women and can be treated with antibiotics and clinical management. These studies in Malawi suggest that mastitis may contribute to transmission of HIV through breast milk.