Ray E. Trussell

Experimental Basis for the Chemotherapy of Trichomonas vaginalis Infestations. I.

Summary 1. A standardized test procedure employing a highly favorable culture medium has been employed to test the tricho-monacidal action of a number of recommended and suggested drugs. 2. Inspection of the data in Tables I and II suggests an approach which may lead to a more satisfactory therapeutic agent than is now available for the treatment of Trichomonas vaginalis vaginitis. 3. The following compounds in dilutions of 1:1000 or more killed trichomonads in vitro in less than 10 minutes: arsphenamine, clymocol, dihexylin, mercuric oxycyanide, neoarsphenamine, phemerol, phenylmercuric acetate, phenylmercuric benzoate, phenylmercuric chloride, phenylmercuric nitrate, silver picrate, sulfadiazine, sulfarsphenamine, tartar emetic, vuzin dihydrochloride.

Physiology of Pure Culture of Trichomonas vaginalis: III. Fermentation of Carbohydrates and Related Compounds

This study is a continuation of a survey of the physiologic activities of a bacteria-free culture of Trichomonas vaginalis. 1 2 3 4 5 Knowledge of the fermentation reactions of this organism is desirable to serve as a basis for the comparison of this species with other pure cultures when they may become available. Moreover, since compounds containing carbohydrates are extensively used in the therapy of vaginal trichomoniasis, the demonstration of any trichomonas-growth-stimulating action of a carbohydrate suggests that it would probably be of limited clinical value. Experimental. All experiments were performed in duplicate and for those compounds utilized by the protozoa a third test was made. Utilization of the various substances was determined by comparing the population increase and pH shift in a basic medium with and without the test compounds. Four tubes with the test compound were used in most of the experiments and the results averaged. Population counts were made in hemocytometers (one cubic mm counted per tube). pH measurements were made with glass electrode equipment standardized each time against 2 known buffers. The basic medium employed and recommended, which gives very poor growth in the absence of utilizable carbohydrates, is prepared as follows: Two percent proteose peptone No. 3 (Difco), 0.5% NaCl, and 0.1% agar in distilled water adjusted to pH 6, is tubed in 9 cc amounts and autoclaved. After cooling, 0.5 cc of sterile filtered undiluted human serum (adjusted to pH 6 with N/1 HCl) and sufficient autoclaved concentrated sodium thioglycollate solution to give a final concentration of 0.1% are added. The latter is necessary because it was found that “aerobic”fermentation did not occur in its absence. The 32 compounds listed in Table I were added to the basic medium to a final concentration of 0.5%. The test substances in concentrated solution were sterilized either by filtering or by auto-claving 8 minutes. The basic medium without any additions served as the control.

Vaginal trichomoniasis: Complement fixation, puerperal morbidity, and early infection of newborn infants☆

Abstract Examination of fresh vaginal discharge is the more practical and economical way to diagnose the presence of Trichomonas vaginalis. Cultures are highly satisfactory but add little to the study. Approximately 50 per cent of women infected with T. vaginalis gave positive complement fixation reactions, which were noted less often in carriers than in women with vaginitis. One-sixth of women in whom Trichomonas vaginalis could not be demonstrated also gave positive reactions. It is not improbable that some of these women had been previously infected. Trichomonas vaginalis infection is not associated with an increase in puerperal morbidity and its presence does not constitute an indication for treatment in asymptomatic patients. Approximately 5 per cent of female babies born to infected mothers were shown to be infected with Trichomonas vaginalis during the first eight days of life.

Vaginal acidity (in vivo glass electrode measurements) in late pregnancy and its relation to the vaginal flora

Abstract The glass electrode technique offers a rapid and convenient method for determining the pH at any desired level in the vagina. In late pregnancy the acidity is highest in the middle portion of the vagina, with the region just inside the introitus being somewhat less acid (see Table I), and the cervix and upper vaginal fornices having an alkaline or only slightly acid reaction. The latter situation is undoubtedly due to the admixture of cervical mucus. The acidity variations observed in the middle vagina correlate roughly with the type of vaginal flora, and apparently with the content of the vaginal bacilli of Doderlein. The monilia are most frequently present in the more acid discharges, while the trichomonads are favored by a less acid reaction. Consistent with this observation, it is generally true that the fungi are most easily cultivated from the middle vagina and the trichomonads from the upper portions near the cervix. Reported variations in the vaginal pH and in the asymptomatic presence of the trichomonads and the monilia under similar conditions and in comparable groups of patients may be explainable on this basis.

Latent gonorrhea in obstetric patients

Abstract The gonococcus has long been identified as an etiologic factor in puerperal morbidity and the syndrome of second-week fever associated with lower abdominal pain and considerable general reaction has been recognized as characteristic of this type of puerperal infection. It has also been appreaciated that certain women who harbor gonococci even during the last month of pregnancy suffer no such complication, but the true extent of such silent infections could not be demonstrated. Recently improved cultural techniques offer the opportunity to approximate more closely the true frequency of latent gonorrheal infections. This report is concerned with an investigation by modern bacteriologic methods of the vaginal flora of a consecutive series of patients admitted to the University Hospitals for delivery.

pH of Secretion in Normal Conjunctival Sac Determined by Glass Electrode

Summary The pH of the conjunctival surfaces can be determined by placing a specially designed glass electrode in direct contact with the conjunctiva. The method is adaptable to clinical use. A study on 88 normal adults is reported. The results indicate that stimulation of lacrimation results in increased alkalinity of the conjunctival surfaces. A larger series must be studied to establish normal values of pH prior to the onset of lacrimation for it is possible that, with further experience and speed of manipulation, the initial pH determination will show a smaller range and a more nearly neutral reaction.

Comparison of Growth of Trichomonas foetus and Trichomonas vaginalis in Chick Embryos.

Nelson 1 first reported the cultivation of Trichomonas foetus in chick embryos after inoculations of 1 cc of a culture into the allantoic sac. The eggs were opened 3 to 4 days after inoculation. Allantoic fluid from the most heavily infected embryos was used to carry the protozoan through 14 subcultures. Later, Levine, Brandly, and Graham, 2 following the same procedure, carried T. foetus through 23 passages and found that 12-day embryos were better than others in an 8- to 16-day series tested. Hogue 3 inoculated T. foetus into the allantoic sac of developing chick embryos and allowed the embryos to hatch or die. In one of 4 chicks that hatched, the protozoa were found in the yolk sac, esophagus, intestines, gall bladder, and cloaca 2 days after hatching. The other 3 gave negative results on fecal examinations. In embryos that died after inoculation, the trichomonads were also found in the digestive tract, yolk, and gall bladder. The present report concerns a comparison of the growth of bacteria-free cultures of Trichomonas foetus 4 and Trichomonas vaginalis 5 in chick embryos. Also, successful subculturing of T. vaginalis in chick embryos is recorded for the first time. After a few preliminary trials, T. foetus was established in chick embryos and was carried through 14 passages in 78 days. The inoculations were made into the allantoic sac as described below for T. vaginalis. The organisms seemed to grow better after the first few subcultures. Seven- to 14-day-old embryos were employed and were inoculated with 0.1 cc to 0.4 cc of trichomonas-containing material. The small inoculum may explain the slight difficulty encountered in establishing the infection. The eggs were opened from 4 to 7 days following inoculation. Observations and experiences were essentially the same as those already reported by others. Examination of the different egg parts showed that the protozoa developed in the allantoic fluid or the amnionic fluid, but were not found in the egg white, the yolk sac, the actual embryo or its blood stream.

Non-Pathogenicity of Gonococci for Larger Animals.

Summary Vaginal and conjunctival inoculations of a pure culture of Neisseria gonorrheœ in cattle, sheep, swine, goats and the horse have failed to produce any infection demonstrable by repeated cultures.