Risk factors associated with uterine fluid after breeding caused by Streptococcus zooepidemicus

Infectious endometritis is a major cause of infertility in the mare and inflicts major losses on the equine breeding industry. The ability of the mare to eliminate uterine infections has been studied intensively for decades; however, despite identification of several factors contributing to the multifactorial pathogenesis and improved treatment, infectious endometritis remains a significant problem in a subpopulation of broodmares. Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) is one of the most commonly isolated pathogens from the uterus of mares, suffering from infectious endometritis. Its ability to cause chronic latent infection by residing deep within the endometrial tissue has previously been described. The aim of the present study was to correlate different mare risk factors to infectious endometritis and pregnancy rates in broodmares and to investigate whether clonal or genetically distinct S. zooepidemicus strains isolated from mares with endometritis were associated with mare risk factors and the outcome of insemination. Mares (N = 152) were examined after natural cover, and 20% (31 mares) had intrauterine fluid (IUF) accumulation. Fifty-five percent (16 of 29) of the mares with IUF had infectious endometritis, and S. zooepidemicus was isolated in 81% (13 of 16) of these mares. Significantly more resting mares had IUF compared with foaling mares, and the foaling mares had the highest prevalence of positive bacterial growth from the uterine swab. The per-cycle pregnancy rate for the study was 63%. Pregnancy rate was significantly negatively affected by increased age (>12 years) and increased parity (>4), and the lowest pregnancy rate was observed in resting mares compared with foaling, barren, and maiden mares. Up to four S. zooepidemicus isolates were selected from each mare with growth of S. zooepidemicus from the uterine swab sample and further characterized by pulsed-field gel electrophoresis. In total, S. zooepidemicus isolates from 18 mares were analyzed with pulsed-field gel electrophoresis. In 13 mares, the isolates selected from each mare showed a high genetic relatedness within each individual mare, whereas two genetically distinct strains were isolated in five mares. A clonal S. zooepidemicus infection was associated with increased age, high parity, and poor vulvar conformation. Mares with clonal infection had a low pregnancy rate (38%) compared with mares with two strains isolated (80%). In conclusion, the results indicate that clonal S. zooepidemicus endometritis is associated with increased age, parity, and poor vulvar conformation in the broodmare.