Bacteriological examination of urogenital smear

Bacteriological examination of urogenital smear in women

Bacteriological examination of the vagina and cervix is ​​performed during the examination.

The normal flora of a woman's genital tract changes according to the pH of the mucous membrane and the concentration of estrogen. These figures are closely related to age:

• Prepubertal and postmenopausal flora staphylococci and corynebacteria dominate (the same flora is found on the surface of the epithelium);
• In sexually active women Enterobacteriaceae, streptococci, staphylococci, anaerobic bacteria (lactobacilli, anaerobic bacilli, anaerobic cocci) participate in the creation of microbial flora. Lactobacilli are the normal vaginal microbial flora.

Group B hemolytic streptococci  If present in the vaginal flora, it can be transmitted to the newborn with neonatal complications.

Classification of female genital tract infections:

Female genital infections are one of the frequent reasons for consulting a gynecologist. The mechanism of their development is as follows:

• Caused by microorganisms of normal vaginal flora Endogenous infections;
• Exogenous infections, Caused by sexually transmitted microorganisms:

- Bacteria (Neisseria gonorrhoeae, Chlamydia trachomatis - DK serotypes, pale Treponema pallidum)

- Viruses (Herpes simplex virus type 2, papillomavirus)

- Protozoa (Trichomonas vaginalis).

It is damaged during infections of the external genital organs  Vulva, vagina and cervix - usually develop as a result of intercourse or an imbalance of the normal genital flora.

It is damaged during infections of the internal genital organs Uterus, fallopian tubes, ovaries - often develops as a complication of external genital organs.

Lower genital infections

Infections of the vulva It can be bacterial, viral, fungal or parasitic and can develop in isolation or in combination with vaginitis.

- Frequent infections: folliculitis, furuncles, pyoderma;

- Specific infections: Trichomonas vaginalis, fungal infections, Treponema pallidum, simple hepatic virus type 2, papillomavirus;

Bartholinitis (inflammation of Bartholin's glands located at the junction of the vulva and vagina) can be caused by Neisseria gonorrhoeae, Chlamydia trachomatis or an imbalance of the local genital flora. Blockage of the duct of the gland by an inflammatory process can cause an abscess with aerobic and anaerobic microflora.

Vaginitis (Inflammation of the vagina. Most often described as vulvo-vaginitis) may be:

- Specific: Causes are - fungi, Trichomonas vaginalis, pale treponema, papillomavirus;

- Nonspecific: Develops due to imbalance of normal vaginal flora;

- Caused by foreign bodies (Eg contraceptives)

Golden Staphylococcus (St. Aureus) Found in the vagina in 5-10% of healthy women; It can cause purulent discharge and toxic shock when using hyperabsorbent tampons during menstruation.

Vulvovaginitis can also be caused by Neisseria gonorrhoeae, Chlamydia trachomatis or Streptococcus pyogenes.

Vaginosis (non-inflammatory syndrome) – develops due to the replacement of normal lactobacilli flora by anaerobic bacteria (Bacteroides spp, Prevotella spp, Porphyromonas spp, Peptostreptococcus spp, Mobiluncus spp) and is associated with Gardnerella vaginalis. These bacterial species are part of the normal flora of the vagina, but in the case of vaginosis, their number increases by 1000 times compared to normal. Although the infection mainly develops in sexually active individuals, it can also develop in adolescents.

Cervicitis (inflammation of the cervix)

• Trichomonas vaginalis, Candida albicans - infections that develop in the form of cervico-vaginitis;
• Papillomavirus (especially types 16 and 18) is an etio-pathogenic factor of cervical intraepithelial neoplasms.
• Herpes simplex virus type 2 - Infection with endo- and exocervical ulcerative lesions.

Lactobacillus (Lactobacillus spp.), golden staphylococcus (S. Aureus), group B hemolytic streptococcus and Candida spp.

Bacteriological examination of urogenital smear in men

Bacteriological examination of urethral smear, prostate secretion and sperm is carried out.

The male genital tract is normally sterile, which is ensured by the mechanical effects of urine and ejaculate, as well as by a polypeptide with antibacterial properties secreted by the prostate. As a rule, the source of ascending infection is the male urethra.

Classification of male genital tract infections

Depending on the location, male genital infections are divided into: Urethritis, prostatitis, epididymitis and orchitis.

Urethritis (Inflammation of the urethra)

Gonococcal urethritis - In more than 70% of cases there is an acute course, there is dysuria and often purulent discharge from the urethra, and in about 5-10% the infection is asymptomatic. Untreated gonorrhea can develop into a chronic infection and can lead to complications.

Gonococcal urethritis can also manifest as a dual infection (e.g. gonococcus + C. trachomatis or U. urealyticum). Also, urethritis can develop as a result of infection with Cryptococcus neoformans.

Among the etiological factors of non-gonococcal urethritis, it is worth noting C. trachomatis (50%), Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and the herpes virus. Complaints are less intense.  Inflammatory processes caused by Gram-negative microflora are a risk factor for the development of urethral strictures or phimosis.

Prostatitis (Inflammation of the present gland)

Bacterial prostatitis:

Acute: most commonly caused by N. gonorrhoeae;

Chronic: more common causes are C. trachomatis, Enterobacteriaceae, pseudomonads, enterococci; Rarely causes Staphylococcus saprophyticus, Trichomonas vaginalis.

Non-bacterial prostatitis The causative agent may rarely be Candida spp.

Epididymitis (Inflammation of the testicular appendage)

Appears as an ascending infection developed as a complication of prostatitis or urethritis. A contributing factor to the inflammatory process is local injuries, especially in conditions of bacteriuria.

Nonspecific bacterial epididymitis: Most commonly caused by Enterobacteriaceae, pseudomonads, and sometimes gram-positive cocci;

Sexually Transmitted Epididymitis: Caused by C. trachomatis and N. gonorrhoeae;

Epididymitis in systemic diseases: Rarely found in tuberculosis, blastomycosis.

Orchids (Inflammation of the testicles) Invite:

- Viruses: Urlian virus and Coxsackie virus, which infects the testicles unilaterally or bilaterally, hematogenously;

- Bacteria: infection develops near the epididymis.

The condition of the body, the severity of the infectious process and the virulence of the cause play a decisive role in the development of the inflammatory process.

Antibioticogram after examination Is done Of need according to.

When should a bacteriological examination of a urogenital smear be performed?

•  In the presence of symptoms characteristic of infectious diseases of the urogenital tract
• For post-treatment monitoring (7-14 days after stopping the use of antibacterial, immunobiological drugs).

How to prepare for the test?

• The research material should be collected before the start of the treatment with antibacterial and antifungal agents or no earlier than 7-10 days after the end of the treatment.
• It is recommended to refrain from sexual contact for 3 days before taking the research material
• For women: Vaginal douching, suppositories, ointments, tampons should not be used for three days before collecting the material.
• For men: Do not ejaculate for 3 days before collecting the material
• The collection of material is not carried out in the laboratory center (material for research must be brought to the laboratory).

Research material

In women: Vaginal smear, cervical smear.

In men: Urethral smear, prostate secretion, semen.

Possible interpretation of the results

In case of detection of pathogenic microflora or any other disorder in the smear, it may be necessary to use additional methods of diagnostics, for which you must consult a specialist doctor. Taking into account the results of the examinations, the clinical picture and other anamnestic data, it is the doctor-specialist who decides on the appointment of treatment.

Resources

https://www.synevo.ro/shop/cultura-secretie-uretrala-cu-antibiograma-dupa-caz/

https://www.synevo.ro/shop/cultura-secretii-vaginale-cu-antibiograma-dupa-caz/

https://spravochnik.synevo.ua/ru/bacteriologia/id1771.html