Mycelium and candida how to treat. Fungal and protozoal genital infections - ways of transmission, symptoms, prevention, treatment

Candida in a smear indicates that the mucous membrane is susceptible to attack by the pathogen. As a rule, this is a well-known thrush, called candidiasis in medicine. The causative agent of pathology is a fungus of the genus Candida, by whose name the disease is named.

What can smears tell?

Yeast fungi of the genus Candida live on the vaginal mucosa of any woman. This subspecies of opportunistic microorganisms at a normal amount does not cause negative reactions and does not provoke the disease thrush. The norm for the content of candida albicans is up to 10 to 4 degrees CFU / ml. Any excess of fungi is considered dangerous and can cause thrush at any time.

When conducting analyzes, pseudomycelium of yeast fungal spores is sometimes found, in this case, the morphology confirms the development of pathology. Abnormal reproduction has the following reasons:

puberty;
pregnancy;
menopause;
treatment with certain drugs: antibiotics, corticosteroids, hormonal contraceptives.

In addition, the development of fungal microorganisms can be triggered by a deficiency or excess of estrogen. Multiple pathogenic microorganisms affect patients with diseases:

diabetes;
tuberculosis;
STDs;
chlamydia;
trichomoniasis;
gonorrhea;
genital herpes.

If candida is found in a smear, only a specialist will understand what it is. It is possible that spores may appear due to external provoking factors: heat, dark underwear made of synthetics, frequent douching, infection during sexual contact, stress, decreased immunity.

Important! Pregnancy is a common cause of candida on the mucous membranes. In the process of bearing a child, the hormonal background undergoes changes that affect the vaginal environment. The elevated sugar level observed during pregnancy also provokes the appearance of candidiasis in women. It is necessary not only to identify the disease in the early stages, but also to completely cure candidiasis.

A smear for candida will tell you how dangerously the number of spores of the fungus is exceeded. With bacteriological analysis and detection of excess of the norm, the risk of dangerous consequences increases significantly. Yeast in a smear is the main symptom of thrush, which, if left untreated, leads to infertility.

Symptoms of candidiasis

A yeast infection is manifested by fairly obvious and characteristic signs:

Curdled discharge from the reproductive organs is leucorrhoea with some admixture and a clear sour smell;
Itching and burning of the genitals;
Unpleasant sensations when urinating, during intercourse.

Important! The fungus candida albicavs causes a chronic disease in which there are no accompanying symptoms, only mild itching.

Whiteness and discharge are not always uniform, may have a yellow, greenish tint, but the smell remains, as does itching. Plaque sometimes accumulates in certain places, where cracks then form. Symptoms of thrush also appear externally - the external genitalia swell, they turn red, begin to itch. At night, the itching intensifies, causing an unbearable desire to comb the area, but this should not be done so as not to injure the skin, not to provoke an additional infection.

In the period 3-5 days before the menstrual cycle, the symptoms intensify, this is due to a change in the microflora of the vagina. Often, an exacerbation of the clinical picture is observed after taking water procedures, drinking alcohol, douching.

Important! Clinical symptoms do not always indicate only thrush, the development of Candida fungi is a concomitant symptom of sexually transmitted diseases. Such pathologies should be treated not only by taking antifungal drugs, but comprehensively and under the supervision of a doctor.

Since the disease of thrush in women occurs with severe negative symptoms, you should immediately consult a doctor at the first sign and take all measures to eliminate the infection and the causes of its occurrence.

Tests for thrush candidiasis

The detection of thrush requires examination by a specialized doctor. Only a doctor can refer a patient to all the necessary procedures. Analyzes and diagnostics are time-consuming, candidiasis is detected through the following studies:

Microbiology is carried out through microscopy. For research, material is taken from the area of localization of the fungus. In the presence of predisposing factors, the growth of the fungus is indicated, which leads to the manifestation of symptoms of the disease.
Sowing on the fungus to determine the level of sensitivity of spores to drugs. The process allows you to get a clear picture of the causative agent of the pathology. The analysis is carried out with a material of a biological type: urine, feces, smear, sputum. The taken material is placed in a nutrient medium, where all conditions for reproduction are created. Once the colonies have been grown, drug sensitivity testing of the spores begins. This is how the threshold of sensitivity of a fungal infection is determined. The duration of the analysis is up to 10 days, during this period the patient receives maintenance therapy to reduce the symptoms of the pathology.
polymer chain reaction(PCR method) is a mandatory item that determines the likelihood of progression of the pathology.
Linked immunosorbent assay sums up all the procedures, helping to choose the most the best treatment. By checking for the presence of antibodies in the blood, experts observe the growth of pathogenic flora with the release of immunoglobulin LgG. Only thanks to this analysis, thrush is confirmed, since leucorrhoea can be a sign of many other pathologies.

Each procedure pursues a specific function, therefore, the conduct of all processes must be comprehensive. This method will allow not only to determine the danger, the clinical picture of the pathology, but also to determine the most effective method treatment of candidiasis, excluding the occurrence of relapses. In conclusion, after all procedures, specialists issue the following information:

Presence/absence of fungal microflora;
Species affiliation of the causative agent of infection (thrush);
The number of colonies of the fungus.

Fact! The asymptomatic course of the disease is characterized by the content of the fungus below 104 CFU / ml, with equal or elevated rates, candidiasis is diagnosed and tests are carried out for the threshold of sensitivity of the fungus to antimycotic agents.

Before taking tests, the patient is forbidden to take antifungal drugs - otherwise the clinical picture of the diagnosis will be blurred. Laboratory tests and studies are scheduled for repetitions during and after treatment. Only a negative smear result gives an understanding of the effectiveness of therapy. In the absence of the expected effect, another treatment regimen with the use of other drugs is prescribed.

Treatment of candidiasis in women

Regardless of the form of the disease, treatment of candidiasis is required. As a rule, a course of antibacterial drugs is used, selected based on the result of the tests. First of all, it is necessary to get rid of Candida fungi, and this can be done through local antifungal therapy, that is, vaginal tablets, suppositories, ointments, gels.

Important! Self-medication is unacceptable! The type of therapy, medicines are selected only by the doctor. It all depends on the individuality of the disease in women, the condition and the presence of additional aggravating factors, such as diabetes, STDs, and others.

Prescribed oral antifungal drugs help get rid of candidiasis after a short time, but intravaginal drugs should be taken much longer. The most popular topical vaginal treatments are:

Compositions with ketoconazole;
Compositions with clotrimazole;
Pimafucin;
Zalain.

Acting locally, these medicines help to completely heal from candidiasis in a mild form, when it is impossible to take systemic therapy, for example, during pregnancy. However, if the thrush is already chronic and the genital organs are severely affected, not only local, but also systemic medicines will be required. The most used drugs:

Levorin;
Nystatin;
Clotrimazole;
Itraconazole;
Fluconazole;
Iodine-containing preparations.

Completion of antifungal therapy requires complete restoration of the vaginal microflora. It is possible to prescribe probiotics, eubiotics present in vaginal suppositories of a certain type. Without fail, it is necessary to increase immunity, eliminate the possibilities and causes of infection with thrush as much as possible and drink a course of vitamins. In any case, the appointment is made by the doctor, who should be contacted as soon as possible, even the slightest signs of candidiasis are found.

Thrush is considered a common ailment that affects both women of different ages, as well as men and children. Therefore, you need to know how thrush and spores are related. Thrush caused by fungi of the genus Candida is a disease that manifests itself in different parts of the skin and mucous membranes on the human body. More often found on the genitals. When a swab was taken at the girls' gynecologist's appointment, the result of the analysis may indicate the presence of yeast spores or mycelium (body) of fungi in the lubricant. In this case, the patient is diagnosed with thrush.

The gynecologist takes a smear, and the presence of mycelium of the fungus is determined by a microscopic method. If their number exceeds the norm, then a diagnosis of "vaginal candidiasis" will be made. It is worth remembering that these fungi are constantly in the human body, but cause thrush only under the influence of certain factors. If spores are found in the smear, then the person is a carrier of the yeast-like fungus Candida.

Certain factors influence the development of thrush. It often occurs in pregnant women. When carrying a fetus, the level of female sex hormones increases, which leads to a change in the microflora of the vagina. As a result, conditions are created for the growth and reproduction of the fungus, and the physiologically weakened immunity, whose forces are thrown to protect the embryo, is not able to restrain the development of a fungal infection.

The main reasons for the appearance of fungal spores, and then urogenital thrush, are:

The presence of thrush spores in a smear indicates a high risk of developing thrush, since it is from them that the fungi themselves grow with the slightest decrease in immunity. If the patient is constantly worried about the main symptoms of candidiasis, such as burning, itching and pain, then the disease has already passed into the active phase and inflammation of the tissues has begun. If the treatment is not started in time, the cells lose their strength, which contributes to the traumatization of the vaginal mucosa when performing daily hygiene procedures or during childbirth. Active formation of spores in a smear indicates a decrease in immunity, which can also be caused by another, more dangerous disease, such as HIV. Therefore, a doctor's consultation is necessary.

It is possible to recognize thrush by some symptoms, but the disease can also be asymptomatic. Differential diagnosis of early stages is complicated by similarity with other infectious diseases. Possible symptoms are:

the presence of curdled secretions;

itching, burning and redness of the genitals;

pain during intercourse;

plaque white color on the genitals;

pain when urinating.

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What treatment to apply?

Treating thrush is not easy. Often, the disease returns after a certain period of time, in particular, with a repeated decrease in immunity. Preparations for the fungus are divided into 2 types: local and systemic. AT severe cases, with advanced disease, doctors prefer the second type of treatment. Taking pills affects the main focus of fungi. Local preparations include suppositories and various healing creams. Their effectiveness is less, as they relieve local symptoms of candidiasis, which is important in the early stages. For the treatment of tablets and ointments alone is not enough, it is important to eliminate the provoking factor in the appearance of thrush.

Preventive measures are also important to prevent the recurrence of candidiasis. You need to choose loose underwear, be less nervous and not take antibiotics for long or frequent courses, change your diet. For the duration of the therapeutic diet, completely exclude alcohol. From diet menu remove foods containing yeast, cheeses, canned food and sweets (required). The amount of fresh unsweetened vegetables and fruits (but not grapes), fish and garlic should be increased in the diet. Occasionally you can afford dairy products. It is important to drink more water.

Candida fungi in a smear on the flora in men, women and children

A smear for candidiasis is a mandatory procedure for suspected candidiasis in men, women and children.

A smear for thrush allows you to differentiate it from other diseases and obtain material for research on the microflora of the organ. Depending on the gender and the place of inflammation, both the methods of taking the material and the organs from which the material for research will be taken will differ.

So a smear for thrush in men is usually taken from the head of the penis by inserting a special applicator inside the urethral canal for a couple of centimeters. If the patient has whitish discharge on the head of the penis, then their sample is also taken and sent to the laboratory.

In newborns whose mothers were ill with thrush during pregnancy, they must take a swab from the throat for candida. These babies have a 35 times higher chance of detecting Candida spores in a mouth swab than babies born to healthy mothers. In such cases, saliva is taken from the child for analysis of candida in it, and if a white coating is visible on the throat, it is removed with an applicator for further research.

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In women, biomaterial for the detection of candidiasis is taken from the vagina, and very often candida spores can be detected in a smear in a small amount (titer 10 * 3 or less), which indicates the absence of thrush and is regarded only as an asymptomatic carrier.

Since thrush usually develops when the immune system is weakened and during the restructuring of the hormonal background, candida in a smear on the flora is a frequent guest in the analyzes of pregnant women. That is why in pregnant women when registering general analysis on the microflora of the vagina is mandatory.

In order for the doctor to be able to detect candida in a smear, before the sampling procedure, you should not urinate 2 hours before the study, do not use antifungal and antibiotic drugs, and do not have sex for a day.

After taking secretions from the pharynx, urethra, or vagina, they are applied to several glass slides, dried, stained, and examined under a microscope. Then all the data obtained is entered into the results of the analysis, which indicates the presence or absence of Candida spores, the number of leukocytes (an increased number of leukocytes indicate an inflammatory process), as well as the presence of squamous epithelium and atypical cells. Having compared all the data, the doctor concludes whether the patient has thrush or if it is a question of another disease.

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Mushrooms in a smear

Candidiasis or thrush is one of the most common urogenital infections.

According to statistics, every woman of sexually active age has experienced this disease at least once.

The causative agent of candidiasis are yeast-like fungi.

These are conditionally pathogenic microorganisms that constantly live on the mucous membrane of the genitourinary tract.

A yeast infection develops when the body's immune defenses are weakened.

And along with this, the local tissue immunity of the urogenital tract decreases, its barrier function weakens.

Under these conditions, Candida fungi acquire pathogenic properties and cause infectious inflammation of the tissues of the genital tract.

In some cases, a fungal infection spreads from the vagina or penis to the urethra or intestines.

Yeast fungi in a smear: causes of appearance

Factors contributing to the development of a yeast infection are:

hypothermia,

change in diet with an increase in the amount of sugary foods consumed,

immunosuppressive conditions - diabetes mellitus, HIV infection

pregnancy,

endocrine disorders,

taking hormonal contraceptives,

uncontrolled use of antibiotics,

concomitant sexually transmitted infections,

vaginal dysbiosis.

The lieutenant colonel of the medical service, doctor Lenkin Sergey Gennadievich tells about what the mushrooms say in the smear

How does vaginal candidiasis manifest itself in women?

Acute course infection is accompanied by profuse vaginal discharge of white or white-gray color, curdled consistency, with a sour smell.

There is marked itching of the mucous membrane of the vulva and the vestibule of the vagina.

During colposcopy, there is severe swelling, soreness of the vaginal mucosa, its hyperemia.

The walls are covered with a curdled white coating with fibrin films.

When it is scraped off, a red mucosa with foci of erosion is exposed, which bleeds easily.

With a chronic process, the vulvar mucosa atrophies, becomes thinner, and foci of excoriation and thickening are noted on it.

The infectious-inflammatory process turns into chronic form 2-2.5 months after the onset of the disease in the absence of therapeutic measures.

In men, thrush is manifested by damage to the mucous membrane of the head of the penis.

It is covered with a curdled white-gray coating with a sour smell, the mucous membrane is dry, painful.

There are phenomena of dysuria, burning, itching of the urethral mucosa, pain during urination.

Mushrooms found in a smear: diagnosis and treatment

Diagnosis of candidiasis is carried out by a gynecologist in women and a urologist in men.

The diagnosis is made on the basis of typical clinical signs of the disease, the detection of Candida fungi in a smear during microscopy, and the isolation of fungal spores using bakposev.

A smear for research in women is taken from the vagina, placed on a clean glass slide and examined under a light microscope.

If a yeast fungi were found in the smear in large quantities, a diagnosis of vaginal candidiasis can be made.

Mushroom elements in a brushstroke have a round or oval shape, often look like budding cells.

During bacteriological examination, the growing colonies of yeast fungi have a rounded shape, look like shiny convex elements of white color.

Bakposev allows simultaneously with the identification of the pathogen to establish its sensitivity to antifungal drugs.

Treatment of candidiasis involves a systematic approach and local interventions.

The regimen of drug therapy includes the administration of antimycotic drugs of systemic action.

Also external antifungal agents, douching, urethral instillations.

The body's resistance is increased with the help of immunostimulants and multivitamin complexes.

Restoring the normal microflora of the vagina involves taking prebiotics (hilak forte) and eubiotics (bifiform, acidolact, probifor).

When detecting fungi in a smear, contact the author of this article, a venereologist in Moscow with 15 years of experience.

What does pseudomycelium say in a smear and what is it?

Passing smears for microflora and receiving test results, men and women ask themselves the question: pseudomycelium in a smear - what is it and what does it say?

When is pseudomycelium found in a smear?

The body is a complex system, where each person in the intestines and genitals normally coexists with many other microorganisms - bacteria and fungi, necessary to ensure full-fledged work organs.

Together, all microorganisms - normal and conditionally pathogenic - create a special microflora. In order for human health to remain in order, it is necessary to maintain a balance between all components of the microflora.

A smear is one of the diagnostic procedures used in gynecology and urology to detect the presence of pathogenic fungi or bacteria.

A smear for flora is one of the most popular and effective types of laboratory microscopic analysis. A smear allows you to evaluate the amount of conditionally pathogenic microflora according to characteristic features.

In the genital organs of women, the microflora is mainly represented by lactobacilli, which maintain an acidic environment in the vagina that prevents the development of infection.

One of the most common "female" diseases caused by an imbalance of microflora is thrush (candidiasis), in the presence of which pseudomycelium can be detected in the analyzes.

Smears should be taken for preventive purposes once or twice a year. In addition, both men and women must undergo research if discomfort and unusual discharge occur.

In women, thrush is characterized by:

unpleasant, pungent odor;

painful sensations that appear during intercourse or urination;

the presence of white curdled discharge;

itching and burning on the surface of the genitals.

In men, candidiasis is usually asymptomatic.

But sometimes they appear:

mucus excreted in the urine.
pain during urination and sexual intercourse;
white plaque in the folds at the head of the penis;
redness of the skin in the genital area;
burning sensation and itching in the area of the foreskin and glans penis.

Tests may reveal the presence of pseudomycelium in a smear or detect other pathological manifestations.

What does pseudomycelium mean in a smear?

Pseudomycelium is formed by some types of yeast. The appearance of pseudomycelium in a smear in men and women indicates an increased reproduction of Candida albicans - unicellular microorganisms of a round or oval shape.

Pseudomycelium is a thread of loosely connected elongated cells with blastospores - a kind of "buds" attached to pseudomycelium constrictions.

In such cases, in addition to pseudomycelium, the smear may contain some types of chlamydospores.

Candida differs from regular yeast in:

the absence of spores in the cellular structure of microorganisms;
characteristic cultural features;
the presence of pseudomycelium.

The disease provokes an increase in the number of opportunistic microorganism Candida, which is part of the normal microflora of the intestine, vagina and oral cavity (a smear reveals pseudomycelium only with thrush during an exacerbation).

Candidiasis can develop due to the active reproduction of the fungus or as a result of more pathogenic strains entering the body.

In most cases, the cause of thrush in women and men include a general or local decrease in immunity.

So, candidiasis often appears regardless of the sexual partner - under the influence of stress, as a result of a decrease in immunity, or due to the use of antibiotics. Candida occurs even in young children.

In women, under the influence of the fungus, balanoposthitis, balanitis and vulvovaginal candidiasis can develop.

Conditionally pathogenic microflora is also transmitted through sexual contact, so if one of the partners has a pseudomycelium in a smear, then in order to avoid relapse, treatment procedures must be completed by both, regardless of the severity of the symptoms.

A smear should also be taken by women during and at the planning stage of pregnancy in order to reduce the likelihood of transmission of infection to the fetus.

In addition, during the bearing of a child, immunity is greatly reduced, and all "hidden sores" can actively manifest themselves.

Deciphering smears and test norms

In order for the smear tests to be as reliable as possible, it is necessary to prepare for the study in a day - you need to exclude sexual intercourse, do not use douching and do not use creams, ointments or suppositories.

The material for analysis is taken with a disposable spatula and applied to a special glass. The glass is sent to a laboratory for analysis, where it is stained and examined under a microscope.

Taking a smear is usually painless, but may be accompanied by discomfort.

In women, a smear is taken from three areas:

from the urethra;
from the cervix;
from the vagina.

The analysis indicates the results of the study of all points.

In men, a swab is taken only from the urethra.

During the study, you can find:

flat epithelium;
leukocytes;
gram-positive rods;
traces of mucus;
pathogenic microorganisms and traces of their activity (including pseudomycelium).

When decoding, specialists are guided by certain norms.

In women, the norms of vaginal cleanliness are divided into 4 degrees. The first degree appears only in healthy women. The analysis confirms a large number of "normal" microorganisms and some squamous epithelium.

The second degree allows a small number of cocci in women with a predominance of normal microflora and is also not a sign of the development of pathology.

In the third degree in women, the number of cocci is much greater, in addition, the material for analysis contains leukocytes (more than 10).

At the fourth degree, the beneficial microflora in women is practically destroyed, and the analysis reveals a large number of leukocytes and multiple traces of infection.

It is at the third or fourth stages that the threads of pseudomycelium appear in a smear on the flora.

The procedure for taking a smear during pregnancy is absolutely safe for the health of both the fetus and the woman herself.

Features of treatment and prevention of thrush

Many drugs are used in the treatment of candidiasis. These are local remedies - ointments, creams, vaginal suppositories, and oral preparations - tablets or capsules.

The most famous drugs include: Natamycin, Clotrimazole, Mikosist, Fluconazole, Miconazole and Nystatin. There are a large number of other drugs, the effectiveness of which is not lower.

The choice of medicine should be entrusted to a specialist. This is due to the fact that microorganisms develop resistance to the active components of drugs.

With the wrong selection of funds, fungi can develop significant resistance, and further treatment will be difficult: you need to use more and more new, stronger and more modern drugs.

Women are prescribed vaginal suppositories, and men - ointments or creams. To increase the effectiveness of treatment, oral medications may additionally be prescribed.

Women should be especially careful when treating thrush during pregnancy. The means used must be extremely gentle so as not to harm the health of the fetus.

For these purposes, you can use a solution of chlorhexidine.

In the presence of pseudomycelium in the analyzes of one of the partners, the second must also be tested and undergo treatment. The disease is often asymptomatic (in men more often than in women).

As a result, one partner, without undergoing therapy, can infect another with an activated strain, due to which the disease will be recurrent.

For the duration of the therapy, it is worth refusing to have sexual intercourse. In men, the disease, as a rule, passes faster and manifests itself less often than in women. That is why thrush is considered mainly a female disease.

Maintaining hygiene, maintaining a healthy immune system, and taking care of your health are the most effective and simple ways to reduce the likelihood of candidiasis.

Thrush and pregnancy: spores and mycelium in a smear

Often, women during pregnancy are faced with such a problem as the detection of fungal mycelium in a smear. What it is, and how pregnancy and thrush are connected, you can find out by reading this interesting and informative article.

Surely every woman at least once in her life heard about thrush. This is a fairly common disease, according to statistics, one out of three women felt what it is.

There is a category of women who go through life with this disease, while others encountered it for the first time during pregnancy. Thrush refers to a disease caused by one pathogen - a fungus from the genus Candida, which is why it is called candidiasis. The main symptoms of thrush are itching and burning of the external genital organs, pain during intercourse, vaginal dryness, and also curdled discharge, resembling flakes, with a sour smell.

If during pregnancy a woman felt at least one of these symptoms, it is necessary to contact her gynecologist as soon as possible, because not only candidiasis has similar symptoms. Genital herpes, chlamydia, colpitis - all these diseases can cause burning and itching.

There are three main forms of candidiasis. The first form is carriage, that is, the absence of complaints and a clinical picture. The second form is acute candidiasis, it is characterized by vivid manifestations of inflammation, and the manifestation of the full clinical picture of this disease. The third form, chronic candidiasis. This form is characterized by periods of remission, alternating with exacerbations, for more than two months.

In order to make an accurate diagnosis, the gynecologist must take a smear. Usually, in order to identify the mycelium of the fungus in a smear, a microscopic examination method is used. To do this, a smear is taken from several places, from the cervical canal and vagina. After that, the taken material is sent to the laboratory, where, after special staining, the laboratory assistant examines it under a microscope.

If the mycelium of the fungus is found, then there is an active process of infection with fungi of the genus Candida, in other words, the woman is sick with thrush. The mycelium of mushrooms in a smear is an accumulation of thin threads with branches that make up the nutritious and vegetative part of the fungus. If spores of the fungus were found in the smear, this indicates that the disease is asymptomatic, or the woman is absolutely healthy, but is a carrier of this disease.

Also, a cultural method is used to diagnose candidiasis, it is based on the identification of the pathogen by sowing. The smear samples are placed in a special environment favorable for the reproduction of fungi, where they begin to actively multiply and form colonies, and after a while they can be easily seen with a microscope, even if they were not visible during microscopy.

The newest and most informative method for identifying the pathogen is PCR. Today it is one of the most accurate methods, but also quite expensive. This method is based on the detection of single pathogens. But, it is believed that during pregnancy, due to changes in the microflora of the vagina, it can give a false positive result. Therefore, most often the diagnosis is made on the basis of characteristic complaints and the detection of spores and mycelium in a smear.

The main cause of thrush during pregnancy is a hormonal imbalance that occurs in every pregnant woman in response to changes in the body. There is a change in the microflora of the vagina, it creates a favorable environment for the reproduction of fungi, and therefore if a woman previously had thrush and did not cure it, or if she is a carrier of spores, there is a great opportunity to re-transfer candidiasis during pregnancy.

Another reason for the occurrence of thrush during pregnancy is the wearing of synthetic or tight underwear. Also, non-compliance with the diet, eating a large amount of bakery products, a large amount of sweets, vitamin deficiency, all this can lead to thrush.

Taking medications such as antibiotics, corticosteroids, immunosuppressants also affect the microflora of the vagina. During pregnancy, there is a significant decrease in immunity, so thrush may appear after a cold or hypothermia.

Some women, on the advice of their friends or mothers, believe that candidiasis during pregnancy is an absolutely normal phenomenon that does not require any intervention. Every woman should know that thrush during pregnancy is not something ordinary and harmless, she, like a litmus test, indicates violations in a woman's body.

Not always, but candidiasis can lead to complications during pregnancy, the fungus is quite capable of disrupting the development of the baby and affecting its organs. The mucous membranes, umbilical cord, lungs and skin are most often affected.

Infection can occur both during childbirth, in contact with infected areas, and during pregnancy. Launched thrush can have an extremely negative impact on the unborn child, up to death.

If symptoms of thrush appear during pregnancy, you should not self-medicate, all drugs and doses should be prescribed by a doctor. To date, the treatment of thrush is not difficult, and the exact observance of the recommendations of the attending physician leads to a complete recovery. It is believed that thrush can be sexually transmitted, so it is advisable to be treated with a sexual partner and use barrier contraception during intimacy.

The main principle of the treatment of candidiasis is to take drugs that inhibit the growth and reproduction of fungi. Local treatment consists of douching procedures, the use of vaginal suppositories with an antifungal effect and the use of topical drugs that eliminate itching. Immunity boosters are also prescribed.

In order to avoid the appearance of thrush during pregnancy, you need to follow a few simple rules. Firstly, it is necessary to properly treat thrush before pregnancy, and plan conception only after a complete examination. Compliance with the rules of nutrition during pregnancy, use the vitamins prescribed by the doctor.

Refuse to wear synthetic underwear and carefully monitor cleanliness.

Thrush and pregnancy should not go hand in hand, this is not a physiological condition, it requires the intervention of a specialist.

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Source: uruh-sovet.ru

What can smears tell?

puberty;
pregnancy;
menopause;
treatment with certain drugs: antibiotics, corticosteroids, hormonal contraceptives.

In addition, the development of fungal microorganisms can be triggered by a deficiency or excess of estrogen. Multiple pathogenic microorganisms affect patients with diseases:

diabetes;
tuberculosis;
STDs;
chlamydia;
trichomoniasis;
gonorrhea;
genital herpes.

Important! Pregnancy is a common cause of candida on the mucous membranes. In the process of bearing a child, the hormonal background undergoes changes that affect the vaginal environment. The elevated sugar level observed during pregnancy also provokes the appearance of candidiasis in women. It is necessary not only to identify the disease in the early stages, but also to completely cure candidiasis.

Symptoms of candidiasis

A yeast infection is manifested by fairly obvious and characteristic signs:

Curdled discharge from the reproductive organs is leucorrhoea with some admixture and a clear sour smell;
Itching and burning of the genitals;
Unpleasant sensations when urinating, during intercourse.

Important! The fungus candida albicavs causes a chronic disease in which there are no accompanying symptoms, only mild itching.

Important! Clinical symptoms do not always indicate only thrush, the development of Candida fungi is a concomitant symptom of sexually transmitted diseases. Such pathologies should be treated not only by taking antifungal drugs, but comprehensively and under the supervision of a doctor.

Tests for thrush candidiasis

Microbiology is carried out through microscopy. For research, material is taken from the area of localization of the fungus. In the presence of predisposing factors, the growth of the fungus is indicated, which leads to the manifestation of symptoms of the disease.
Sowing on the fungus to determine the level of sensitivity of spores to drugs. The process allows you to get a clear picture of the causative agent of the pathology. The analysis is carried out with a material of a biological type: urine, feces, smear, sputum. The taken material is placed in a nutrient medium, where all conditions for reproduction are created. Once the colonies have been grown, drug sensitivity testing of the spores begins. This is how the threshold of sensitivity of a fungal infection is determined. The duration of the analysis is up to 10 days, during this period the patient receives maintenance therapy to reduce the symptoms of the pathology.
Polymer chain reaction (PCR technique) is a mandatory item that determines the likelihood of progression of the pathology.
Enzyme immunoassay sums up all procedures, helping to choose the best treatment. By checking for the presence of antibodies in the blood, experts observe the growth of pathogenic flora with the release of immunoglobulin LgG. Only thanks to this analysis, thrush is confirmed, since leucorrhoea can be a sign of many other pathologies.

Each procedure pursues a specific function, therefore, the conduct of all processes must be comprehensive. This method will allow not only to determine the danger, the clinical picture of the pathology, but also to determine the most effective method of treating candidiasis, excluding the occurrence of relapses. In conclusion, after all procedures, specialists issue the following information:

Presence/absence of fungal microflora;
Species affiliation of the causative agent of infection (thrush);
The number of colonies of the fungus.

Fact! The asymptomatic course of the disease is characterized by the content of the fungus below 104 CFU / ml, with equal or elevated rates, candidiasis is diagnosed and tests are carried out for the threshold of sensitivity of the fungus to antimycotic agents.

Treatment of candidiasis in women

Important! Self-medication is unacceptable! The type of therapy, medicines are selected only by the doctor. It all depends on the individuality of the disease in women, the condition and the presence of additional aggravating factors, such as diabetes, STDs, and others.

Prescribed oral antifungal drugs help get rid of candidiasis in a short time, but intravaginal drugs should be taken much longer. The most popular topical vaginal treatments are:

Compositions with ketoconazole;
Compositions with clotrimazole;
Pimafucin;
Zalain.

Levorin;
Nystatin;
Clotrimazole;
Itraconazole;
Fluconazole;
Iodine-containing preparations.

Throat fungus symptoms. How to treat an adult and a child

A fungus in the throat (pharyngomycosis, fungal tonsillitis) is an inflammatory disease of the mucous membrane, which is the result of a mycotic infection in the oral cavity.

Pharyngomycosis affects immunocompromised children and adults, as well as patients who use inhaled corticosteroids and wear dentures.

In adults, fungal tonsillitis is often combined with glossitis, gingivitis, cheilitis, or stomatitis. In children, thrush in the mouth flows in its pure form.

Causes of pharyngomycosis

The causes of the development of the disease in the throat are fungi of the genus Candida - conditionally pathogenic flora, which is always present in reasonable quantities in the human body. Candida live in the mucous membranes and do not cause concern to a person as long as the immune system remains strong enough to resist the development of infection.

Factors predisposing to a deterioration in immunity are:

Tuberculosis.
Avitaminosis.
Menopause.
Pathologies of the gastrointestinal tract.
Frequent viral diagnoses.
endocrine disorders.
Systemic blood diseases.
Chemotherapy.
Injuries of the mucous membrane of the pharynx.
Dental diseases.
The use of oral contraceptives.
Long-term treatment with glucocorticosteroids or antibiotics.
malignant processes. The development of tumors leads to disruption of protein and carbohydrate metabolism, depletes the body and makes it resistant to infection by pathogenic agents.

In children, fungal tonsillitis develops due to the incidence of thrush in a pregnant mother. The pathogen enters the fetus through the placenta, amniotic fluid or umbilical cord. Also, infection occurs at the time of childbirth or after them, if the medical staff violates sanitary and hygienic standards when caring for a newborn.

At home, a child under the age of 1 year becomes infected with thrush from the mother during breastfeeding if a woman is sick with vaginal candidiasis.

From the age of 2, the baby becomes infected in everyday life when using family dishes, towels, combs and toothbrushes of other family members and other items. Signs of infection with a fungus in a child can be observed after a stay in public children's institutions.

Symptoms of a fungal infection in the throat

The main symptoms of a fungus in the throat are whitish dots and spots on the mucous surface of the oropharynx, which looks edematous and creates severe discomfort. The curdled discharge corrodes the delicate tissues, causing them to ulcerate and blister. The patient notes increased sensitivity of the oral cavity.

Other signs of pharyngomycosis:

Weakness.
Pain when swallowing.
Bad appetite.
Burning, dryness and scraping sensation in the mouth.
Hyperthermia with subfebrile body temperature.
Soreness and enlargement of regional lymph nodes (cervical lymphadenitis).
Seizures in the corners of the mouth, bright outline and infiltration of the border of the lips, cracks in the corners of the mouth (indicate concomitant glossitis and candidal cheilitis).

Usually, pharyngomycosis is provoked by candidal flora, so the plaque in the mouth will be white and curdled. The film is easily scraped off, under it the edematous inflamed mucous tissue of the oropharynx is visible. Ulcerated lesions may bleed.

If fungal tonsillitis is associated with infection of the oral cavity with mold strains, the plaque looks yellowish and cannot be removed. A plaque of mold fungi resembles foci of diphtheria in appearance.

How the fungus in the throat will be treated, the doctor will decide after studying the patient's symptoms and comparing them with the photos that are found in the medical literature. We offer you to see a selection of photographs with characteristic signs of pharyngomycosis.

Treatment of fungal angina with medicines

A treatment regimen for Candida fungus in the throat is developed by otolaryngologists based on visual data and responses from the analysis of a smear taken from the throat. Stained smear screening reveals mycotic cells, pseudomycelia and spores. A cultural study establishes the type of pathogen and its sensitivity to antibacterial drugs.

To determine the cause of pharyngomycosis, the patient is helped by tests for diabetes mellitus, syphilis, HIV and hepatitis. For successful therapy of a fungal infection of the throat, it is important to differentiate it from true tonsillitis, pharyngitis, bacterial lesions of the oropharynx and throat cancer.

The doctor knows how to treat a fungus in the throat of an adult, so he can easily make a therapeutic course. In mild cases, you can get by with local treatment of the oral cavity, using one of the ointments:

Amphotericin - destroys any active infections of a fungal nature. The drug is contraindicated in pregnant and lactating women, newborns and patients with a history of liver disease, as well as hypersensitivity to the active ingredient.
Clotrimazole - a powerful fungicidal drug penetrates the fungal body and inhibits the development of the pathogen. During pregnancy, individual intolerance to the drug and hepatic abnormalities, this ointment is not used. Sometimes clotrimazole causes itching and red spots in the treatment area.

Of the antiseptics for the treatment of a fungus in the throat of a child or a patient of an older age group, Miramistin, Chlorhexidine, Lugol's solution, Oxyquinoline, Natamycin are prescribed. Drugs alternate weekly. They are used to treat the posterior pharyngeal wall, wash the tonsils and endopharyngeal installations.

In a mild form, pharyngomycosis can be cured by repeated alkalization of the oral cavity. For this purpose, use:

Iodinol.
Borax solution 10 - 20%.
Aqueous solutions of aniline dyes 1%.
A solution of ordinary baking soda 25%.

With moderate severity, fungal tonsillitis is treated with levorin, nystatin or decamin ointments. Processing is carried out 3 - 4 p. per day for 10 days.

A neglected fungus in the throat can be cured with fungicidal tablets. These are Nystatin, Levorin, Decamine, Fluconazole, Itraconazole, Terbinafine, Diflucan, Ketoconazole, Mikoflucan, etc. In the acute stage, the medicine prescribed by the doctor is taken for 7-14 days.

After paying off the relapse, the tablets are drunk with a prophylactic dosage. Complicated forms of pharyngomycosis are subject to inpatient therapy. To completely destroy the fungal infection, you should also drink restorative drugs:

Poly vitamin complexes.
Probiotics (Linex, Yoghurt, Bifiform).
Immunomodulators (Immudon, Arbidol, echinacea or ginseng extract, Immunal, Polyoxidonium).

Features of the treatment of pharyngomycosis in children

Parents should not decide how to treat a fungus in the throat of a child without consulting a doctor. After examining the baby and confirming the diagnosis, the pediatrician or ENT specialist will prescribe the treatment of the oral cavity with decoctions of oak bark or calendula flowers, solutions of borax with glycerin or baking soda.

Of the medications for fungal tonsillitis, the child is prescribed:

Pimafucin drops.
Tea tree oil.
Spray Nizoral.
Miramistin solution.
Ointment with clotrimazole.

The baby cannot be separated from the mother during the treatment of thrush in the mouth. But before each feeding, a woman should treat the nipples and the surrounding area with an antiseptic. If the baby is transferred to artificial feeding, all his bottles, nipples and pacifiers must be carefully sterilized.

From the diet of older children who eat different foods, spicy, sour, salty and spicy dishes that contribute to mucosal irritation are removed for the duration of therapy. Sweets, sugar, sour fruits and vegetables are harmful. The diet during the treatment of candidal fungus in the mouth should be sparing.

An approximate diet for a small patient:

Viscous cereals (any).
Pureed vegetables.
Lean soups with fish/meat broth.
Plentiful drink (compotes, fruit drinks, herbal teas, uzvars, still water).

Prevention

Prevention of infection of the throat with a fungus comes down to the fact that a person must keep the oral cavity clean, not using other people's toothbrushes and not giving their own hygiene accessory to other people.

It is advisable to buy toothpastes containing antimicrobial components. It is recommended to rinse your mouth after every meal. boiled water. It is necessary to treat caries, periodontitis, stomatitis, tonsillitis and other pathologies of the oral cavity in a timely manner.

Fungal infection of the feet

Most people have a superficial knowledge of what types of foot fungus can exist, but are completely unaware of how to identify the first signs of the disease.

The main groups of mycoses

The general group of diseases caused by the presence of pathogenic fungi on the legs is called mycosis. There are the following types of skin lesions:

ringworm, a fungus that affects the skin;
onychomycosis, the fungus affects the nail.

Foot fungus is very insidious and many-sided. The existing classification distinguishes the main types of foot fungus:

trichophyton menagrophytes, which leads to the development of epidermophytosis of the foot;
trichophyton rubrum refers to rubrophytia, is very contagious and is transmitted through common objects. Athlete's foot and rubromycosis are often referred to by the same name as athlete's foot;
trichophyton interdigitale, affecting the skin of the legs between the fingers at an early stage. Later transmitted to the entire foot;
candida albicans is a specific female fungus.

The main manifestations of the fungus

It is not difficult to determine the first signs of the disease if a person is attentive to his health. Any deviation from the norm, if it becomes sustainable, should be alarming. This is fine.

It is better to immediately ask yourself the question - why did a slight peeling and itchy small cracks appear on the legs. Perhaps this is a manifestation of the fungus.

Signs of the disease

The main varieties of the form of skin disease on the legs have different course and signs.

Squamous-hyperkeratotic stage, accompanied by thickening of the skin in the upper and lateral parts of the foot. The skin on the legs takes on a bluish red appearance. Dry and flat rashes appear that itch and there is a burning sensation in these areas. In the initial stage, the skin is affected on one foot, and then it passes to the other.

There are cases when patients with this form do not feel the symptoms of the disease and are in no hurry to see a doctor.

The intertriginous form is manifested by the appearance of fungi between the fingers. The fungus should not be confused with diaper rash. It has a delineated border with a white edging of the epidermis, which is traced along the contour. There is itching and burning.

The dyshidrotic form is determined by a large number of bubbles with fluid on the foot in the area of its arches, between the fingers and on their skin. The skin on the legs is swollen and itches a lot. It is strictly forbidden to open the blisters, as this can cause skin erosion.

The fungus shows the first signs at a very early stage in the form of an erased form of the disease.

Candidal lesions of the feet

The form of candidal lesions on the legs is associated with interdigital yeast erosions. Lesions are located between 3 and 4 or 4 and 5 fingers. The skin is red and puffy. Bubbles and pustules are located nearby.

This form is less common than epidermophytosis and rubromycosis. A large number of Candida spores are constantly on the skin. Normally, they do not cause manifestations of the disease. With a weakened immune system, the likelihood of a transition to a pathogenic form of the disease increases.

Household items with Candida spores on their surface can become a source of infection. Sour-milk and meat products, as well as milk, are a possible habitat for such microorganisms.

In order to avoid infection with an infection of the Candida species, personal hygiene measures and food storage rules must be observed.

Damage to the nail plate

The defeat of the toenail usually accompanies athlete's foot. Signs of the disease are determined by the yellow and deformed nail. At the beginning, the changes affect the free edge of the nail plate. Later, he flakes off his bed.

Types of nail infections.

Hypertrophic onychomycosis leads to thickening of the nail. It starts to crumble and exposes the skin. The skin has a thickened and flaky appearance.
Atrophic onychomycosis thins and destroys the nail plate. The skin underneath becomes keratinized.
Onychomycosis, which occurs as a result of the presence of molds, is not an independent disease. It develops against the background of other diseases of the nails. The color of the nail is black, brown, yellow and green color. A complication may be inflammation of the nail bed.

Very often, onychomycosis can have a normotrophic form, in which the nail is preserved, and a yellow spot appears on it.

Fungus on the feet can exist for years. Special activity of fungi is manifested in the winter. In addition to the main symptoms of the presence of fungi, there is another unpleasant factor. It is manifested by a persistent unpleasant odor from the feet.

Cause causing disease

There is always a root cause that causes the appearance of the fungus. People with impaired immune systems or metabolism can get the fungus through small breaks in the skin. Excessive sweating of the feet can also trigger the appearance of a fungus on the feet.

The probability of the presence of fungi is especially high in baths, gyms. In rooms that are poorly ventilated, and where it is very hot, a huge amount of spores of the fungus is produced. Its spores can exist for a long time on clothes, shoes and other items.

Children are rarely affected by trichophytons. In adolescents, the disease is more than 15%. More and more often men suffer from fungi. In the group with the highest percentage of sick people:

workers from production processes in hot shops;
miners;
bath staff;
athletes, swimmers are more likely to get sick.

There is even a special term for athlete's foot. So called mycoses of the legs in swimmers.

Very often, the presence of foot fungus is diagnosed in smokers. Poor-quality synthetic material, foot injury with tight shoes are also factors in the appearance of fungus.

Preventive measures

feet should always be dry and clean;
use ointments against fungus when visiting baths, pools and gyms;
shoes must be ventilated and never use someone else's, even when buying new shoes You need to bring your own sock to try on.

In addition to preventive measures, it is necessary to eat a varied and proper diet, take seasonal vitamin complexes, sleep and rest enough.

If it was not possible to avoid infection, it is necessary to take all necessary measures to treat the fungus. Having noticed the first signs of the disease on the legs, you need to contact a dermatologist and get the necessary comprehensive treatment. The disease must be treated until complete recovery, as the infection is easily transmitted.

To date, methods of treating mycoses of various types give excellent results. It all depends on your attitude towards your own health problems. Be healthy and don't get sick!

Candidiasis is a mycotic infection that is caused by a yeast-like microflora. A fungus of the genus Candida is a sporeless yeast with a well-developed mycelium. Such microorganisms do not form capsules and do not form carotenoid-type pigments. For human body most dangerous view Candida is Candida albicans. Diagnosis of candidiasis is of great importance in drug therapy. Without determining the amount of yeast-like microflora and the type of thrush pathogen, it is impossible to prescribe an effective treatment.

For the diagnosis of candidiasis, it is necessary to follow the recommendations for testing. Otherwise, there is a high probability of obtaining a false negative result. This is fraught with further progression of the infectious disease, which causes the development of serious complications and the addition of a bacterial infection.

Predisposing factors for thrush

In order to prevent thrush, the diagnosis of thrush is carried out when the patient is exposed to certain factors that provoke the development of the disease:

Long-term antibiotic therapy.
Decreased protective functions of the body.
Use of oral contraceptives.
Diabetes and autoimmune diseases.

More than others, women are exposed to the development of candidiasis during pregnancy. This is due to hormonal changes in the body. In this case, the fungus begins to multiply due to an increase in the amount of glucose in the area of \u200b\u200bthe microflora of the vagina. The disease is often the cause of pregnancy complications. That is why, in order to prevent candidiasis, the diagnosis of the disease in pregnant women is carried out once a month in the early stages and 2-3 times in the later stages.

After the development of primary symptoms and as a preventive measure during a visit to the doctor, the patient is tested for thrush. Among the main precursors, the presence of itching and white plaque in the genital area, mucous membranes or skin should be highlighted. Discomfort intensifies after a shower and at night. Be sure to take tests for women suffering from vaginitis, urethritis, cystitis or vulvovaginitis, and men with the development of diseases such as prostatitis, cystitis, urethritis and epididymitis.

Determination of the form of the disease

Before conducting diagnostic studies, the doctor conducts a visual examination, which allows you to determine the form of the disease and the area of localization of foci of infection with the fungus.

Tests for candidiasis are prescribed taking into account the form of thrush, which can be of the following types:

Damage to the oral mucosa. It occurs mainly in young children. The main symptomatology is the appearance of a white coating on the tongue and oral mucosa, which has a curdled consistency.
Progression of fungal microflora in the intestinal area. In this case, candidiasis is considered as a severe form of dysbacteriosis. The disease develops in the absence of beneficial bacteria in the digestive tract. The main symptoms are flatulence, diarrhea and the appearance of white flakes in the stool.
Urogenital form of the disease. Appears in violation of the local microflora in the area of the external and internal genital organs in women and men. With this form of the disease, severe itching occurs, and whitish discharge appears, which in structure resemble cottage cheese.

The difference in the clinical picture of candidiasis is observed depending on the gender of the patient. In women with damage to the external genitalia, we are talking about vulvitis, with the progression of the fungus in the vaginal area - about vaginitis. Most often, vulvovaginitis is diagnosed, less often cystitis and urethritis.

For men who develop inflammation of the foreskin, balanoposthitis is diagnosed. When the urethra is affected, we are talking about urethritis. It is not excluded the development of prostatitis on the background of a fungal infection. In advanced cases, inflammation of the epididymis occurs - epididymitis. In men, the development of candidal cystitis is quite common.

Informative methods

Before identifying thrush, the patient must be examined by a specialized specialist. Only a doctor can refer the patient for diagnosis by prescribing all the necessary tests for candidiasis.

Candidiasis is diagnosed through the following studies:

Microbiological diagnosis of candidiasis.
Sowing on the fungus to determine the level of sensitivity to antifungal drugs.
PCR technique, the so-called polymerase chain reaction.
Immunoassay or ELISA for short.

Each laboratory study performs a specific function. That is why it is recommended to carry them out in a complex. Only a thorough diagnosis allows you to determine the stage of the disease and prescribe an effective drug therapy that excludes the likelihood of relapses.

In conclusion, experts indicate the following information:

The presence or absence of fungal microflora.
Species affiliation of the causative agent of thrush.
Number of Candida Albicans colonies grown.

For example, asymptomatic carriage is characterized by a low number of -<104 КОЕ/мл. При показателях равных или превышающих установленный уровень, ставится диагноз кандидоз (если выявилось >104 cfu/ml). In this case, tests for sensitivity to antimycotic agents are carried out.

In order to more accurately diagnose thrush, the patient should not take any antifungal drugs. Otherwise, the clinical picture may be blurred, which will complicate the process of identifying the pathogen.

smear microscopy

Diagnosis of thrush using this method is carried out through microscopy. For research, scraping is carried out from the area where the fungus is localized. The presence of Candida cells does not yet indicate the presence of the disease. It's all about how much fungus is present in the human body. Normally, each of us has it in moderation. In the presence of predisposing factors, an increase in yeast-like microflora is noted, which is the cause of the development of symptoms of the disease.

Seeding for flora

Laboratory diagnosis of candidiasis, performed in a similar way, allows you to get more detailed information about the causative agent of the disease. For the study, such biological material as sputum, urine, feces or a smear taken from the area of localization of the infectious process caused by the fungus Candida is required.

How will the result be revealed? For inoculation, the biological material is placed in a laboratory environment in a nutrient medium. This contributes to its reproduction and the creation of entire colonies, which after a while are visible even to the naked eye.

Next, an antifungal drug is applied to the fungal colonies. After that, experts observe which of the drugs is the most effective. Thus, the sensitivity of pathogenic microorganisms to drugs is determined.

It takes a lot of time to detect sensitivity - about 7-10 days. During this period, the patient receives supportive treatment, which is aimed at suppressing the activity of the fungus and preventing the development of complications.

PCR and ELISA

Polymerase chain reaction and enzyme immunoassay is the "gold standard" of all infectious diseases, including candidiasis.

PCR allows you to recognize the DNA of the virus, which allows you to accurately determine the causative agent of the disease. Using the results of this technique, doctors can prescribe highly effective therapy, which eliminates the likelihood of disease progression and complications. The polymerase chain reaction is a highly sensitive assay. For laboratory testing, blood, sputum, urine or scrapings are taken from the patient.

If the pathogen is found, the result is positive; if not, the result is negative. Even with a small amount of the pathogen, one can get an idea of the state of the microflora of the patient's body and make an assumption about the development of candidiasis. In this case, after a certain period of time, a second diagnosis is carried out.

ELISA tests for candidiasis allow you to check for the presence of antibodies in the blood. If pathogenic flora grows in the body, then IgG immunoglobulins are released into the blood, which is manifested in a laboratory study through biochemical reactions. Proteins can also appear in other infectious diseases, but thanks to high-precision equipment, specialists can determine what exactly caused them.

Basics of laboratory diagnostics

All tests for candidiasis are carried out using different biological material, due to the polymorphism of clinical manifestations. The fence is carried out depending on the nature of the disease and the area of localization of the lesion. To begin with, the native material is examined, bile, urine, skin flakes, feces, etc. are checked. Then the diagnosis is carried out on the blood. The preparations used are prepared in a 10-20% solution.

During microscopic examination, the filamentous phase of the mycelium may appear, which indicates the presence of a pathogen in the body. Next, the amount of mycelium or pseudomycelium is determined. This allows you to do a quantitative inoculation on nutrient media.

Pathological material is diluted by means of a liquid medium of MPB or Saburo with glucose and without antibiotics, because combinations of candidiasis with a bacterial form of sepsis are possible. For a clearer result, they began to use a combined type of medium - the heart-brain. The course of the procedure depends on the type of material being studied:

Blood cultures are carried out 3-4 times, which allows you to get more accurate results. In this case, the sampling is carried out from different veins for 1-2 days. In this case, the patient should not receive drugs that have a systemic effect. If a patient has fungemia, then the growth of yeast-like microflora is observed after a few days.
Sectioned and biopsied material is used to prepare so-called histological preparations. The remains are sown on a liquid or solid medium. Tests for candidiasis in this case take up to 48 hours. In some cases, the growth of fungal colonies can be detected the very next day.
Urine examination is carried out in several stages. To do this, one portion of the biological material is placed in a special centrifuge for 5 minutes and Gram-stained. For this, methanol and antiglobulin antiserum are used.

Most pathogens are identified without assimilation tests. In the presence of chlamydospores, we are talking about identifying such a pathogen as C.albicans. In their absence, further diagnostics are carried out.

The whole complex of tests for thrush allows you to make an accurate diagnosis and prescribe effective drug therapy. After the patient undergoes a course of treatment, laboratory tests are necessarily repeated, which makes it possible to determine the effectiveness of the therapy. If tests for candidiasis at the same time give a positive result, the treatment is repeated using other drugs.

What does spores mean in a smear?

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Why are there controversies?

The destruction of beneficial microflora creates favorable conditions for the reproduction of the fungus.

The main reasons for the appearance of fungal spores, and then urogenital thrush, are:

constant wearing of tight underwear;
hormonal disbalance;
diet change;
stress;
long-term use of antibiotics;
hypothermia;
pregnancy.

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Are spores in a smear dangerous?

Spores are activated against the background of a decrease in immunity.

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Possible symptoms

the presence of curdled secretions;
itching, burning and redness of the genitals;
pain during intercourse;
white plaque on the genitals;
pain when urinating.

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What treatment to apply?

Topical preparations are effective in the initial stages of the lesion.

Treating thrush is not easy. Often, the disease returns after a certain period of time, in particular, with a repeated decrease in immunity. Preparations for the fungus are divided into 2 types: local and systemic. In severe cases, with advanced disease, doctors prefer the second type of treatment. Taking pills affects the main focus of fungi. Local preparations include suppositories and various healing creams. Their effectiveness is less, as they relieve local symptoms of candidiasis, which is important in the early stages. For the treatment of tablets and ointments alone is not enough, it is important to eliminate the provoking factor in the appearance of thrush.

Preventive measures are also important to prevent the recurrence of candidiasis. You need to choose loose underwear, be less nervous and not take antibiotics for long or frequent courses, change your diet. For the duration of the therapeutic diet, completely exclude alcohol. Remove foods containing yeast, cheeses, canned food and sweets from the diet menu (mandatory). The amount of fresh unsweetened vegetables and fruits (but not grapes), fish and garlic should be increased in the diet. Occasionally you can afford sour-milk products. It is important to drink more water.

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Indications for research

A swab for flora in women is taken during a routine preventive examination by a gynecologist, pregnancy planning, obstetric registration, as well as when infectious inflammation of the genital organs is suspected and in order to monitor the effectiveness of the treatment.

During pregnancy, this study plays a particularly important role, since due to changes in the hormonal background (in particular, hyperestrogenism) and the resulting decrease in immunity, the risk of developing inflammatory processes in the external and internal genital organs increases. Inflammation can cause abortion, premature birth, infection of the child during passage through the birth canal.

During pregnancy, the study of the vaginal microflora, as a rule, is prescribed three times at certain intervals, and more often if infectious inflammation is detected.

The main symptoms that serve as the reason for the appointment of a smear on the flora:

pain in the lower abdomen (spontaneous or during intercourse);
itching and / or discomfort in the vulva;
unusual discharge from the genital tract;
painful urination;
menstrual disorders.

For preventive purposes, it is recommended to take a gynecological smear for flora at least once a year, even in the absence of any symptoms, since many diseases of the reproductive system, including infectious ones, are characterized by undercurrent. It is also recommended to take a prophylactic smear for flora if a woman has had unprotected sexual contact with a dubious partner.

Where to take a smear for flora and how much is the analysis done?

A swab for flora can be taken at a antenatal clinic, at a polyclinic at the place of residence, in a private specialized clinic, in the material sampling room of some laboratories.

Usually, a smear examination takes one working day, however, it is better to clarify the time for obtaining the result from the doctor, since the time for making the analysis in different laboratories may vary.

Study preparation

Usually a smear for flora is taken on the fourth or fifth day of the menstrual cycle, unless otherwise indicated. It is undesirable to take an analysis during menstruation, since it is inevitable that menstrual blood enters the material, which is highly likely to distort the result.

If the patient is undergoing a course of anti-infective therapy, it should first be completed and only then be tested. A smear for microflora is taken no earlier than three weeks after the end of treatment with antibacterial and antimycotic drugs (unless otherwise instructed by the attending physician). The use of antibacterial, antimycotic, anti-inflammatory drugs and contraceptives may lead to false negative test results.

It should be borne in mind that often pathogenic pathogens that cause STDs (sexually transmitted diseases) are not detected by smear microscopy, despite their presence in the body.

Within 1-2 days before submitting the material for analysis, it is necessary to exclude sexual contacts, also during this period, vaginal suppositories, ointments should not be used, douching should not be performed. On the eve and on the day of the delivery of the material, you can not use means for intimate hygiene. Restrictions on physical activity and nutrition, this analysis does not require.

It is advisable not to urinate for 2-3 hours before taking the material for analysis.

How is a smear taken on the flora

Before taking material for research, the patient undergoes a routine gynecological examination using mirrors. The doctor visually evaluates the vulva, the walls of the vagina and the vaginal part of the cervix, then, using a sterile spatula, takes material from three sections - the vaginal wall, the external opening of the urethra, and the cervix. In some cases, the material for research is taken from one specified point, for example, only from the vagina or cervix. The procedure is painless.

The material taken from different parts is applied with a spatula on a glass slide separately from each other, marked (V - vagina, U - urethra, C - cervix), dried and sent to the laboratory.

For a detailed acquaintance with the material sampling technique, you can watch the corresponding video on how to take a swab for flora in women.

Read also:

Frequent female diseases and their symptoms

7 regular examinations that a woman should undergo

9 myths about uterine fibroids

Vaginal microflora: normal

During the examination of the smear, the so-called degree of purity of the vagina is determined. This is a primary screening, which allows you to determine the need for further examination and its scope.

Within 1-2 days before submitting the material for analysis, it is necessary to exclude sexual contacts, also during this period, vaginal suppositories, ointments should not be used, douching should not be performed.

Depending on the nature of the microflora and cellular contents, 4 degrees of purity of the vagina are distinguished:

A large number of Dederlein sticks, a small amount of squamous epithelium in the preparation. Determined in clinically healthy women.
A small number of cocci are found, however Dederlein's sticks predominate. It is not a sign of pathology, it is observed in many clinically healthy women.
The preparation revealed a small number of Dederlein sticks, a diverse coccal flora predominates, the number of leukocytes is more than 10 per field of view. Observed in inflammatory processes.
Dederlein sticks are practically absent in the smear, a large number of cocci and leukocytes are found. Sign of bacterial vaginosis.

Normal values for women reproductive age are given in the table.

Deciphering indicators

When deciphering the results of a smear on the flora in women, first of all, the number of leukocytes is estimated (depending on where the material was collected from), the nature and amount of the detected microflora.

Leukocytes

Leukocytes are white blood cells that ensure the destruction of pathogenic microorganisms, a component of the immune system. If the number of leukocytes in the smear is increased, this may indicate an inflammatory process. When evaluating the result, the phase of the menstrual cycle is taken into account, depending on which the number of leukocytes may vary.

A smear for microflora is taken no earlier than three weeks after the end of treatment with antibacterial and antimycotic drugs (unless otherwise instructed by the attending physician).

lactobacilli

Dederlein's sticks (lactobacilli, vaginal sticks, lactobacilli, gram-positive sticks) is the common name for non-motile acidophilus sticks that do not form spores and are the main component of the normal microflora of the vagina. Normally, in a smear, Dederlein's sticks should be contained in the studied biomaterial in large quantities. A decrease in their number, especially in the presence of other representatives of the microflora, is a sign of inflammation.

squamous epithelium

Squamous epithelium is the cells that line the inside of the vagina, present in the urethra and cervix. Normally, the amount of squamous epithelium in a smear may vary slightly depending on the hormonal status and the phase of the menstrual cycle. If a large amount of squamous epithelium is found, an inflammatory process (urethritis, cervicitis, vulvovaginitis) can be suspected. The absence of squamous epithelium in a smear may indicate a violation of the hormonal background (in particular, it may be a sign of a violation of the production of sex hormones).

When deciphering the results of the analysis, it should be taken into account that in women during pregnancy, as a rule, there is an increase in the number of leukocytes and squamous epithelium.

Slime

Mucus is produced by the glands of the vagina and cervical canal. Normally, a moderate amount of mucus is detected in the smear (it may be completely absent in the material from the urethra), an increase in its amount may indicate the presence of an infectious-inflammatory process.

bacteria

Normally, the causative agents of sexually transmitted diseases should be absent in the test material. Their detection indicates the presence of a particular infection. So, the detection of gonococci indicates gonorrhea, trichomonas are determined with trichomoniasis, etc.

The use of antibacterial, antimycotic, anti-inflammatory drugs and contraceptives can cause false negative test results.

The detection of microscopic yeast-like fungi may be a sign of vaginal candidiasis (the so-called thrush), but these microorganisms, like some others (cocci, for example), are also present in healthy women, so their quantitative assessment is important.

However, it must also be taken into account that often pathogenic pathogens that cause STDs (sexually transmitted diseases) are not detected by smear microscopy, despite their presence in the body. Therefore, if an infection is suspected, additional studies are resorted to (for example, polymerase chain reaction). Smear microscopy also does not make it possible to determine the sensitivity to antibiotics or antifungal drugs of the detected microorganisms. To do this, carry out a cultural analysis (tank sowing) with an antibiogram.

key cells

Normally, key cells are absent in the material; their appearance may indicate bacterial vaginosis, as well as erosive or tumor changes in the mucous membrane.

Result evaluation

Even if the results of a smear study that go beyond the limits of the norm are obtained, the diagnosis is usually not made - this requires a comprehensive diagnosis, as well as the clinical picture of the disease, so only a specialist can correctly assess the result. He, if necessary, prescribes therapy.

It should be taken into account that the detection of coccal and other opportunistic microflora is not a basis for prescribing anti-infective therapy without their quantitative assessment and taking into account data from other diagnostic studies.

Self-medication in most cases leads to serious imbalances in the vaginal microflora and, as a result, the development of complications, including the further spread of infection.

Video from YouTube on the topic of the article:

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Indications for a swab for flora

In addition to taking an analysis at a preventive examination by a gynecologist, a swab for flora must be taken in the following cases:

with abundant discharge (possibly with an unpleasant odor), accompanied by pain in the lower abdomen;
with any discomfort in the genitals (itching, burning in the vagina, urethra);
when conducting an active sexual life without protection with different partners;
with painful sexual intercourse;
when planning pregnancy and during pregnancy;
after taking antibiotics

When is the best time to take a swab for flora?

A smear on the flora can be taken on any day of the cycle except for menstruation. Blood during material sampling can distort the results. best time for passing the analysis, the first day after the end of menstruation or the day before they begin is considered. At this time, natural immunity is slightly reduced, which makes it possible to identify all pathogenic microorganisms.

Special preparation for taking a smear on the flora is not required. Gynecologists only advise a few days before going to the doctor to abandon any local remedies (vaginal suppositories, creams, lubricants) and not to have sexual intercourse or douche the day before. On the day of the visit to the doctor, you can take a light shower without the use of gels for intimate hygiene. It is advisable not to urinate for a couple of hours before taking a smear.

Deciphering a smear for flora. The smear norm for flora.

After receiving the results of the analysis on the flora, not everyone can decipher it on their own. In fact, there is nothing complicated about this. Just enough to know designations and norms:

1. Place of taking a smear:

"V" —vagina(vagina, vagina) - decoding of the analysis taken from the vagina

"C" — cervix(cervical canal, cervix) - decoding of the analysis taken from the cervical canal

U — uretra(urethra, urethra) - decoding of the analysis taken from the urethra

2. "L" - leukocytes

Leukocytes are white blood cells whose main function is to protect the body from infectious agents. The norm of leukocytes in a smear: up to 20-30 units. p.sp. in the cervical canal, up to 10 in the vagina and up to 5 in the urethra. The excess of these indicators indicates the development of the inflammatory process and requires further diagnosis and treatment. The exception is pregnant women. For them, the rate of leukocytes in the analysis is slightly higher.

3. Ep. - squamous epithelium

Squamous epithelium - cells that cover the mucous membrane of the genital tract. In women of reproductive age, with a stable hormonal background, the epithelium regularly dies and is rejected, falling into the vaginal secretion, as a result of which the optimal balance of the flora of the genital organs and the health of the mucosa are maintained.

Normally, the amount of squamous epithelium should not exceed 5-10 units. If the result of your analysis is higher, there is a possibility of an inflammatory process in the vagina. In the complete absence of squamous epithelium in the smear, atrophic processes in the uterus are suspected, which is typical for hormonal imbalance, namely, a lack of estrogens.

4. Slime

Normally, mucus is produced only in the vagina and cervix, it should not be in the urethra. The appearance of a large amount of mucus in a smear is a sign of an inflammatory process.

5. Cocci

The entire microflora of the vagina can be conditionally called "cocci". Cocci are divided into Gram-positive (Gr+) and Gram-negative (GR-) depending on their ability to stain blue and pink under the influence of a special dye.

Lactobacilli - the main inhabitant of the vaginal environment - refers to gram-positive cocci. Also Gr+ are staphylococci, streptococci, enterococci. They can be present in the vagina in a small amount, without causing any diseases of the genital organs.

Gram-negative cocobacilli (E. coli, gonococcus, Proteus) are much more dangerous. Some of them can also live in the vagina, but when immunity declines, they cause infectious and inflammatory processes. Others should not normally be found in the pelvic organs (for example, gonococcus - the causative agent of gonorrhea) and are subject to mandatory treatment together with a sexual partner.

6. Pal. or see flora - rod or mixed flora

Doderlein stick (Lactobacillus) are large and immobile gram-positive rods - the main representative of the normal microflora of the vagina, helping to maintain optimal balance in the intimate sphere. Normally, they should make up the majority of the female flora (90-95%), and their lack indicates vaginal dysbacteriosis and the risk of developing an inflammatory process.

The remaining 5% is accounted for by other opportunistic microorganisms (E. coli, enterococci, streptococci, staphylococci, corynobacteria, etc.), which in small quantities are not dangerous, and with excessive growth can cause the development of colpitis, cervicitis, adnexitis, etc. diseases of the pelvic organs.

If a woman's flora consists predominantly of lactobacilli, this is indicated in the analysis as "rod flora", which is the absolute norm. With the predominance of coccal flora in the smear, the entry “mixed flora” or “coccal flora” is written. If at the same time there is no increase in the number of leukocytes, mucus, then the situation should be observed.

If there are signs of an inflammatory process in the smear, it will be necessary to do an additional study of vaginal discharge by bacteriological seeding for microflora and sensitivity to antibacterial agents in order to determine the pathogen and its growth and prescribe the correct treatment.

Also in some laboratories you can see such definitions as "poor mixed flora" or "abundant mixed flora". This means the degree of seeding with opportunistic bacteria. With poor flora, suppositories with beneficial bacteria can be prescribed ( Atsilakt, Vagilak, Laktozhinal), if the flora is abundant, then the doctor prescribes suppositories with an antimicrobial and antibacterial effect ( Poligynax, Terzhinan and etc.).

7. Yeast, mycelium spores - yeast-like fungi of the genus Candida

If yeast, candida is found in a smear on the flora, this means that the patient has developed thrush caused by fungi of the genus Candida. Sometimes thrush can be asymptomatic, but in most cases it is accompanied by abundant curdled discharge with a sour smell, itching of the genitals, and their redness.

Frequent recurrences of thrush may indicate the presence of a permanent provoking factor in the form of a sexual infection or some kind of chronic disease. For the treatment of thrush, drugs containing flucanazole and vaginal suppositories are usually prescribed ( Pimafucin, Neo-penotran, Clotrimazole and etc.). How to get rid of thrush, read here.

8.Trich. - Trichomonas

Trichomonas (Trichomonas vaginalis) is a unicellular microorganism, the causative agent of urogenital trichomoniasis, a very unpleasant sexually transmitted infection. Symptoms of trichomoniasis are copious, watery, frothy discharge of a greenish or yellowish color, itching, hyperemia, and swelling of the genital organs.

In a smear on the flora, Trichomonas is not always detected, therefore, for more accurate diagnosis if infection with trichomoniasis is suspected, it is worthwhile to additionally pass an analysis for trichomonas by PCR diagnostics.

9. Gn. — gonokkki

Gonococci are Gram-negative pyogenic bacteria of the genus Neisseria gonorrhoeae that cause gonorrhea. An absolute pathogen, normally there is no gonococcus in a smear for flora. Symptoms of the disease are usually abundant purulent discharge from the vagina, burning, swelling and hyperemia of the mucosa. The detection of this bacterium is a 100% indicator for the examination of the whole family, the treatment of the patient and his sexual partner.

10. Cl. cells - key cells (gardnerella)

Key cells are the cells of the squamous epithelium lining the mucous membrane of the genital organs, covered with bacteria adhering to them. Most often, these bacteria are gardnerella (Gardnerella vaginalis), belonging to the opportunistic flora. Detection of key cells in a smear is a sign of vaginal dysbacteriosis (bakvaginosis).

Symptoms of gardnerellosis are abundant grayish or yellow discharge with a fishy smell, burning and discomfort in the genitals. Treatment of bacterial vaginosis is carried out in 2 stages: first, the pathogen is destroyed (the most common drugs for the treatment of gardnerella are Trichopol, Dalatsi n), then the flora is populated with beneficial bacteria (capsules Vagilak).

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Main indicators in gynecological analysis

The vaginal environment in women is normally not sterile..

A large number of various microorganisms live there, all together they represent the flora of the vagina. Among these microorganisms, there is a constant competition for space and food.

The most common representatives of the vaginal flora are lacto- and bifidobacteria.

In many ways, they themselves determine the environment of their habitat., releasing alcohols, peroxide, acids, including lactic acid, in the course of its life, as a result of which the pH of the vaginal environment matters in a smear on the flora, characterizing an acidic environment.

In addition, these bacteria secrete enzymes, which prevent other microbes from multiplying.

So what does a swab for flora in women reveal?

Leukocytes and erythrocytes

First of all, in the selected smear, the number of white and red blood cells is determined. The norm in a healthy woman - leukocytes - 10 - 15, and erythrocytes - about 2.

If the analysis is taken immediately after menstruation, then the number of leukocytes can be up to 25. If the patient is in position, then the level of leukocytes is allowed no more than 30.

A lot of white blood cells indicates an infectious disease, so in this case you need to retake the analysis.

It should also take into account all conditions that additionally affect the level of leukocytes - pregnancy, menstruation, colds. If all these cases are excluded, then an inflammatory process is suspected.

Phagocytosis

What does phagocytosis mean in a smear on flora? Phagocytosis is the process of capturing and destroying foreign cells (for example, pathogenic bacteria) by leukocytes. The smear may show incomplete phagocytosis- the presence of undigested microbial cells inside leukocytes. This happens during infection, as well as if the patient's body is exposed to:

cytolysis

Cytolysis in the analysis means the presence of a non-inflammatory process in the vagina caused by overproduction of a special type of lactobacilli that produce hydrogen. Their uncontrolled growth leads to alkalization of the vaginal environment and cytolysis (destruction) of epithelial cells.

Epithelium

What does a large amount of epithelium in a smear for flora in women indicate and what to do if there is a lot of it?

The presence of squamous epithelium in a smear for flora in women is the norm subject to a certain type and quantity.

The presence of 5 to 10 squamous epithelial cells in the selected sample is considered normal.

When passing a smear on the flora at the gynecologist, deviations from the norm are:

Decreased number or absence of epithelial cells, which shows the death of the epithelium due to an increase in testosterone levels and / or a decrease in estrogen levels.
A significant excess of the content of epithelial cells in a smear may appear for the following reasons:

Ectopia is not a disease, but requires observation.

Fibrin

Fibrin is a blood plasma protein. Its detection in a smear means the presence of an inflammatory process.

Slime

Mucus can be in healthy patients only in a smear from the vagina. If mucus is found, for example, in the urethra, then this indicates inflammation. A vaginal mucus sample may contain normal moderate or low amounts, which are denoted by ++ and +, respectively.

Doderlein sticks

Doderlein's sticks should normally prevail in the microflora of the vagina.

These are the so-called lactobacilli that secrete lactic acid. necessary for the formation of normal vaginal microflora.

If lactobacilli are present in the vagina in sufficient quantities, infections do not develop there, since lactic acid does not allow other bacteria to multiply.

If the number of these beneficial microorganisms is reduced, then the pH of the vagina shifts to the alkaline side.

As a result, inflammation may occur.

In a normal smear, lactobacilli make up 95% of the total flora.

Conditionally pathogenic flora

In gynecology, opportunistic pathogens are those microbes in a smear on the flora that may not cause any diseases until they begin to multiply beyond measure. The main varieties of such microbes are:

cocci

Cocci are round-shaped bacteria.

They are subdivided according to the method of staining into gram-positive and gram-negative.

Gram-positive cocci (staphylococci, streptococci and enterococci) are opportunistic, their presence is considered normal within:

But gram-negative cocci are the causative agents of dangerous diseases. These include gonococci - the causative agents of gonorrhea.

Ureaplasma

These are very small bacteria when multiplying over 104 units cause inflammatory diseases. In addition, they can prevent conception.

Leptothrix

This is a representative of the anaerobic UP flora, a gram-positive rod-shaped microorganism. By itself, leptothrix in a smear on the flora is dangerous only during pregnancy., - while it is believed that he is able to provoke a miscarriage. But in non-pregnant patients, the detection of leptothrix is not a cause for concern.

Diphtheroids

As representatives of the UP flora, they may be present in the smear in small quantities. When their level is exceeded, vaginosis begins. Diphtheroids are similar to the bacteria that cause diphtheria, Corynebacterium.

If corynobacteria were found in the flora smear, then it is necessary to determine what their number is. With a moderate amount, a course of treatment is prescribed medicines. If corynebacteria are greater than a certain threshold, then further testing for other infections should be performed, as these bacteria are often associated with others.

Klebsiella

Being a representative of the UP flora, Klebsiella under certain conditions (most often, with a decrease in immunity, in particular, during pregnancy) can cause urinary tract disease.

Candida mushrooms (soor)

What gives a positive soor in a smear for flora? If a fungus of the genus Candida is isolated from a smear, this indicates candidiasis.

These fungi are also representatives of the UP flora, most often they are introduced into the vagina from the outside. Usually, candidiasis is provoked by a decrease in immunity. With candidiasis in a smear on the flora can be found:

Pseudomycelium is represented by filamentous growths of blastospores with constrictions:

If an indicator such as blastospores is found in the analysis of a vaginal smear for flora, it means that the body of this woman is affected by candidiasis. The number of blastospores varies with the prevalence and stage of the disease. Blastospores are embryonic forms of cells formed by budding from mother cell forms.

If blastospores are found in a flora smear, this means that it is necessary to conduct an examination of the female body directly for yeast spores of fungi.

Key (atypical) cells

The key cells in the flora smear are epithelial cells, on the surface of which microorganisms have collected (this is especially true for gardnerella in women that cause bacterial vaginosis). The presence of atypical cells in the smear is a sign of an infectious disease.

Scarcity and abundance

According to the smear sample on the flora, the type of microflora is found out:

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Preparatory activities

Before passing the analysis, you need to prepare:

do not take antibiotics for 14 days before the study;
for three days - do not enter vaginal preparations with contraceptive, antiseptic and antibacterial action;
two days - do not have sexual intercourse;
do not take a bath a day before going to the doctor;
do not douche;
before a visit to the doctor, conduct hygiene procedures of the genital organs;
do not empty your bladder three hours before the procedure;
do not take the test during menstruation.

In case of permanent drug treatment a woman should warn the doctor and tell what drugs she is taking.

Failure to comply with these simple rules distort the results, which, in turn, will affect the diagnosis of pathology. It is desirable for all women to undergo a bacteriological examination once every six months.

Collection of biological material

For research and interpretation, a gynecological smear is taken from the urethra, cervical canal and vaginal walls. Examine the microflora and determine the degree of purity.

The procedure for taking the material is carried out using a spatula or a special spatula and is carried out in the following cases:

preventive examination;
clinical examination;
complaints of women: burning sensation and itching of the genitals, pain near the pubis, discharge.

In order to take a general gynecological smear (its decoding is given below), a gynecological mirror is inserted into the woman's vagina, through which the cervix and vaginal walls are visible. For girls and women who do not have sexual relations (virgins), regardless of age category, this tool is not used.

Gynecological smear: transcript. Norms

The female genitourinary system normally contains approximately 40 different types of microorganisms, most of which are lactobacilli. In a healthy woman, up to 95% of lactic acid bacteria are normally determined. Lactic acid maintains an acidic environment in the vagina and rapidly suppresses pathogens.
Another part of the flora is Klebsiella, Escherichia coli, Corynebacterium, Staphylococcus, Gardnerella, Myrococcus, Peptostreptococcus, Eubacteria and others. The presence of a minimum amount of Candida fungi is also acceptable.

Causes of deviations from the norm

In some cases, immunity decreases (menopause, pregnancy or other hormonal failure, stressful situations), in which case the doctor may prescribe a gynecological smear for the general flora. Deciphering it will show how the quantitative composition of bacteria has changed. Normal microflora decreases, and, as a result, susceptibility to genital infections increases due to an increase in opportunistic microorganisms: streptococci, Escherichia coli, staphylococci. With a weak immune system pathogens multiply at a high rate and actively suppress lactic microorganisms. As a result, pathology develops: gardenelosis, candidiasis or vaginal dysbacteriosis, which provokes:

inflammation of the appendages and uterus;
ectopic pregnancy;
the birth of a premature baby;
miscarriage;
infertility.

What is the purpose of the analysis

The study and interpretation of a gynecological smear allows you to timely diagnose various diseases of the female genital area, as well as assess microbial contamination, including the qualitative and quantitative composition of microorganisms, the condition of the epithelial tissues of the vagina, and the presence of inflammatory processes.
This type of study is called the gold standard for detecting bacterial vaginosis.

Vaginal dysbacteriosis: main causes

If a gynecological smear was taken and its decoding showed the presence of dysbiosis, then the reasons may be the following:

hormonal imbalance (low estrogen);
metabolic disease;
long-term use of broad-spectrum antibacterial agents;
errors in observing the rules of personal hygiene of the genital organs.

Analysis results

In the laboratory of a medical organization, a gynecological smear is examined. Decryption:

Leukocytes. For the cervical canal, the presence of up to 30 cells in the field of view is considered normal, for the urethra - within 5, for the vagina - no more than 10. A small amount of white blood cells protects the genitals, and their growth indicates the presence of inflammation: urethritis, colpitis, cervicitis. In the case of the acute phase of the inflammatory process, the number of leukocytes exceeds 100 cells in the field of view.
Slime. This indicator is normal if it is absent in the urethra (urethra), a small amount of mucus is acceptable in the vagina. During menstruation, its presence in the cervix is allowed. If mucus is found in the urethra, inflammation is suspected.
Epithelial cells, which normally should be no more than 15. In the vagina - flat epithelium, in the cervical canal - cylindrical epithelial cells. If a gynecological smear was taken and its decoding showed the presence of epithelium in excess of the norm, then this indicates an acute or chronic inflammatory process in the genitals.
Microorganisms. Normally present in the vagina: coccal flora in women during menopause and in girls who have not reached puberty; lactobacilli - in women of reproductive age. There should be significantly less bacteria in the cervix than in the vagina. The microflora in the urethra should be absent. If there is a pathogenic or conditionally pathogenic flora, then vaginal dysbacteriosis or inflammation is diagnosed.
Trichomonas, gonococcus, key cells, the detection of which implies the following diseases: trichomoniasis, gonorrhea, gardnerellosis. Normally, they shouldn't be.
Fungus Candida. Mycelium and spores are detected. The latter suggest the carriage of this type of fungus and may be present in a practically healthy woman. The appearance of mycelium means that a woman in the active phase has an infectious process caused by candidiasis, or thrush.

The degree of purity of the gynecological smear: transcript

According to the degree of purity of the gynecological smear, and there are only four of them, determine the presence of an inflammatory process in the female body:

First. This degree of purity is found in two categories: in practically healthy women (there are no chronic and acute inflammatory diseases of the genital organs) and in girls who are not sexually active. Indicators: enough lactobacilli, acidic pH of the vagina, leukocytes 0-5.
Second. With this degree of purity, therapy is not prescribed. Preventive measures are recommended to improve the immune status in order to prevent the development of inflammatory processes. Indicators: mixed vaginal microflora is sown (both normal and pathogenic microbes are present), acidic pH of the vagina, leukocytes five to ten, mucus and squamous epithelial tissues are moderate.
The third - this means that there is an inflammatory process in the genitals of a woman and immediate treatment is required. Indicators: lactobacilli are practically absent, virulent microflora and epithelial cells are increased, slightly acidic or alkaline pH of the vagina.
Fourth degree - high level danger. According to the results of laboratory tests, the doctor prescribes an additional examination in order to exclude dangerous, including oncological diseases of the female genital organs. Indicators: lactobacilli are not sown, alkaline pH of the vagina, the microflora is completely pathogenic, there are a huge number of leukocytes.

A gynecological smear and deciphering it into microflora allows you to diagnose the disease at an early stage, prescribe treatment in a timely manner and prevent the development of a chronic process.

Smear on flora during pregnancy

This analysis in pregnant women is taken when registering with a antenatal clinic, as well as at 30 and 38 weeks in order to control the degree of purity of the vagina throughout pregnancy.

Women planning children are advised to first take care of themselves and the health of the unborn baby, and pass a gynecological smear on the flora before the expected pregnancy. Explanation: Normally, 95% of all bacteria are lactobacilli, 5% are conditionally pathogenic flora that do not multiply in an acidic environment. Under certain conditions, when the pH shifts towards an alkaline environment, pathogenic bacteria begin to actively spread. One of the reasons for the change in microflora is pregnancy.

Throughout the entire period of bearing a baby, a woman has a different hormonal background. There is an increased production of the hormone progesterone, and estrogen is the minimum amount. Thanks to this restructuring of the body, the number of Doderlein sticks (lactobacilli) increases by about ten times in order to protect the fetus from infection during pregnancy.

Thus, it is very important before planning a pregnancy to undergo the necessary laboratory tests and get a transcript of the analysis of the gynecological smear, including the degree of purity of the vagina. Otherwise, the opportunistic flora will get an impetus to activation and provoke various diseases. Some diseases - bacterial vaginosis, gonorrhea, trichomoniasis - loosen and weaken the walls of the vagina, and there may be tears during the birth of the baby.

Cytomorphological analysis of smears

This type of study is prescribed after a gynecological smear on the flora has been assigned. Decoding (norm or pathology) of the results will help in making an accurate diagnosis. With the help of this analysis, oncology or cervical dysplasia, papillomavirus infection are detected.
Biomaterial for atypical cells is taken from the urethra and cervix, its vaginal part. There are several types of smears:

Type 1 means that the cervix is normal.
Type 2 is the presence of an inflammatory process or a mild degree of dysplasia. In this case, the doctor prescribes anti-inflammatory drugs, and after a full course of treatment, a second analysis for cytology.
Type 3 is severe or moderate dysplasia. Upon receipt of such a result, an additional examination is prescribed, namely a biopsy of the tissues of the cervix and their cytomorphological examination, colposcopy, with the help of which the lesions of epithelial tissues, their localization and nature are revealed.
Type 4 is characterized as a precancerous condition. As with the third type, a new examination and consultation with an oncogynecologist is recommended.
Type 5 is a cancer. All examinations and treatment take place in a specialized medical facility.

Preparation for a cytological study

The informativeness and accuracy of the result depends on proper preparation:

pass the analysis not earlier than the fifth day of menstruation and not later than five days before the next menstrual cycle;
24 hours before sampling the biomaterial, it is not recommended to use drugs, including contraceptives;
at least a day before going to the doctor, you should refrain from sexual intercourse.

Conclusion

Thus, a gynecological smear on the flora (the interpretation of which is given above) and a smear on cytology allows you to identify various diseases of the female genital area and, with properly prescribed therapy, gives a great chance for a speedy recovery.

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When to get tested

Indications for the delivery of a gynecological smear in women are the following conditions:

aching or paroxysmal pain in the lower abdomen, unpleasant cramps or a feeling of heaviness;
an increase in secreted mucus that smells bad;
discomfort in the genitals - itching, burning;
preventive examinations by a gynecologist at least once every six months;
in the process of planning a child;
during pregnancy.

The analysis is necessary for long-term treatment with antibacterial drugs or hormonal means. It is important to take a smear on the flora and when changing a sexual partner.

What does a smear on flora show?

In gynecology, the analysis of the discharged fluid from the vagina shows the composition of the microflora and helps to study important indicators:

the quantity and quality of white and red blood cells (leukocytes and erythrocytes);
identify various cocci, Trichomonas or fungal infection;
the number of lactobacilli.

The analysis allows you to determine the cause of the woman's ailment and select the most effective drugs to eliminate pathological changes in the genitourinary system.

Rules for taking a smear

Proper preparation for the procedure and compliance with the requirements for the collection of biological material are integral components of reliable results.

Study preparation

To pass the analysis for the study of the microflora of the vagina, a woman must carefully prepare.

Avoid sexual intercourse for 48 hours.
Hygiene procedures within 2 days before the test should be carried out without special means and douching. Do not use vaginal suppositories, ointments.
2.5-3 hours before the smear, do not go to the toilet.

How to take a swab

The procedure for taking biological material takes place on a gynecological chair. The gynecologist is responsible for the entire process.

With a disposable spatula, a spatula, the doctor removes part of the discharge from the urethra, cervical canal and vagina.
The material is placed on a sterile glass slide and transferred to the laboratory.

The process of taking gynecological material does not bring discomfort to the woman and takes 5-10 minutes. Results are ready the next business day.

Norm

A healthy microflora of the genitourinary system is the presence of several leukocytes and rod flora. The basis is gram-positive rods or Dederlein rods. They must be present in large numbers.

Table "Reference smear values for flora"

Indicators	Norm, the number of cells in the field of view
Indicators	Vagina and urethra	cervical canal
Squamous epithelium (lines the inner walls of the vagina and cervix)	5–15
Leukocytes (protective cells responsible for phagocytosis - the elimination of pathogenic bacteria) -	3–12 (during pregnancy, the norm is up to 35)	3–30
Lactobacilli (Dederlein sticks) - provide a healthy acidic environment in which pathogens cannot live	A large number of	Not
Mucus (the result of the secret glands)	moderate amount

Research transcript

The presence of pathogenic cells in the smear indicates the development of pathological abnormalities in the genitourinary system.

Depending on which microorganisms are present in the biological material, the disease is determined:

Blastospores. Immature cells of pseudomycelium show active reproduction of pathogens of candidiasis (thrush).
An increase in key (atypical) cells. The squamous epithelium begins to grow, which indicates abnormal disturbances in the microflora, the appearance of bacterial vaginosis.
Leptothrix or leptotrichia. The cells cause degenerative changes in the epithelium and provoke colpitis (inflammation of the vagina). Pathogenic organisms can accompany the development of chlamydia, candidiasis, leptotrichiasis.
coccal flora. The smear may contain gonococci, which indicates gonorrhea.
Trichomonas. Pathogenic cells indicate the development of a sexual infection - trichomoniasis.
Fibrin strands are evidence of inflammation.

When examining a smear, much attention is also paid to detritus - dead cells. The substance is an integral part of a healthy microflora, both in women and men. It consists mainly of a small number of obsolete epithelial cells. In the case of an increase in this indicator, we can talk about inflammation in the cervix or infectious pathologies that provoked a mass death of epithelial tissue.

Evidence of pathology can be not only the appearance of pathogenic bacteria, but also changes in the quantity and quality of the constant composition of the flora.

A decrease in Dederlein sticks and an increase in leukocytes indicates a decrease in local immunity, the development of inflammation in the reproductive organs.
Changes in epithelial cells. If the squamous epithelium is absent, we are talking about atrophy of the uterus or cervical canal. An increase in such cells indicates inflammatory processes.
Excessive appearance of cylindrical epithelium - infectious foci in the tubes of the uterus, malignant tumors in the cavity of the reproductive organ or cervical canal.
Mucus in the cervix. Normally, there should be no noticeable discharge from the cervical canal. If there is a large amount of mucus, we are talking about severe inflammation.

Degree of purity - what does it mean

An integral indicator of a smear on the flora is the degree of purity. The marker indicates the level of acidity and the number of pathogenic cells.

There are 4 degrees:

Poor flora - gram-positive rods predominate in the biological material (95%), there are few opportunistic bacteria (5%), single leukocytes are present, the environment is acidic. The woman is completely healthy.
Moderate flora - a large number of lactobacilli, a slight increase in leukocytes (7–10), a moderate presence of opportunistic microorganisms. The condition is not painful, but local immunity is slightly weakened, which indicates an increased sensitivity to harmful cells.
Mixed flora - the number of white blood cells is increased (up to 30), the concentration of lactobacilli is reduced, the predominant presence of cocci. The medium is slightly acidic. A woman develops inflammatory processes, there is a vaginal infection.
Abundant bacillary environment - homogeneous mucus contains a large number of leukocytes, there are traces of phagocytosis, the complete absence of gram-positive rods. High concentration of aerobic or anaerobic bacteria. The amount of secreted liquid with an unpleasant odor increases. The medium is alkaline. In the genitourinary system, a pronounced inflammation, the presence of a dangerous urogenital infection.

It must be understood that if abnormalities are found that are identified by a 3 or 4 degree of purity, it is important to begin treatment immediately. Otherwise, the likelihood of severe complications is high.

Treatment

If the smear results on the flora are poor, therapy is prescribed by the doctor based on the specific pathogen and its sensitivity to certain antibiotic drugs.

Table "Therapy of possible deviations in a smear for flora"

The result of the analysis (identified pathologies)	Drug groups
Inflammatory processes of various etiologies	Local medicines for douching - a solution of Chlorhexidine, Miramistin, potassium permanganate
Inflammatory processes of various etiologies	Vaginal suppositories - Hexin, Betadine
Urogenital candidiasis	Antifungal suppositories - Pimafucin, Clotrimazole, Livarol
Hidden sexual and venereal infections	Antiviral drugs - Cycloferon, Acyclovir, Kagocel, Diflucan, Metronidazole, Ornidazole
	Penicillin antibiotics - Oxacillin, Ampiox, Ampicillin
	Cephalosporins - Ceftibuten, Cefaclor
	Macrolides - Sumamed, Clarithromycin, Erythromycin

To restore the flora and strengthen local immunity, tampons and vaginal suppositories with a probiotic can be used.

The most effective are:

Lactobacterin;
Acylac;
Bifidobacterin.

Adequate treatment is prescribed exclusively by a doctor. The specialist evaluates the results of a smear on the flora and selects the most effective drugs that will eliminate the causative agent of inflammatory or infectious processes in the reproductive organs.

The study of a smear on the flora is of great importance in gynecology - the procedure is painless for a woman. Microscopic examination allows you to check the condition of the vagina, uterus and urethra, identify negative deviations and identify the causative agent of pathological processes. Proper preparation and compliance with the requirements for biomaterial sampling allows you to get a reliable result on the next business day.

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Reasons for performing cultures in gynecology

If the smear has a moderate or high number of leukocytes, but the causative agent of the infection is not known. Since under microscopy there is a lower limit of detection of microorganisms: 10 to 4 - 10 to 5 degrees.
If the microbe is identified, to determine its sensitivity to antibiotics.
If there are signs of a fungal infection. To accurately establish the type of fungi and prescribe an effective antimycotic drug.
Other types of Candida fungi can be left untreated if there are no pathological symptoms.

If key cells are found (signs of bacterial vaginosis), but other microbes are present in addition to them. For identification.

What is the difference between culture, flora smear and vaginal cleanliness

in the research method. With a general smear, the material applied to the glass is stained with special dyes and viewed under a microscope. And when a bacteriological (bakposev, cultural, microbiological) study is done, then it is first “sown” on a nutrient medium. And then, after a few days, they look under a microscope - colonies of which microorganisms have grown.

That is, if we are talking about express analysis, you will be given a conclusion only on the number of leukocytes, epithelium and mucus. Sowing is not urgent

Also, with microscopy, you can quickly determine the degree of purity from the vagina. Here the doctor only evaluates the ratio between normal, opportunistic and pathogenic microflora.

The classic assessment of vaginal cleanliness.

Updated table

What doctors don't see on microscopy

Pregnancy. To determine it, a smear is not needed and no matter what result it will show. It is necessary to take a blood test for hCG, undergo a gynecological examination with a doctor or do an ultrasound of the uterus. You can determine the chorionic gonadotropin in the urine, but not in the discharge from the genitals!
Cancer of the uterus and cervix. To diagnose a malignant degeneration of the endometrium, histological material is needed, and in large quantities. And they take it directly from the uterus with separate diagnostic curettage.
CC and other pathologies (erosion, leukoplakia, koilocytosis, HPV lesions, atypical cells, etc.) are based on the results of a cytological study. This analysis taken directly from the cervix, from the transformation zone, according to a certain technique with Papanicolaou staining (hence the name of the analysis - the PAP test). It is also called oncocytology.
Does not show infections (STDs) such as:
- herpes;
- chlamydia (chlamydia);
- mycoplasmas (mycoplasmosis);
- ureaplasma (ureaplasmosis);

The first four infections are diagnosed by PCR. And it is impossible to determine the presence of the immunodeficiency virus by a smear with high accuracy. You need to take a blood test.

How to prepare for the test and when it is needed

The doctor takes a smear from the patient on the gynecological chair (regardless of whether she is pregnant or not) using a special brush or a sterile Volkmann spoon. It doesn't hurt at all and is very fast.

It is technically possible to achieve a good, even perfect smear, if you sanitize the vagina with chlorhexidine or miramistin, for example. But what's the point?

Can I take a smear while taking antibiotics or immediately after treatment? It is undesirable to do this within 10 days after the use of topical drugs (vaginal) and one month after taking antibacterial agents inside.

Microscopic examination is prescribed:

in a planned manner when visiting a gynecologist;
upon admission to the gynecological hospital;
before IVF;
during pregnancy (especially if there is often a bad smear);
if there are complaints: unusual discharge, itching, pelvic pain, etc.

Deciphering the results: what is considered normal and what is pathology in the microflora

To begin with, we bring to your attention a table that displays the indicators of the so-called first degree of purity. There is no mention of the urethra in it (although the material is also taken from there), since we are talking about gynecological diseases. The inflammatory process in the urethra is treated by a urologist.

Epithelium - the number of epithelial cells is not counted, as it has no diagnostic value. But too little epithelium indicates an atrophic type of smear - it happens in women during menopause.

Leukocytes - are considered in the "field of view":

no more than 10 - a small amount;
10-15 - a moderate amount;
30-50 - a large number, a woman notices pathological symptoms, and the doctor, upon examination, diagnoses an inflammatory process in the vagina and (or) on the cervix.

Mucus (strands of mucus)- normally should be present, but a large amount of it happens with inflammation. There should be no mucus in the urethra.

Rod flora or gr lactomorphotypes- the norm, this is the protection of the vagina from microbes.

Trichomonas, gonococci and key cells a healthy woman should not have it in the cervix and vagina. Candida is also normally absent. At least in a significant amount, which is detected in the analysis of the flora.

The validity of the smear is not great. But if a woman enters a hospital, then right there, during the initial examination on the chair, they take a fresh one.

Usually the results are valid for 7-14 days. Therefore, if you need to take it before the operation, do it 3 days before admission to the hospital. The last of the scheduled tests.

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Normal microflora of the vagina

The vagina of a healthy woman is not sterile. It contains many types of microorganisms, their combination is called microflora. Bacteria constantly compete with each other for habitats on the walls of the vagina and for food.

The most numerous are lactobacilli and bifidobacteria, which attach to the epithelium of the vagina. They produce alcohols, peroxide, lactic and other acids, providing an acidic reaction of the vaginal secretion. As well as lysozyme and other enzymes that inhibit the reproduction of other types of bacteria.

Microorganisms that make up the microflora of a healthy woman

Microorganisms	Number of CFU/ml
Lactobacillus or doderlein sticks Lactobacillus spp.	10 7 -10 9
Bifidobacteria Bifidobacterium spp.	10 3 -10 7
Clostridia Clostridium spp.	Up to 10 4
Propionibacterium Propionibacterium spp.	Up to 10 4
Mobiluncus Mobiluncus spp.	Up to 10 4
Peptostreptococcus spp.	10 3 -10 4
Corynebacteria Corynebacterium spp.	10 4 -10 5
Staphylococci Staphylococcus spp.	10 3 -10 4
Streptococcus Streptococcus spp.	10 4 -10 5
Enterobacteria Enterobacteriaceae	10 3 -10 4
Bacteroides spp.	10 3 -10 4
Prevotella Prevotella spp.	Up to 10 4
Porphyromonas Porphyromonas spp.	Up to 10 3
Fusobacteria Fusobacterium spp.	Up to 10 3
Veilonella spp.	Up to 10 3
Mycoplasma M.hominis	Up to 10 3
Ureaplasma U.urealyticum	10 3
Candida - yeast-like fungi	10 4

Abbreviation CFU/ml means - colony-forming units in 1 ml of nutrient medium. Each colony-forming unit is a microorganism from which a colony can form.

The number of bacteria is expressed in decimal logarithms, in order not to write numbers with a lot of zeros.

In the description of the vaginal microflora, one can often find names Gram-positive or Gram-negative bacteria. These terms mean that the first bacteria are stained according to the method developed by the microbiologist Gram, while others do not change their color.

Gram-positive rods in a smear, which include lactobacilli, are a good sign. Normally, they predominate in women of reproductive age. During menopause (menopause) and postmenopause, gram-negative bacteria come to the fore.

Based on their need for oxygen, bacteria are divided into

aerobic- those that develop in the presence of oxygen;
anaerobic which do not require oxygen to survive.

In the vagina of a healthy woman, most bacteria are anaerobes 10 8 -10 9
cfu/ml

How to make a smear on the microflora of the vagina?

The smear is taken in the gynecologist's office. Also, a woman can undergo this study in a private laboratory.

The procedure includes several steps.

The woman is placed in a gynecological chair.
Insertion of sterile speculum to gain access to the walls of the vagina and cervix.
Collection of material from the posterior wall of the vagina. This procedure is absolutely painless. Unpleasant sensations can occur only when the spatula touches the inflamed area.
Applying material to a glass slide. The vaginal secret is distributed with dashed movements on a skimmed glass as thin as possible so that the cells are arranged in one row and do not cover each other.
Fixation of the smear is necessary if it is delivered to the laboratory after more than 3 hours. Processing avoids cell deformation during drying and makes it possible to preserve the drug.
Gram smear staining. Methylene blue is used as a dye. After staining, it is easier to establish the type of bacteria and determine the composition of the microflora.
Evaluation of the result, which consists of 3 parts: counting of leukocytes, species composition of microflora, assessment of the purity of the vagina.

Often a smear is taken from three points at once:

openings of the urethra and paraurethral passages (narrow channels located parallel to the urethra);
the walls of the vagina;
cervical canal.

The anatomical proximity of these sites leads to the fact that infections and inflammations are interconnected. For each area, a separate sterile spatula, brush or cotton swab is used. The taken material is applied to 3 sterile glass slides, separately for each area.
A smear on the flora from the vagina is an absolutely harmless procedure that is allowed, including for pregnant women. During the sampling of the material, the mucosa is not injured, so there are no restrictions after the procedure. It is allowed to take a bath, swim, have sex, etc.

How to prepare for this smear?

It is necessary to take a smear for flora no earlier than 3 days after the end of menstruation. Menstrual blood cells in a smear can skew the results. The period from the 10th to the 20th day of the cycle is considered optimal.
The result of the analysis will be as reliable as possible if the following rules are followed.

stop taking antibiotics and antifungal drugs within 14 days;
2 days to stop the introduction of any vaginal forms of drugs - solutions, suppositories, tablets, tampons, ointments, creams;
refrain from sexual intercourse for 2-3 days;
before the procedure, you can not douche and wash inside the vagina.

What does a smear show for the microflora of the vagina?

A smear on the microflora of the vagina shows the presence of a number of diseases and pathological conditions.

Sexual infections (sexually transmitted infections). They are evidenced by the presence in the smear of a significant number of ureaplasmas, mycoplasmas, gardenella, gonococci, Trichomonas and other pathogenic bacteria.
Inflammation vagina(vaginitis, colpitis) or cervical canal(cervicitis and endocervicitis). Evidence of the inflammatory process is a large number of leukocytes in the smear.
Dysbacteriosis of the vagina. Violation of the composition of the microflora contributes to the development of diseases of the genital area. Dysbacteriosis is diagnosed when the number of lactobacilli decreases, and other types of microorganisms begin to predominate.
Candidiasis or thrush. Normally, single fungi of the genus Candida are acceptable. With a fungal infection, their number increases sharply, a pseudomycelium is found in the smear - threads of elongated cells and kidney cells sitting on them.

In a smear for flora, the following indicators are evaluated:

4 degrees of vaginal purity

Degree	Identified changes	What does he say
I	Wednesday is acidic. Leukocytes - up to 10. Epithelial cells - 5-10. Most microorganisms are lactobacilli (Dederlein sticks). Other bacteria - singly. Slime - a small amount.	The ideal state of the microflora of the vagina. It is extremely rare in women of childbearing age who are sexually active.
II	The medium is slightly acidic. Leukocytes - up to 10. Epithelial cells 5-10. Most are Dederlein sticks. Gram-positive cocci in small numbers. Slime in a small amount.	Normal condition. It occurs in most healthy women.
III	Medium is neutral. Leukocytes - over 10. Epithelial cells - over 10. Microorganisms in moderate or large quantities. Gram-negative and gram-negative rods and cocci are present. Single sticks of Dederlein. There are "key" cells. Slime - a moderate amount.	Inflammation of the vagina - colpitis. Symptoms may occur: creamy vaginal discharge, itching, burning, discomfort during intercourse. In some women, this condition is asymptomatic.
IV	Medium neutral or alkaline, pH over 4.5. Leukocytes - over 30 or the entire field of view. Epithelial cells - in large numbers. Microorganisms in massive quantities. The microflora is represented by various opportunistic and pathogenic microorganisms. Dederlein sticks may be missing. Mucus in large quantities.	Pronounced inflammatory process. Symptoms: copious discharge from the vagina (white, yellowish, greenish), often with an unpleasant odor. Itching, burning, dryness, discomfort. Discomfort, pain during intercourse.

What is the norm of a smear on the microflora of the vagina?

In smear microscopy for flora, the norm is:

flat cells of the vaginal epithelium - up to 10 in the field of view;
single leukocytes - up to 10 in the field of view;
cells of the intermediate layer - single;
"False key" cells - rarely;
the total number of microorganisms is "moderate", sometimes "large";
mucus - in a small amount;
among bacteria, lactobacilli predominate, other types of microorganisms are single, rare.

The smear should not contain:

Destroyed epithelial cells in large numbers. This indicates cell lysis, which occurs with abnormal growth of lactobacilli.
key cells. These are epithelial cells covered with various bacteria.
Parabasal cells. Cells of the lower layers of the mucosa. Their appearance indicates significant inflammation or atrophy of the mucosa.
"Massive" amount of bacteria except for lactobacilli.
Yeast cells with pseudomycelium and blastopores (kidney cells). Their presence indicates thrush.
Strict anaerobes - most of them are pathogens.
Gonococcus - gonorrhea pathogens.
Trichomonas - causative agents of trichomoniasis.
atypical cells, which are a sign of precancerous or oncological changes .

Some microorganisms (chlamydia, various viruses) are not detected when viewed under a microscope due to their small size. To identify them, a blood test for the ROC is needed.

What do white blood cells say in a smear on the vaginal flora?

Leukocytes are white blood cells that are designed to fight infection. They can go through the wall of blood vessels and move independently. Leukocytes have the ability to phagocytosis - they absorb bacteria and digest them. After the bacterium is digested, the leukocyte is destroyed. In this case, substances are released that cause inflammation, manifested by swelling and redness of the mucosa.
Normally, the number of leukocytes in the vagina should not exceed 10. A large number of leukocytes indicates inflammation. The higher the number of leukocytes, the more pronounced the inflammatory process.

Why is antibiotic susceptibility done in a smear test?

Sensitivity to antibiotics or antibiogram- Determining the sensitivity of bacteria to antibiotics. The study is carried out simultaneously with sowing a smear if pathogenic bacteria that cause inflammation or genital infections are found in the vagina.

There are a large number of antibiotics, but not all of them are equally effective against different groups of bacteria (antibiotics do not affect viruses). It happens that after a course of antibiotics the patient did not recover or the disease returned after a few days/weeks. This happened because antibiotics were prescribed for treatment, which had little effect on the causative agent of the disease.
In order for the treatment to be as effective as possible, it is necessary to determine which antibiotics:

completely destroy the bacterium - the causative agent of the disease;
stop the growth of the pathogen;
do not affect the activity of this bacterium.

Based on the study, a antibiogram. This is a list of antibiotics to which bacteria are sensitive.

How is antibiotic susceptibility testing done?

After the bacteria that caused the disease have been identified, they are distributed into several test tubes with nutrient media. A specific antibiotic is added to each tube. The test tubes are placed in a thermostat, where optimal conditions are created for their reproduction.

After cultivation (about 7 days) analyze the growth of bacteria in test tubes. Where bacteria are sensitive to antibiotics, colonies do not form. This drug is optimal for the treatment of the patient. In a test tube where drugs are added to which antibiotics are insensitive, the growth of bacteria is the most intensive. Such drugs cannot be used to treat this disease.

What is a smear culture?

Smear culture or bacteriological culture (bakposev) smear- This is a laboratory study in which the contents of the vagina are placed in a nutrient medium and create optimal conditions for the growth of bacteria.

Research objectives:

determine the causative agent of infection of the genital organs;
establish the degree of contamination - the number of bacteria in the vagina;
control the state of the microflora after long-term treatment with antibiotics, cytostatic drugs. It is carried out 7-10 days after the drug is discontinued.

In what case is a smear culture prescribed?

all pregnant women upon registration;
with inflammatory processes in the genitals;
Gram-negative diplococci were found in the smear - to confirm gonococcal infection (gonorrhea);
with vulvovaginitis recurrent or chronic.

How is a microbiological study carried out?

The vaginal discharge is placed in nutrient media - solutions or jelly-like masses that contain nutrients for bacteria. Test tubes and Petri dishes are placed in a thermostat for 3-5 days, where a temperature of about 37 degrees is constantly maintained, which is optimal for the reproduction of microorganisms.

After cultivation, the laboratory assistant evaluates the results. From each microorganism in the process of division, a whole colony of bacteria grows. According to her appearance the laboratory assistant determines the type of pathogen. And by the number of colonies, one can judge the concentration of these microorganisms in the vagina. Next, the concentration is compared with normal values.
Bacteria whose concentration exceeds 104 cfu/ml are considered significant. At this concentration, microorganisms are capable of causing disease. If such a number of bacteria is detected, the result of the analysis is considered positive.

The conclusion issued by the laboratory states:

view microorganism that prevails in the smear;
pathogenicity microorganism - the ability to cause disease:

Pathogenic - the presence of which can only be caused by a disease.
Conditionally pathogenic - bacteria that cause disease only with a decrease in immunity, with a significant increase in their numbers.

concentration microorganism in the vagina. In a numerical indicator and in the form of a verbal characteristic: “scarcely”, “moderate growth”, “abundant growth”.

In the laboratory conclusion, the number and growth of bacteria can be characterized by the degree of:

Degree	Features of bacterial growth
Degree	Liquid culture medium	Dense culture medium
I	Growth is very poor.	There is no bacterial growth.
II	Moderate growth	Up to 10 colonies of bacteria.
III	Abundant growth.	10 to 100 colonies.
IV	Massive growth.	Over 100 colonies.

I degree is the norm. At the II degree, they speak of a violation of the microflora of the vagina. III-IV degrees indicate a disease caused by this type of bacteria.