What tests should a woman undergo for infection? Tests for sexually transmitted infections: why, when and how to take them. The process of taking a smear

Flora smear analysis is one of the most important diagnostic methods in gynecology. A smear is taken from the mucous membrane of the vagina, cervix or urethra. This analysis allows you to assess the state of the microflora of the genitourinary system and identify the presence of pathogenic microorganisms.

A smear test for flora in women is performed during a preventive examination by a gynecologist and in the presence of complaints from the genitourinary system. These include: painful sensations in the lower abdomen, itching, burning in the vagina, discharge, indicating a possible inflammatory process. It is also advisable to do this analysis at the end of a course of antibiotic therapy to prevent thrush and when planning pregnancy.

Why is this analysis prescribed?

Usually a vaginal smear is part of a woman's routine medical check-up. It is performed by a specialist during a gynecological examination. Biological material is also collected from the urethra and cervix.

This diagnosis allows you to detect possible problems with women's health, such as an inflammatory process or a disease caused by an infection. In medical terminology, such a study has another name - bacterioscopy.

A gynecological smear is taken if the following diseases are suspected:

• or vaginitis;

Specialists can prescribe a smear if the patient has the following complaints:

• Pain during sexual intercourse.
• Unpleasant-smelling copious discharge with discoloration.

A smear is taken when planning pregnancy and after antibiotic therapy. In addition, the smear allows you to monitor the effectiveness of therapy in the treatment of gynecological diseases.

Advantages of the method:

• Painless procedure.
• Simple rules for preparing for a smear test.
• Monitoring the effectiveness of treatment of female diseases.
• Possibility of identifying many diseases of the genitourinary system.

For preventive purposes, women periodically need to undergo this diagnosis. This will help prevent possible undesirable consequences.

Preparation for delivery

Some doctors say that this test does not require special preparation, however, this is not true. To ensure the reliability of the results, the patient is advised not to go to the toilet for 2-3 hours, since urine can wash away all pathogenic bacteria and infections, making it difficult for the attending physician to determine the causes of your pathological condition.

Douching, vaginal suppositories and antibacterial soap also contribute to unreliable indicators. Women must undergo this test after the end of menstruation, and in addition, all patients should refrain from any sexual intercourse 2 days before taking the biomaterial.

How is it surrendered?

The analysis is most often taken by a doctor when you come to him for a regular appointment at the clinic or when you simply go to a paid laboratory, where obstetricians and medical staff take biomaterial from you.

The gynecologist, obstetrician or any other medical professional lightly runs a special disposable stick-shaped spatula over three points - the vagina, urethra and cervical canal.

In men, a urologist or another doctor inserts a special disposable probe into the urethra, turns it around its axis several times and takes an analysis. It is believed that the examination does not cause pain, however, this does not exclude the carelessness of the doctor, as well as individual sensitivity or the presence of a particular disease, which can cause discomfort.

The meaning of the letters on the analysis form

Doctors do not use full names, but abbreviations - the first letters of each of the analysis parameters. To understand the normal microflora of the vagina, knowledge of the letter designations will be very helpful.

So, what are these letters:

1. abbreviations of the areas from which the material is taken are designated by the letters V (vagina), C (cervical area of ​​the cervix) and U (urethra or urinary canal);
2. L - leukocytes, the value of which may not be the same in normal conditions and in pathology;
3. Ep - epithelium or Pl.Ep - squamous epithelium;
4. GN - gonococcus (the “culprit” of gonorrhea);
5. Trich - Trichomonas (causative agents of trichomoniasis).

In the smear, mucus may be detected, indicating a normal internal environment (PH), beneficial Doderlein bacilli (or lactobacilli), the value of which is equal to 95% of all beneficial bacteria.

Some laboratories make it a rule to mark the content of a specific type of bacteria. For example, somewhere they use the “+” sign for this. It is put into 4 categories, where one plus is an insignificant content, and the maximum value (4 pluses) corresponds to their abundance.

If there is no flora in the smear, the abbreviation “abs” is indicated (Latin, this type of flora does not exist).

What doctors don't see with microscopy?

Using this analysis, the following conditions or diseases of the body cannot be determined:

1) Cancer of the uterus and cervix. To diagnose malignant degeneration of the endometrium, histological material is needed, and in large quantities. And they take it directly from the uterus during separate diagnostic curettage.

2) . To determine it, a smear is not needed and it does not matter what result it shows. It is necessary to take a blood test for hCG, undergo a gynecological examination by a doctor, or do an ultrasound of the uterus. It is possible to detect human chorionic gonadotropin in urine, but not in genital discharge!

3) CC and other pathologies (leukoplakia, koilocytosis, HPV infection, atypical cells, etc.) are diagnosed based on the results of a cytological examination. This analysis is taken directly from the cervix, from the transformation zone, using a certain method with Papanicolaou staining (hence the name of the analysis - PAP test). It is also called oncocytology.

4) Does not show infections (STDs) such as:

• (chlamydia);
• (mycoplasmosis);
• (ureaplasmosis);

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

Smear standards for flora

After receiving test results, it can sometimes be very difficult to understand the numbers and letters written by the doctor. It's actually not that complicated. In order to understand whether you have gynecological diseases, you need to know the normal indicators when deciphering the smear analysis for flora. There are not many of them.

In smear tests in an adult woman, the normal indicators are as follows:

1. – must be present, but only in small quantities.
2. (L) – The presence of these cells is allowed because they help fight infection. The normal number of leukocytes in the vagina and urethra is no more than ten, and in the cervical area - up to thirty.
3. (pl.ep.) – normally its quantity should be within fifteen cells in the field of view. If the number is higher, then this is evidence of inflammatory diseases. If less is a sign of hormonal disorders.
4. Dederlein sticks - a healthy woman should have a lot of them. A small number of lactobacilli indicates a disturbed vaginal microflora.

The presence of Candida fungi, small rods, gram(-) cocci, Trichomonas, gonococci and other microorganisms in the analysis results indicates the presence of a disease and requires a more in-depth study and treatment.

Table for deciphering the normal smear in women (flora)

A breakdown of the results of a smear analysis for flora in women is presented in the table below:

Degrees of purity based on flora smear

Depending on the results of the smear, there are 4 degrees of vaginal cleanliness. The degree of purity reflects the state of the vaginal microflora.

1. First degree of purity: The number of leukocytes is normal. Most of the vaginal microflora is represented by lactobacilli (Doderlein bacilli, lactomorphotypes). The amount of epithelium is moderate. Mucus – moderate. The first degree of purity means that everything is normal for you: the microflora is fine, your immunity is good and you are not in danger of inflammation.
2. Second degree of purity: The number of leukocytes is normal. The vaginal microflora is represented by beneficial lactobacilli along with coccal flora or yeast fungi. The amount of epithelium is moderate. The amount of mucus is moderate. The second degree of vaginal cleanliness is also normal. However, the composition of the microflora is no longer ideal, which means that local immunity is reduced and there is a higher risk of inflammation in the future.
3. Third degree of purity: The number of leukocytes is higher than normal. The main part of the microflora is represented by pathogenic bacteria (cocci, yeast fungi), the number of lactobacilli is minimal. There is a lot of epithelium and mucus. The third degree of purity is already inflammation that needs to be treated.
4. Fourth degree of purity: The number of leukocytes is very large (the entire field of view, completely). A large number of pathogenic bacteria, the absence of lactobacilli. There is a lot of epithelium and mucus. The fourth degree of purity indicates severe inflammation that requires immediate treatment.

The first and second degrees of purity are normal and do not require treatment. At these degrees, gynecological manipulations are allowed (cervical biopsy, uterine curettage, hymen restoration, hysterosalpingography, various operations, etc.)

The third and fourth degrees of purity are inflammation. At these degrees, any gynecological manipulations are contraindicated. You need to first treat the inflammation and then take the smear test again.

What is coccal flora in a smear?

Cocci are bacteria that have a spherical shape. They can occur both normally and in various inflammatory diseases. Normally, single cocci are detected in the smear. If immune defense decreases, the amount of coccobacillary flora in the smear increases. Cocci can be positive (gr+) or negative (gr-). What is the difference between gr+ and gr- cocci?

To describe bacteria in detail, microbiologists, in addition to indicating their shape, size and other characteristics, stain the preparation using a special method called “Gram staining”. Microorganisms that remain colored after washing the smear are considered “gram-positive” or gr+, and those that become discolored when washed are “gram-negative” or gr-. Gram-positive bacteria include, for example, streptococci, staphylococci, enterococci, and lactobacilli. Gram-negative cocci include gonococci, Escherichia coli, and Proteus.

What are Doderlein sticks?

Doderlein bacilli, or, as they are also called, lactobacilli and lactobacilli, are microorganisms that protect the vagina from pathogenic infections by producing lactic acid, which helps maintain an acidic environment and destroy pathogenic flora.

A decrease in the number of lactobacilli indicates a disturbed acid-base balance of microflora in the vagina and a shift towards the alkaline side, which often occurs in women who are sexually active. The pH of the vagina is significantly influenced by both pathogenic microorganisms and opportunistic microorganisms (which are sometimes found in the vagina normally).

Flora smear during pregnancy

The microflora of each woman is strictly individual, and normally consists of 95% lactobacilli, which produce lactic acid and maintain a constant pH of the internal environment. But opportunistic flora is also normally present in the vagina. It got its name because it becomes pathogenic only under certain conditions.

This means that as long as there is an acidic environment in the vagina, opportunistic flora does not cause any inconvenience and does not actively multiply. These include yeast-like fungi, which under certain conditions can cause vaginal candidiasis, as well as gardnerella, staphylococci, streptococci, which under other conditions can cause bacterial vaginosis (inflammatory process) in a woman.

A woman's flora can change for a variety of reasons - with decreased immunity, taking antibiotics, common infectious diseases and diabetes. One of these factors that can change the microflora is a change in hormonal levels. Thus, a pregnant woman produces virtually no estrogen until the end of pregnancy, but produces the hormone progesterone in large quantities. This hormonal background allows Doderlein's rods to increase 10 times, so the body tries to protect the fetus from possible infection during pregnancy. Therefore, it is very important to undergo an examination before a planned pregnancy to determine the degree of cleanliness of the vagina. If this is not done, then during pregnancy the opportunistic flora can be activated and cause various diseases of the vagina.

Candidiasis, bacterial vaginosis, gardnerellosis, gonorrhea, trichomoniasis - this is not a complete list of diseases that weaken and loosen the walls of the vagina. This is dangerous because ruptures may occur during childbirth, which might not have happened if the vagina was clean and healthy. Diseases such as mycoplasmosis, chlamydia and ureaplasmosis are not detected by smear analysis, and these pathogenic microorganisms can only be detected by blood analysis using the PCR (polymerase chain reaction) method, using special markers.

A smear test is taken from a pregnant woman during registration, and then for monitoring at 30 and 38 weeks. Usually, to assess the state of the vaginal microflora, doctors talk about the so-called degrees of vaginal cleanliness, which a woman should know and ensure that the required degree is maintained during pregnancy.

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Flora smear in women- a laboratory test that determines the types of bacteria that are present in the vagina. This is the most common and simplest method for detecting inflammation and STDs (sexually transmitted diseases).

The examination is absolutely painless. It is performed during a routine gynecological examination. The doctor takes the material with a disposable spatula from the walls of the vagina and cervix. The contents of the vagina (vaginal secretions) are applied to the glass. In the laboratory, the material is stained so that the bacteria become clearly visible.

Purpose of the study

• determine the state of the vaginal microflora;
• identify sexually transmitted infections and their causative agent;
• determine the degree of the inflammatory process;
• assess the degree of cleanliness of the vagina, which is mandatory before further diagnostic studies and gynecological operations - cauterization of erosions, removal of polyps, curettage;
• assess the health status of pregnant women.

When does a gynecologist take a smear for flora?

• complaints of itching or vaginal discharge, other symptoms of inflammation;
• preventive examinations;
• control of the treatment;
• taking hormonal drugs and immunosuppressants;
• control of microflora during long-term use of antibiotics;
• pregnancy. It is carried out 3 times during pregnancy (at registration, at the 30th and 36th week).

Normal vaginal microflora

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

Microorganisms that make up the microflora of a healthy woman

The number of bacteria is expressed in decimal logarithms in order to avoid writing numbers with a large number of zeros.

In the description of vaginal microflora one can often find the 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 the 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 first.

Depending on their oxygen demand, bacteria are divided into

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

CFU/ml.

How to make a smear on the vaginal microflora?

The procedure includes several stages.

1. The woman is placed in a gynecological chair.
2. Insertion of sterile speculum to gain access to the vaginal walls and cervix.
3. Collection of material from the posterior wall of the vagina. This procedure is absolutely painless. Unpleasant sensations can only occur when the spatula touches the inflamed area.
4. Applying material to a glass slide. The vaginal secretion is distributed with streaking movements over the skim glass in the thinnest possible layer so that the cells are arranged in one row and do not cover each other.
5. Fixation of the smear is necessary if it is delivered to the laboratory after more than 3 hours. The treatment avoids cell deformation during drying and makes it possible to preserve the drug.
6. Smear staining using the Gram method. 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.
7. Evaluation of the result, which consists of 3 parts: counting leukocytes, species composition of microflora, assessment of vaginal cleanliness.

• openings of the urethra and paraurethral passages (narrow canals located parallel to the urethra);
• vaginal walls;
• cervical canal.

How to prepare for this smear?

• stop taking antibiotics and antifungal drugs 14 days before;
• 2 days in advance, stop administering any vaginal forms of drugs - solutions, suppositories, tablets, tampons, ointments, creams;
• abstain from sexual intercourse for 2-3 days;
• Before the procedure, you should not douche or wash the inside of the vagina.

What does a smear show on the vaginal microflora?

• Sexually transmitted 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.
• Vaginal dysbiosis. Violation of the composition of 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, and pseudomycelium is found in the smear - threads of elongated cells and bud cells sitting on them.

4 degrees of vaginal cleanliness

What is the norm for a smear on the vaginal microflora?

• 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 are single;
• “false key” cells - rare;
• the total number of microorganisms is “moderate”, sometimes “large”;
• mucus - in small quantities;
• Lactobacilli predominate among bacteria; other types of microorganisms are rare and rare.

• Large numbers of destroyed epithelial cells. 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 lactobacilli.
• Yeast cells with pseudomycelium and blastopores (bud cells). Their presence indicates thrush.
• Strict anaerobes - most of them are pathogens.
• Gonococcus - pathogens of gonorrhea.
• Trichomonas - causative agents of trichomoniasis.
• Atypical cells which are a sign of precancerous or oncological changes .

What do leukocytes indicate in a smear on vaginal flora?

Why is sensitivity to antibiotics performed when examining a smear?

Antibiotic sensitivity

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 does not recover or the disease returns after a few days/weeks. This happened because antibiotics that had little effect on the causative agent of the disease were prescribed for treatment.
In order for treatment to be as effective as possible, it is necessary to determine which antibiotics:

• completely destroy the bacteria that causes the disease;
• stop the growth of the pathogen;
• do not affect the life activity of this bacterium.

How is antibiotic sensitivity testing performed?

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

What is smear culture?

Objectives of the study:

• identify the causative agent of genital infection;
• establish the degree of contamination - the number of bacteria in the vagina;
• monitor the state of microflora after long-term treatment with antibiotics and cytostatic drugs. It is carried out 7-10 days after discontinuation of the drug.

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

How is microbiological testing performed?

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 the temperature is constantly maintained at about 37 degrees, optimal for the proliferation of microorganisms.

After cultivation, the laboratory assistant evaluates the results. From each microorganism, during the process of division, a whole colony of bacteria grows. Based on its appearance, the laboratory technician 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.
Those bacteria whose concentration exceeds 10 4 CFU/ml are considered significant. At this concentration, microorganisms can cause disease. If such a quantity of bacteria is detected, the result of the analysis is considered positive.

The conclusion issued by the laboratory states:

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

• Pathogenic - the presence of which can only be caused by disease.
• Opportunistic - bacteria that cause disease only when immunity decreases, with a significant increase in their number.

• concentration microorganism in the vagina. In numerical terms and in the form of verbal characteristics: “meager”, “moderate growth”, “abundant growth”.

Analysis for hidden infections and list of hidden infections

Due to the structure of the female body, some infectious diseases of the reproductive system may occur without significant symptoms. Hidden sexually transmitted infections are dangerous. In the early stages, they do not cause discomfort to their owner. And subsequently they cause chronic diseases and irreversible changes in the functioning of the reproductive organs, up to the malignant transformation of cells.

Thrush does not pose a serious threat, but it causes severe discomfort and causes secondary damage by bacterial flora, so it is included in the list for mandatory determination.

Mycoplasma and ureaplasma

The declared microorganisms normally inhabit the flora of the genital area. They begin to multiply when immunity decreases, causing itching and burning, as well as clear discharge. Mycoplasmosis and ureaplasmosis are caused by different pathogens, but are studied together, since often in the presence of one pathogen, a second one is also detected.

The infection causes problems with reproductive functions and leads to complications during pregnancy. When vaginal discharge has a thick consistency, they immediately look for mycoplasma and ureaplasma.

Chlamydia

A smear test for gonococci is required for expectant mothers. Laboratory evaluation is carried out when a patient comes in with complaints of strange discharge, elevated temperature without symptoms. The peculiarity of microorganisms is that they develop good resistance to antibacterial drugs.

Gonorrhea often occurs in combination with trichomoniasis. Gonococci absorb Trichomonas, making them inaccessible to drugs. The pathological process leads to lengthy and unsuccessful attempts to treat trichomoniasis, which is extremely dangerous for expectant mothers. If your list of tests for latent infections for laboratory evaluation includes Trichomonas, then you cannot ignore the requirements; you need to test a smear for gonococci.

Syphilis

The disease is dangerous and asymptomatic in the early stages. The causative agent is Treponema pallidum. The pathology affects the mucous membranes, nervous system, and bone structures. It is transmitted mainly through sexual contact, but a domestic mechanism of infection cannot be ruled out.

Pregnant women and people preparing for surgery are examined for syphilis. Even during routine hospitalization, a blood test is taken for this infection. Due to the possibility of transmission of Treponema pallidum through blood, donors also undergo the procedure.

Tuberculosis and pneumococcus

The peculiarity of these microorganisms is that they can be transmitted not only through close contact, but also through the air. Pathogenic microorganisms provoke damage to the respiratory system, pneumonia, diseases of the nervous system, and irreversible changes in the brain. Proceeding in a latent form, they pose a particular danger not only to the infected person, but also to his environment.

The definition of tuberculosis is not usually prescribed for a pregnant woman. People living with her undergo fluorography. An important breakthrough in medicine was prevention. Recently, the pneumococcal vaccine has become mandatory.

conclusions

Timely tests for hidden infections from the main list make it possible to identify the pathogen that will multiply latently in the human body. It is important to consider the results of the study as a whole: assessment of blood and smear.

If pathogens are detected in increased numbers, treatment is prescribed. The sensitivity of pathogenic microorganisms from the detected list to certain types of drugs: antimicrobials and antibiotics must first be established. After the therapeutic course, a repeat analysis is taken to evaluate the effectiveness of the therapy.

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Smear for genital infections

Most often, the entry gates for microbes that form the primary foci of latent diseases in the body are the mucous membranes of the respiratory tract, digestive and urogenital tracts.

Microorganisms that inhabit the external environment in large quantities can be pathogenic, opportunistic or non-pathogenic (saprophytes that are part of the normal human microflora). For the latter, infection does not play a special role, because the leading factor in the development of the disease is the weakness of the immune system. An inadequate immune response in general or a decrease in the functioning of local defenses can cause the formation of an infectious process, which can occur in two ways:

• An obvious infectious disease with an incubation period, a clinical picture corresponding to the pathogen and a certain result (recovery, chronicity, recovery with consequences or progression of the process).
• Asymptomatic carriage. Opportunistic flora does not always give clear manifestations of the presence of the pathogen in the body, the incubation period may be absent, the period of time from infection to the appearance of signs of infection may be indefinitely long, the local inflammatory focus may go unnoticed and the person will be unaware of the presence of chronic latent infection. infections. Many problems in this regard are created by saprophytes, for example, fungi, which constantly live on the intestinal mucosa, but, once in another environment (urogenital tract), with weak immunity, begin to actively multiply. A healthy immune system usually does not allow this, that is, how long the infectious agent lingers in the new host’s body depends on the type of microorganism and the state of the person’s immunity.

Thus, the immune system plays a major role at all levels and stages of any infectious process, where local factors play an important role in defense reactions. However, the influence of other systems (nervous, endocrine) should not be unduly belittled.

When local immunity fails

Sex hormones and thyroid hormones activate the immune system, resulting in rapid restoration of damaged tissue and recovery. On the contrary, if there is something wrong with the hormones, the mucous membrane does not return to normal as quickly and the process is delayed. The quality of local immunity depends on the state of the epithelium, which is determined by hormonal levels. Recent experimental data indicate that epithelial cells not only become a barrier between the infectious agent and the human body, but also participate in immunological reactions, that is, they are immunocompetent cells, since they carry receptors for certain cytokines on their surface. In addition, epithelial cells leave the imprint of past events (infections, treatment methods, types of antibiotics, etc.), so when determining the origin of the inflammatory process, details such as chlamydia, trichomonas, and in other cases - gonococci often come to light.

Hidden infections find favorable conditions for their habitat in the female genital organs, which is greatly facilitated by hormonal fluctuations, which are more pronounced in women than in men. Fungi, chlamydia, myco- and ureaplasmas that fall on fertile soil lead to the development of vaginosis (an analogue of intestinal dysbiosis) and vulvovaginitis. The woman continues to consider herself healthy, since there are no obvious deviations during a traditional examination, and the nature of the discharge and some discomfort can be mistaken for the individual characteristics of the body.

There is a pathogen, there is no disease

Basically, the list of latent infections consists of diseases caused by microorganisms that trigger the process under a certain set of circumstances, therefore in most cases they are classified as latent sexually transmitted infections:

That's why they are hidden, so that there are no symptoms

Many of the listed diseases constitute a group of chronic latent infections that can last for many years and not cause much concern to a person. Symptoms of latent infections, as a rule, are absent, so carriers live and do not suspect that they are sources of infection for other people. And as long as their own immunity regulates an adequate response, they themselves remain healthy, however, weakening of the immune system for various reasons can lead to the development of an inflammatory process (onset in men infected with chlamydia, but confident that everything is fine in their body).

In some cases, there is a hidden leak. Of course, it is difficult for a man not to notice this, but for women this is quite possible. If left unattended, the acute period becomes chronic, the process subsides, and Neisser's diplococci remain. They can “live” in the genital tract for quite a long time until a woman develops a complication (ovarian abscess, peritonitis, sepsis) or a new sexual partner comes to investigate, and a few days after sexual contact, symptoms of a completely hidden infection appear.

Hidden infections in children can appear before, during or after birth. This can be chlamydia, urea and mycoplasma, herpes infection, hepatitis, HPV. As a rule, children who received the pathogen from birth have weak immunity and are registered as often and for a long time ill. The respiratory system is mainly affected if the infection is bacterial in nature.

Diagnostics – tests for hidden infections

Tests for hidden infections cannot be limited to simple ones (flora, cytology). If microorganisms such as trichomonas, candida, gonococci (and even then not always) can still be seen when checking a regular drug, then chlamydia, HPV, herpes and others are not visible at all in a flora smear, and a cytological smear can only indirectly indicate the presence of infection by reaction epithelium. For diagnosis, there is a list of tests for hidden infections, which allows you to identify certain pathogens to the maximum extent:

Before the advent of such methods as ELISA, PCR, RIF, the diagnosis of latent infections was carried out mainly using bacterial culture and, although this analysis has not lost its relevance, the listed methods have become increasingly used due to their availability (a bacteriological laboratory must meet special requirements that not every medical institution can perform).

Pregnant women, as a rule, undergo such tests for free. The gynecologist observing the expectant mother determines the timing and list of pathogens of interest to him (many of them are included in the list of TORCH infections). They usually do not take money from patients undergoing examination in a hospital or undergoing outpatient treatment, which requires additional diagnostic methods.

On personal initiative, any person has the right to be tested for hidden infections. In skin and venereal disease clinics, infectious diseases hospitals, and medical centers, there are paid laboratories that carry out their diagnosis. The cost of research depends on the list of pathogens, search methods, region and status of the medical institution, so the price in Moscow and, say, in the Bryansk region will vary.

Features of treatment

Called in one word “infection,” these processes have much in common in treatment, for example, therapy is almost always used aimed at restoring immunity (local or general), the suffering of which is obvious in all cases.

However The approach to each pathogen is still somewhat individual:

Situations are possible when one person has hidden infections of various classes (viruses, bacteria, fungi). The doctor decides when and how to combine treatment, because the immune system is unlikely to tolerate an ignorant attitude towards oneself.

Video: hidden infections - infection and treatment, doctor’s opinion

Every female representative, especially if she has already become sexually active, is recommended to visit a gynecologist at least once a year and undergo tests for preventive purposes in order to promptly diagnose changes or diseases of the genital organs.

A gynecological smear for flora, as a diagnostic method, is recommended for every woman, even if she has no reason to worry.

What is a bacteriological vaginal smear?

A gynecological flora smear or, as it is also called, a bacteriological smear allows you to assess the condition of epithelial cells, as well as identify pathogenic microorganisms such as yeast, Trichomonas, gardnerella.

Also, thanks to the study of flora, it is possible to evaluate those microorganisms that are considered normal for the female vagina, since the vagina, unlike the uterus, is not a sterile organ.

In the female vagina, Candida can normally be found - a fungus that is opportunistic, streptococci, staphylococci. A flora analysis will allow you to assess changes in the composition of microorganisms and promptly identify bacterial pathology or, alternatively, suspect a disease of a different origin.

Unlike a smear for flora, a gynecological smear for cytology is a more difficult material to evaluate. To correctly evaluate the results of a cytology study, the doctor must have a special skill. True, the diagnostic event itself carries completely different information.

Any tests that evaluate cytology primarily look at the cellular structure and changes in it. Thus, it is possible to suspect at an early stage, for example, an inflammatory process or other unfavorable changes in the cellular composition of the female vagina.

A cytology smear, in addition to the inflammatory process, helps diagnose tumor diseases and human papillomavirus infection, which can act as a trigger in the development of cervical cancer.

How to prepare for the test

Cytology or flora tests do not require special preparatory measures, however, for reliable results of a smear in gynecology, a woman will have to follow a number of simple recommendations.

Preparation tips:

• A few days before the test, it is recommended to abandon douching, vaginal tablets and ointments so that nothing affects the vaginal flora (it would be optimal to refuse procedures 2-3 days before the test).
• 1-2 days before the diagnostic event, it is recommended to abstain from sexual intercourse.
• In the evening before the procedure, hygiene procedures are performed without using intimate hygiene products.
• There is no need to perform hygiene procedures immediately before the examination (right before taking a smear from a gynecologist, you can easily wash the external genitalia with warm water, but no more).
• It is better to refrain from emptying your bladder several hours before the test.

When choosing the day on which the tests will be carried out, it is worth taking into account the menstrual cycle. For a smear on flora or cytology, the ideal time is considered to be several days after the end of the menstrual cycle or before its start. Read more about how to correctly calculate your menstrual cycle→

Unlike a smear for flora, a smear for cytology is taken in the middle of the menstrual cycle, that is, no earlier than the fifth day after the start of menstruation, but no later than five days before the start of the next one. The rest of the preparation is similar.

If it was not possible to predict the menstrual cycle, then the tests will have to be postponed to a later time. In most cases, the doctor prescribes the date of the study based on the woman’s medical history, so such cases are quite rare and occur only with an unstable cycle.

How to take a vaginal smear

The purpose of the flora smear procedure is to obtain mucus from the vagina, urethra and cervix. Typically, research takes place in three main stages.

Before taking a smear for flora, a woman must undergo a general gynecological examination using a “mirror” - a special instrument whose task is to expand the walls of the vagina.

Gynecological examination is a common, safe and cheap procedure, but sometimes it can be uncomfortable due to the temperature difference between the instrument used and the woman’s body. Doctors note that examination with a “mirror” is easier if the patient relaxes and breathes evenly.

When the visual assessment of the condition of the vaginal walls is completed, the specialist will collect mucus with a sterile swab. This procedure usually does not cause discomfort, but touching the tampon to the cervix may result in mild pain, which goes away as soon as the manipulation is completed.

The resulting mucus sample is transferred to a glass slide, after which it is taken to the laboratory, where it is examined under a microscope. A woman, depending on the workload of the laboratory, receives the results of a smear on the flora in a period of time from several hours to three days.

A smear for cytology is performed using a similar technique, but other data are assessed in the laboratory under a microscope.

What diseases can be detected

A bacteriological smear, carried out according to all the rules, allows you to determine the presence or absence in a woman of a number of typical inflammatory processes that are provoked by pathogenic microorganisms.

Accordingly, during the study a number of pathologies are diagnosed:

• Vaginitis is an inflammatory disease that affects the vaginal walls.
• Cervicitis is a pathology that is inflammatory in nature and affects the cervical canal.
• Bacterial vaginosis is a disease that develops when changes occur in the normal microflora of the vagina.
• Thrush or candidiasis is a fungal infection of the genital organs that occurs due to the excessive presence of Candida (they are opportunistic and may be present in a normal smear). Read more about thrush→

A number of diseases that are sexually transmitted are also diagnosed using a bacteriological smear. These include:

• Chlamydia is transmitted mainly only through sexual intercourse and is caused by chlamydia.
• Gonorrhea is an inflammatory disease that is caused by gonococcal pathogenic microorganisms.
• Trichomoniasis is an infection caused by Trichomonas.
• Ureaplasmosis and mycoplasmosis - provoked by the microbes uraplasma and mycoplasma, affecting not only the genitals, but also the respiratory system.

If there is a need to clarify the results of a smear on the flora, then cultural studies can be performed (they will demonstrate how many microbes are in the genital tract), as well as polymerase chain reaction, which is a method for diagnosing many diseases of the genitourinary system.

Cytological examination shows other pathologies. In total, cytology distinguishes five types of smears, which allow one to judge the condition of a woman’s genital organs.

There are 5 types of cytology smears, depending on the test results:

1. No cellular changes were detected, the cervix is ​​in its normal state;
2. There are cellular changes such as an inflammatory process or mild dysplasia, in this case it is recommended to treat the inflammation and repeat the analysis;
3. Cellular changes correspond to a moderate or severe type of dysplasia; additional diagnostic measures are required;
4. Precancerous condition, consultation with an oncologist or gynecological oncologist is required;
5. Cancer requires treatment in an oncology clinic.

Despite the categorical description of the types of smears, women need to remember that a smear is an indicator of cellular changes, and their exact cause can only be found out after undergoing a full examination.

Cellular changes in the last stages, in addition to the oncological process, may indicate the presence of the following diseases:

What to do if you have a bad smear

Poor results of a bacteriological smear should not cause a woman great fear or nervous shock. She needs to remember that all infections that bacteriological analysis shows are treatable.

If the results are unsatisfactory, then you should follow three simple rules:

1. Have at least one more consultation with a gynecologist so that he can determine the cause of the disease, and if this is not possible, then prescribe additional diagnostic measures.
2. Listen to the doctor’s advice regarding the treatment of the identified pathology.
3. Do not attempt to cure yourself at home, so as not to aggravate the process.

If the bacteriological smear is poor, women are also prohibited from douching. This is due to the fact that it can further disrupt the vaginal microflora, aggravating the course of the disease. With a poor cytological examination, the woman’s action plan is almost the same.

The doctor, having determined harmful changes in the cellular composition of the organ, necessarily sends the patient to undergo additional diagnostic tests, such as colposcopy and cervical biopsy. The final diagnosis is made based on the results of these studies, after which treatment of the pathology begins.

Since cytology tests are screening tests, in most cases pathological changes can be diagnosed in the early stages, when they are still highly treatable if treated promptly and correctly.

Cytological and bacteriological tests in gynecology play an important role not only as screening tests, but also as diagnostic ones.

Every female representative, especially if she has already become sexually active, is recommended to visit a gynecologist at least once a year and undergo these tests for preventive purposes in order to promptly diagnose changes or diseases of the genital organs and begin treatment with the maximum possible effectiveness.

Useful video about preventive examination by a gynecologist

Mama66.ru

if the smear is good, can there be infections?

In the section Diseases, Medicines, to the question Tell me, if you do a simple gynecological smear, will it show whether there are infections? Or should you test only for all infections? The best answer given by the author is a smear for microflora only shows the presence of gonorrhea, trichomoniasis, candidiasis. A traditional flora smear is not the most reliable research method. It may not detect chronic, indolent trichomoniasis and gonorrhea. The tank is much more precise. culture and PCR tests. A microflora smear does not show chlamydia, mycoplasmosis, ureaplasmosis, papillomavirus infection, cytomegalovirus infection. All of the above infections must be treated, as they can lead to serious consequences. For example, oncogenic strains of papillomavirus infection can lead to erosion, dysplasia and cervical cancer. Recently, asymptomatic forms of STIs have become more frequent due to reduced immunity in the population. STIs (sexually transmitted infections) are quite insidious and without treatment can cause unpleasant complications: colpitis (inflammation of the vagina), endocervicitis (inflammation of the cervix), cervical erosion, cervical dysplasia, endometritis (inflammation of the uterine mucosa), endomyometritis (inflammation of the uterine lining) and muscular membranes of the uterus), salpingo-oophoritis (inflammation of the appendages), cystitis (inflammation of the bladder), pyelonephritis (inflammation of the renal pelvis), adhesions in the pelvis, infertility. STIs can lead to miscarriages, premature births, and missed abortions. pneumonia, meningitis, encephalitis, meningo-encephalitis in newborns. Recently, data have emerged on the connection between long-term STIs (in particular trichomoniasis, mycoplasmosis, ureaplasmosis) and the development of uterine fibroids. It is advisable to take the following tests: PCR gonorrhea antigen-gonorrhea PCR trichomoniasis tank. culture for trichomoniasis PCR chlamydia PCR ureaplasmosis biovars PCR mycoplasmosis Tank culture for ureaplasmosis Tank culture for mycoplasmosis PCR HPV (human papilloma virus) with typing PCR cytomegalovirus PCR Candida albicans PCR Gardnerella smear for microflora Tank culture for ureaplasmosis

Answer from Luka [expert] It will show only part of the infections, some are deeper... well, of course, if they exist! Answer from Vladimir Slobozhanin [guru] Any smear is done on the basis of the clinic and complaints))) It is taken mainly for oncocytology, then there is an exception for the development of cervical cancer (unfortunately, this often happens). It is also examined for the presence of sexually transmitted diseases (hourResponse from Yergey Yurievich Buyanov[guru]A regular smear on the flora is enough for the eyes. Gonorrhea, trichomonas, dysbacteriosis are detected. Cultures for intrauterine infections should be done closer to the planned pregnancy. No complaints at all there is no need to do or identify anything. Answer from Squirrel[guru] A smear is taken for oncology, bacteria, infections - the research methods are different and they are indicated either by the doctor or by you yourself after consultation with a specialist... write in a personal message and I will tell you what tests I donated by blood and which ones by smear... I have a folderAnswer from 2 replies [guru] Hello! Here are more topics with the necessary answers:

2oa.ru

Smear for hidden infections in women - analysis procedure and possible results

It's no secret that with the development of technology, medicine and the improvement in the quality of life, the number of various diseases not only does not decrease, but is constantly growing. Today, every fifth person suffers from infectious diseases of the reproductive system, and often a person finds out about the disease too late. That is why doctors strongly recommend using contraceptives and regularly undergoing tests for hidden infections.

Smear for infections: purpose

A smear test for infections is important as it can reveal hidden diseases

Hidden infections occur in many people. They are dangerous because they do not appear in any way for a very long time, which explains their name. This also entails their spread among people who are sexually active.

The infection can develop over several months or even years and only then make itself felt. If the disease is not detected and treated in time, serious illnesses may develop, as well as infertility and cancer, and men and women are equally susceptible to this.

Hidden infections include ureaplasmosis, chlamydia, mycoplasmosis, and HPV.

They are transmitted through unprotected sexual contact and are often difficult to treat.

It is necessary to be tested for hidden infections in the following cases:

• You had unprotected sexual contact with a stranger. In general, these situations should be avoided by all possible means, since an unfamiliar partner can transmit a whole “bouquet” of various diseases that he doesn’t even think about. After such a situation, you must immediately go to the hospital and get tested to rule out infection or begin treatment measures on time. The best protection is prevention, so contraceptives should always be on hand.
• When planning pregnancy or conceiving a child. Many infections can affect the development of the fetus, including miscarriage. In addition, they can be transmitted from mother to child and cause congenital pathologies. A pregnant woman needs to undergo all examinations in order to know the state of her body for the best course of pregnancy.
• If you experience discomfort in the genital area, unusual discharge, itching or irritation. Some infections and diseases can occur due to poor hygiene, after severe stress and for other reasons other than unprotected sexual intercourse. Remember: disease is easier to prevent than to cure, so periodic examinations will help you keep your body healthy and prevent the development of diseases.

Smear analysis: types and purposes of the study

Smear in women for hidden infections

A smear is taken not only to detect infections. This is the study that is the most accessible and is carried out at almost every gynecological examination. The analysis is able to identify any deviations from the norm in a woman in order to conduct more in-depth studies in the future and begin treatment on time.

There are the following types of smears:

• Flora smear. This is the same analysis that is mandatory at an appointment with a gynecologist. It is done quickly and is able to identify any inflammatory processes in the genital organs, as well as monitor the effectiveness of treatment for various diseases.
• Smear for hidden infections. This is a more in-depth analysis, as it helps to identify which pathogen caused the inflammatory processes. It helps to recognize chlamydia, gonorrhea, candidiasis, gardnerellosis, mycoplasmosis, genital herpes, human papillomavirus and other infections. Sometimes a smear culture is done to clarify the diagnosis, for example, if candidiasis is suspected.
• Smear for oncocytology. The procedure is exactly the same, but it helps to detect the development of cancer cells in the initial stages. This test is performed less frequently than the first two, but doctors recommend that all women undergo it regularly for preventive purposes. This will allow you to recognize the danger in time and begin treatment if the tumor does begin to develop.

Preparing for the study

Proper preparation is the key to reliable results

The doctor himself can tell you about some of the nuances that should be taken into account before taking the test.

They can be individual, but there are some general rules that allow you to get the most reliable result so that you don’t have to go through the procedure again:

• A smear should be taken after menstruation, preferably on days 1-2 of the cycle
• Before the procedure, sexual rest is required for several days.
• Before visiting your doctor, do not take any medications, including oral contraceptives and antibiotics, as this may distort the results
• Douching should not be done a few days before taking a smear, as this can change the vaginal microflora
• Before the procedure, you can arrange a provocation: to do this, have a dinner with salty or fried food, drink a little alcohol, as these measures will allow you to identify hidden infections with greater accuracy
• Do not use personal hygiene products several days before the procedure
• You need to wash your face in the evening; it is not recommended to do this in the morning.
• Immediately before the visit, you should not urinate 1-2 hours before the appointment

Smear procedure

Before visiting a doctor, you can purchase a disposable diaper and a gynecological kit in advance. In private clinics, the necessary tools are usually provided to each patient without fail.

A woman needs to sit on a gynecological chair and relax as much as possible. The procedure is painless, but some may have increased sensitivity and this will cause some discomfort. In the presence of very severe inflammation, there may be minor painful sensations, but they quickly pass immediately after taking the biomaterial.

The doctor inserts a special mirror into the vagina, which allows you to see the walls in the light, after which he inserts a thin spatula, onto which he collects the material.

After this, the smear is spread on a glass or sealed in a test tube and sent to the laboratory. A woman can calmly dress and wait for the results.

It is worth noting that the material can be taken both from the vagina itself and from the cervix, urethra and rectum. There is also an oral swab, which is taken much less frequently than others.

Decoding the results

Smear for infections in women: normal and possible diseases

A normal smear should contain leukocytes, epithelial cells and natural rod flora. An increase in the number of leukocytes may indicate the presence of an inflammatory process, but it is impossible to understand from it which infection was the causative agent.

The doctor can immediately draw conclusions about the internal microflora of the vagina and prescribe medications that will help reduce inflammation. Then additional studies are carried out, which will make it possible to identify the pathogen with high accuracy and begin effective treatment in a timely manner.

If the smear shows the presence of pus, an increase in the number of natural bacilli, or other abnormalities, then we are talking about a hidden infection. In order to determine the nature of the pathogen, it is necessary to conduct additional research, and sometimes culture a smear on the flora. Sometimes, even if there are complaints, no deviations from the norm are observed in the smear. But this does not mean that everything is in order: perhaps the infection is hidden very well and other methods of diagnosing it are necessary.

Some infections cannot be seen under a microscope when taking a smear - chlamydia, ureaplasmosis, mycoplasmosis.

Therefore, other types of studies are needed to understand the exact cause of the patient's complaints. Sometimes a smear can detect only one infection, for example, candidiasis, which often accompanies more serious diseases. Having cured only thrush, a woman will not get rid of the problem, and it will bother her again and again. In addition, very often the analysis is taken incorrectly, and the results can be distorted, for example, when foreign pus gets into the biomaterial.

In general, a smear is the primary unit of research that allows you to recognize a danger in time and begin to implement any measures to avoid it. Every woman should undergo such a test at least once every six months and visit a doctor for preventive purposes, since diseases of the reproductive system can have very serious consequences.

Useful video - Smear test for infection in women.

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diagnosislab.com

Smear analysis in gynecology: normal table, what it shows, interpretation and what they charge?

Taking a gynecological smear is a standard procedure during a visit to a women's doctor. This analysis allows you to obtain information about the state of the vaginal microflora and the causes of possible discomfort. Not only his comfort, but also his overall health depends on what bacteria settle on the human body, especially in places such as the oral cavity, intestines and vagina.

Also, during the examination of a smear for flora, it is possible to accurately determine the presence of a focus of inflammation, and often hormonal disorders.

Specifics of the analysis

A gynecological smear is taken not only to determine the flora. Also, if a woman has special indications, she may need to take a smear for other types of tests.

This set of analyzes allows you to get a fairly holistic picture of women’s health.

To take a smear test for flora, it is enough to adhere to some not too serious restrictions:

When a smear is taken for “sterility”, they are most often prescribed to insert a tampon overnight, after which, after eight hours, it is removed in the morning at an appointment with a specialist.

If a woman needs to undergo a cytology test, she should adhere to all of the above rules. It is also worth adding that with this type of examination it is necessary to exclude the presence of an inflammatory process in the vagina. In case of inflammation, the process should be stopped, after which it will be possible to take material for cytological examination.

The analysis will show a true result only if the sampling is carried out before procedures such as a gynecological examination, colposcopy or pelvic ultrasound. If they are carried out, a smear for cytology is taken two days after the procedures.

When a doctor prescribes tests for hidden infections, he can recommend certain preparation nuances for a specific type of test. However, in addition to the above general rules, for this type of analysis a so-called provocation is often done. Then the study shows the most reliable result.

For dinner the day before your smear test, you should eat certain categories of foods, such as:

• all kinds of salinities: herring, pickled vegetables, mushrooms, feta cheese;
• small amounts of fried, fatty foods;
• spicy foods and seasonings.

At the same time, of course, you should not overeat to the point of feeling unwell.

Before going to see a doctor, in addition to the standard gynecological kit, you can purchase a special brush at the pharmacy, which will allow the specialist to take the material for the smear as efficiently as possible.

To contents

Carrying out analysis: taking and studying material

The gynecologist takes a smear from the vaginal or cervical mucosa, depending on the type and purpose of the study. The procedure is quick and painless: the woman is seated on a gynecological chair - and after a few minutes she can already relax. The doctor applies a smear to a glass slide or places the material in a test tube.

Each type of research requires its own time period. When material is taken for a standard flora test, it only takes a day or two for the results to be returned.

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If he is sent for bacterial culture, results should be expected no earlier than a week later. If you undergo an examination for hidden infections, the result can be obtained either the next day or within the next ten days, depending on the chosen research method.

A common complaint among women after taking a smear is the appearance of blood from the vagina. This is due to the fact that for high-quality sampling it is often necessary to slightly remove the surface layer of tissue.

If the cervix is ​​bleeding, you should not panic, but you should still consult a doctor, since in some cases the cause of bleeding may be a pathology, for example, ectopia.

Tables 1 and 2 show the standards for interpreting gynecological smears:

Table 1 - Vaginal flora smear (V)

When collecting material from the cervix (C), the norms for these indicators are similar, with the exception of the presence of microflora; normally, all types of microorganisms are absent in the cervical canal. Also, the number of leukocytes in a scraping from the cervix can normally reach thirty.

Table 2 - Cytology smear. Transcription using the Papanicolaou method.

When material is taken to test for latent infections in women, as a rule, the decoding reveals whether a specific type of pathogen that is causing the illness is present or not. The quantity is indicated using the “+” symbol; an increase in pluses corresponds to an increase in the number of pathogens.

• nervousness, sleep and appetite disturbances...
• frequent headaches...
• bad breath, plaque on teeth and tongue...
• change in body weight...
• diarrhea, constipation and stomach pain...
• exacerbation of chronic diseases...