Since ureaplasmosis mainly affects the mucous organs of the genitourinary system, to determine the presence of parvum and urealiticum bacteria, as well as to determine their titer, a smear with sowing on the microflora is used. For the first time they started talking about bacteria in the middle of the last century. Then it was considered a purely female disease, and closer to the 60s, the bacterium was found in men.
Then, in the course of studies of various pathogenic microflora of the urethra and vagina, it was found that more than half of people of reproductive age have parvum or urealiticum bacteria, which means that a diagnostic method is needed that would determine the titer of the bacteria.
New studies began, the purpose of which was to determine the degree of risk of developing the disease at different titers. It was found that ureaplasma 4 CFU / tamp and more to the 10th degree is the borderline when a conditionally pathogenic bacterium turns into a pathogenic one and the development of ureaplasmosis begins. In order for the ureaplasma parvum 10: 4 CFU / swab in the culture test results to be true, and not less than the actual titer, you should stop taking medications that may affect the final result before taking a smear.
Very often, grade 4 ureaplasma is found during the examination of young couples who have been unsuccessfully trying to have a child for a long time, which is not surprising, because with such an amount, this bacterium can have a detrimental effect on spermatozoa, destroying and slowing them down, which leads to male infertility. In women, with indicators of 10 to the fourth degree, inflammatory processes occur in the fallopian tubes, due to which the egg may not enter the uterus.
To determine ureaplasma urealiticum 10: 4 CFU / swab, a smear is taken from the vagina in women and the urethra in men, then the bacterium is placed in a culture medium (culture), and only then the titer is calculated. sensitivity to different groups of antibiotics, and treatment is prescribed. With ureaplasma rates less than 10: 4 degrees, treatment can be prescribed only with clear signs of an inflammatory process and the absence of other microflora with a titer higher than that of this bacterium.
An exception is the situation in which ureaplasma with a titer of 10: 4 CFU / tamp is detected in the early stages of pregnancy, in which case harmful therapy is postponed to a later date (20-22 weeks), in order to avoid pathologies of fetal development.
This degree implies treatment. However, some doctors believe that therapy in this case is inappropriate, and if patients do not have negative symptoms, then it can be discarded.
Often, ureaplasma with high rates is found in young couples who are trying to have a child for a long period of time, and all attempts are in vain and unsuccessful. However, there is a danger for already pregnant women, so, for example, many are interested in?
In the fairer sex, with such indicators, inflammation processes are observed that occur in the fallopian tubes, as a result of which the paths to the uterus are blocked for the egg, and it cannot enter it.
A high concentration of ureaplasma in the body can lead to a number of concomitant diseases:
- Colpitis.
- Inflammatory processes in the fallopian tubes.
- Cervical erosion.
- Various processes of inflammation in the genitourinary system.
- Cystitis, endometritis.
- Violation of the functionality of the reproductive system.
Despite the fact that in medical circles there is still debate about whether it is necessary to treat ureaplasma or whether it should be abandoned, numerous studies confirm that it can lead to spontaneous miscarriage in women or a frozen pregnancy.
Therefore, we can conclude that if the ureaplasma is more than 10 * 4 degrees, then it is subject to mandatory therapy with the appointment of appropriate medications.
If ureaplasma is observed in a lower concentration, then treatment in this case is not recommended.
The disease does not always indicate its presence with negative symptoms, in a number of situations, the disease is asymptomatic, and it is possible to determine the pathology above the normal border of 10 to 4 degrees only through the delivery of biological material.
The condition of the vagina, a pathogenic change in the microflora, and in this case, the doctor always offers to pass additional tests to confirm or deny the alleged disease, can tell the doctor about the presence of pathology.
Collection of biological material for further study is taken from several places: the walls of the vagina, the cervical canal of the cervix, the urethra. The doctor distributes the resulting secretions on laboratory glass and sends them for analysis.
- 2 days before the manipulation, it is necessary to refuse sexual intercourse.
- Do not use suppositories, gels and topical ointments.
- Refuse douching.
- Hygienic intimate procedures are carried out in the evening, and washing in the morning must be excluded.
The doctors' comments indicate that some drugs are capable of leading to incorrect data, while it is possible to get underestimated values \u200b\u200bor overestimated results. In any case, this will lead to a worsening of the situation and the clinical picture.
Features of preparation for the method:
- You cannot go to the toilet 3 hours before the manipulation.
- If a woman is taking antibiotics or antibacterial drugs, they should be discarded a few days before the procedure.
- Two days before the procedure, give up suppositories and pills that are inserted vaginally.
- On the day of the test, you cannot perform intimate hygiene procedures.
- Exclusion of sexual intercourse a few days before taking a smear.
How to find ureaplasma in men?
To obtain biological material from a patient, the doctor performs a scraping from the walls of the urethra. Reviews of men say that the procedure is not too painful, but uncomfortable.
A special probe acts as a tool, which is inserted into the man's urethra, the approximate depth is 3 centimeters. Then the doctor acts several forward movements to carry out the collection of bacteria and particles of the mucous membrane.
When the probe is removed, the patient may feel slight discomfort in the urethra, burning sensation and other unpleasant symptoms. They usually go away after a few days.
The test procedure requires certain preparatory measures not only for women, but also for men:
- Two days before the manipulation, sexual intercourse is excluded.
- Hygiene procedures are carried out the night before, not in the morning.
- It is recommended to take the analysis so that the patient does not urinate for several hours.
- Refuse to take antibiotics, antibacterial drugs a week before the analysis.
It is worth noting that factors such as stress, severe nervous tension, hypothermia and others can also act as the causes of the disease. Even if the patient was found to have less than 10 degree 4 ureaplasma, he is at risk, and the disease can begin to develop at any time.
If one of the partners does not want to undergo treatment, believing that the test results showed nothing, it means that he is healthy, then the therapy of the second partner will be at risk, and in the overwhelming majority of cases it will be useless, a relapse of the disease is inevitable.
The main principles of therapy:
- Gentle diet food means the exclusion of spicy, salty, smoked and pickled.
- In the overwhelming majority of cases, antibiotics are not combined with the use of alcoholic beverages, so they must be discarded during treatment.
- It is forbidden to have sex during therapy.
As a rule, antibiotics are always selected from the group of tetracyclines, macrolides, fluoroquinolones. The medicine must be taken orally according to the scheme recommended by the attending physician. The duration of treatment varies from 7 to 10 days.
Upon completion of treatment, you do not need to rush to get tested to find out about the effectiveness of therapy. Tests, as a rule, are taken one or even a month and a half after the end of the drug intake.
Ureaplasmosis is an infectious disease, the appearance of which is promoted by ureaplasma of the type urealiticum and parvum. These are microscopic bacteria living in organs, or rather on their mucous membranes, of the urinary system.
Infection with ureaplasma infection occurs during sexual intercourse, during which no means of protection were used. Also, the disease can be transmitted during intrauterine development of the fetus or during labor from the mother to her child.
You should know that a factor that significantly increases the likelihood of infection is weak immunity. Especially if a person has chronic diseases of the genitourinary system. At the same time, the chances of infection with mycoplasmosis in everyday life are minimal.
It is worth noting that symptoms of the disease are rare. Therefore, if analyzes show that ureaplasma is 10 to 5 degrees, or 10 to 4.8, then the infection is unlikely to manifest itself strongly.
However, even such indicators can seriously impair health. If ureaplasmosis is actively progressing, then it is accompanied by such signs as frequent urination, accompanied by burning, mucous discharge from the vagina or urethra, discomfort that occurs during intercourse and stabbing pain in the lower abdomen. If such symptoms occur, you must consult a doctor and pass a number of tests.
Diagnosis of ureaplasma and its norm
It is quite difficult to identify ureaplasmosis, because its pathogens are present in small quantities in the natural microflora of each person. Bacteria can cause illness only if the immune system is severely weakened, for example, during pregnancy.
Therefore, in order to understand whether it is worth treating ureaplasma, for example, 10 to 3.8 degrees, it is necessary to compare different factors. So, if the patient has symptoms of the disease and bacteria were detected in his reproductive system, then most likely the treatment will be carried out.
Today, ureaplasma infection is detected after various diagnostic procedures. First, you should take a smear. If there is inflammation, then the number of leukocytes will be overestimated, but sometimes this figure is normal. Therefore, for an accurate diagnosis, it is necessary to make a bacterial culture on the ureaplasma and conduct a PCR analysis.
PCR will show the degree of development of the pathogenic microflora. But the second study will give a more detailed answer, since, in addition to quantitative indicators, it allows you to establish the sensitivity of a pathogen to certain antibiotics.
Often, diagnostics show that ureaplasma is 10 to 3 degrees, the presence of anaerobic microflora and mycoplasma. The increased alkaline vaginal environment creates positive conditions for the development of pathogenic microflora.
The normal pH in the vagina should range from 3.8 to 4.4. The most common form is "T-960" ureaplasma ten in the third degree.
The more severe form is ten to the fourth degree, but it is not common.
Ureaplasma ten to the fifth degree: what does it mean?
To determine ureaplasmosis, a study of the affected area is carried out, which can vary depending on various factors:
- in men, the urethra;
- in women, the fallopian tubes and vagina;
- in children - the respiratory organs.
This selectivity of the lesion is explained by the fact that ureaplasma is a genital infection. And its habitat depends on the method of infection. So, in men and women, this happens during sexual contact, therefore microorganisms settle on the urethra or uterus.
And the infection penetrates into the child's body along the vertical path, when during labor the child inhales the ureaplasma. As a result, it affects his lacrimal glands, mouth and nasal cavity.
An indicator of 10: 5 degrees or more requires compulsory treatment even if the patient does not have signs of inflammation. After all, even an asymptomatic course of the disease can cause at first temporary, and then irreversible, infertility. TO
in addition, rejection of antibiotic therapy will lead to the development of cystitis, thrush, various inflammatory processes and create a favorable environment for the emergence of other serious infectious diseases.
What do the other test results mean?
Sometimes patients have such an indicator as ureaplasma 10 to the 2nd degree, what does it mean? Doctors gynecologists say that in this case the results are normal and there is no need to carry out treatment. The same can be said if the number of bacteria does not exceed the third indicator.
And what if the study showed that the number of ureaplasma is 10 * 4 degrees? According to the latest WHO recommendations, these numbers are normal. Therefore, in the absence of the unpleasant symptoms described above, there is no need for treatment.
But if the test results are less than 10 * 5, for example, 10 * 4.8, then you need to go to the doctor's consultation and carry out additional tests. When the doctor compares all the factors, conducts an examination and listens to the patient's complaints, he will confirm or deny the need for treatment.
As mentioned above, if the research results show from 10 to 5, and even more so when ureaplasma is 10 to 6 degrees, all this requires compulsory treatment.
What to do with ureaplasma 10 x 5 degrees?
According to certain treatment regimens, you can get rid of ureaplasma in 8-14 days. However, immunocompromised patients will need longer treatment.
Of the antibiotics for ureaplasmosis, tetracyclines (Minocycline, Doxycycline) or azalides (Azithromycin) are most often used. Alternative agents are macrolides such as Erythromycin or Clarithromycin and fluoroquinolones such as Ofloxacin and Lomefloxacin.
In addition to antibiotics, immunity correcting agents are used to treat ureaplasmosis. It is worth noting that this is very effective, especially for patients with immunodeficiencies.
After immunostimulating treatment, it is necessary to carry out restorative therapy, which implies taking the following groups of drugs:
- enzymes (Wobenzym);
- biostimulants (Plazmazole, aloe extract);
- agents that help restore the mucous membranes of the genitourinary organs (Methyluracil);
- adaptogens (Estifan);
- antioxidants (Antioxicaps).
2 weeks after treatment, you need to take tests. And then, even if the results show the absence of ureaplasma, you need to undergo repeated examinations every 6 months throughout the year. If, during this period, the presence of ureaplasmosis is revealed, then therapy will have to be carried out a second time.
Enterococcus faecalis bacteria, found in a smear, it is also enterococcus fecal or intestinal, is a microorganism that usually lives in the human intestine and is opportunistic. That is, it can cause a disease, but only under certain conditions - if it gets into an environment favorable to it (in the mouth, vagina, urinary system) with reduced immunity (typical for pregnancy). It provokes cystitis, aerobic vaginitis, pyelonephritis and other diseases.
The gynecologist diagnoses this pathogen based on the results of bacterial sowing on the flora. This is an analysis that is sometimes taken from expectant mothers on a routine basis without any complaints, as well as in the case of a poor total smear, if too many white blood cells are found.
Sometimes a smear for flora or purity from the vagina is taken simultaneously with the bacterial culture. This is if a woman already has symptoms of a gynecological disease, infection, for example, unusual discharge, itching. Thus, it will be possible to prescribe the correct treatment as soon as possible, because the sowing is performed for more than one day. It is necessary to wait until microorganisms multiply in the discharge from the vagina and cervical canal taken for analysis.
Symptoms of enterococcus faecalis in women
Fecal enterococcus is found in smears in 25% of women, and more often this is the norm. It does not always give any symptoms. If the amount of the microorganism is not large, perhaps it even got into a smear from the rectum due to its improper collection from a healthy woman, the bacteria does not show any signs.
If aerobic vaginitis develops - an inflammation of the vagina caused by a sharp increase in aerobic microflora (including Enterococcus faecalis), that is, microorganisms that need oxygen to develop, then the severity of signs of the disease will depend on its degree... You can judge more about the stages of development of aerobic vaginitis from the table.
For clarity in numbers:
- 10 to 2 degrees or 10 to 3 degrees - moderate growth, probably enterococcus got into the vagina from the rectum by accident;
- 10 * 4 CFU / ml, 10 ^ 5, 10 ^ 6, 10 in the 7th degree - abundant growth.
If there is inflammation, then there will be the following manifestations.
- Pain during intercourse, called dyspareunia.
- Profuse yellow discharge without an unpleasant odor (as opposed to bacterial vaginosis caused by anaerobic microorganisms when there is a smell of rotten fish).
- Swelling and redness of the vestibule and walls of the vagina.
- Itching and burning in the vagina. Sometimes women complain that they pinch the labia.
The listed body signals become especially bright after menstruation.
From time to time, the symptoms become less pronounced, the woman feels an improvement, but then an exacerbation follows again.
Reasons for the appearance of intestinal enterococcus in the vagina and routes of infection
From the intestines, microorganisms enter the vagina during anal-vaginal contacts, ordinary sexual intercourse; due to the proximity of the anus and the entrance to the vagina, improper washing and wearing of thongs, poor personal hygiene, etc.
Aerobic vaginitis is especially common in girls and women during menopause. The problem is low estrogen levels, little or no lactobacilli. To improve the microflora of the vagina, to populate it with beneficial microorganisms for women with menopause, hormone replacement therapy, including the use of topical preparations - "Ovestin" will help. By the way, it is with a low level of estrogen that another gynecological pathology is associated -.
During intercourse, it can be transmitted from one partner to another, like any other opportunistic pathogen, but in small quantities.
Treatment of fecal enterococcus in women
If there are no symptoms of the disease, no treatment is required. If there is, then antibiotics are prescribed by mouth and a topical antibacterial or antiseptic drug.
It is believed that it is imperative to be treated if fecal enterococcus is detected when taking a smear from the cervical canal. Allegedly, it is possible to observe only if it is located exclusively in the vagina. But the microflora of the vagina and the cervical canal is almost identical. And pathogens just won't get into the uterus. A mucous plug will interfere (it is formed not only in pregnant women!), Menstruation (during which the endometrium is rejected with all pathogenic bacteria), constant physiological renewal and leucorrhoea - vaginal discharge also "cleanses" the mucous membrane.
Of the antibiotics, the following are usually preferred:
- "Gentamicin;
- "Sizomycin";
- "Amikacin";
- "Tobramycin";
- "Netilmicin";
- Levofloxacin;
- Linezolid;
- "Amoxiclav";
- "Amoxicillin";
- Levofloxacin;
- "Cefotaxime";
- Rifaximin;
- "Nifuratel";
- Ceftriaxone;
- "Ciprofloxacin".
Pefloxacin, lomefloxacin, ofloxacin, norfloxacin are weakly active. The result of bacterial culture helps to more accurately determine the effective medicine. As a result of this analysis, you will find to which antibiotic the bacterium is resistant (immune) and sensitive.
Of the local drugs, the following help fight enterococcus faecalis:
- Terzhinan;
- Polygynax;
- Hexicon.
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Treatment regimen No. 1 |
"Gentamicin" 2 times a day for 5 days + suppositories "Terzhinan" 1 before bedtime - 10 days. After that, it is possible to use drugs to normalize the intestinal and vaginal microflora. "Bifidumbacterin" inside and "Acylact" vaginally. But this is optional. |
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Treatment regimen No. 2 |
1 candle "Vaginorm S". The next day, antibiotics "Ciprofloxacin" at a dosage of 500 mg 2 times a day for a week. In parallel with this, "Terzhinan" candles, 1 piece for 10 days. After the end of the course of antibiotics - another 5 days "Vaginorm S" and then to restore the microflora of the vagina "Ekofemin" for 10 days. |
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Treatment regimen No. 3 |
"Ampicillin" at a dosage of 0.25, 2 tablets 4 times a day for one week. At night, 1 suppository "Geksikon" vaginally. |
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Treatment scheme No. 4 |
"Tsiprinol" 500 mg 2 times a day. On the 3rd and 10th day of antibiotic treatment - Mikomax 150 mg. From the second day of treatment with antibiotics inside, vaginally combined antibiotic "Polygynax" for 12 days. After that, restore the vaginal microflora with candles "Vaginorm-S" (6 days). |
Some doctors resort to an alternative treatment - increasing immunity so that the body can fight the intestinal microorganism itself. Or a bacteriophage is prescribed for the intestines. Evidence-based medicine advocates are skeptical about such appointments. "Rifaximin", "Viferon" and similar drugs do not have proven efficacy and safety.
If there are manifestations of a fungal infection (thrush) - appoint "McMiror".
Pregnant women cannot do without antibiotics, as the consequences of this inflammatory process can be especially severe for them.
Why aerobic vaginitis is dangerous, the consequences of the disease
The development of severe endocolpitis is possible - an inflammatory-dystrophic lesion of the walls of the vagina and cervix. This often provokes the following complications during pregnancy:
- premature rupture of the amniotic sac with discharge of amniotic fluid;
- chorioamnionitis;
- premature birth;
- intrauterine growth retardation;
- low birth weight baby.
Aerobic vaginitis is exacerbated by pelvic inflammatory disease:
- endometritis;
- salpingitis;
- oophoritis;
- tubo-ovarian abscess;
- pelvic peritonitis.
Symptoms of diseases of the female reproductive organs:
- severe pain during menstruation and in other phases of the cycle; pain radiates to the lower back, sacrum, perineum;
- feeling of heat and fullness in the perineum;
- soreness during intercourse and decreased sex drive;
- infertility;
- mucous, gray leucorrhoea;
- increased body temperature;
- pain when urinating.
Complications of diseases of the reproductive organs:
- scarring, adhesions in the fallopian tubes;
- ectopic pregnancy;
- regular pelvic pain;
- tubo-ovarian abscess;
- pelvioperitonitis.
Concomitant enterococcus faecalis opportunistic flora and terms
You can read these scientific definitions in the test results. Do not be afraid of these microorganisms. They are all conditionally pathogenic. Do not always cause illness. They belong to aerobic, that is, they are able to provoke aerobic vaginitis.