What are candida spores in a smear? Candida spores and mycelium in a smear

Urinary tract yeast infections, or thrush, have become increasingly common in recent years. Doctors believe that this phenomenon is caused by the uncontrolled use of antibacterial drugs.

In this case, men become infected with thrush through sexual contact with a woman in whom this opportunistic fungus has caused inflammation. However, some experts stubbornly do not classify it as a sexually transmitted disease, although in 2006 the World Health Organization classified the causative agent of thrush as a sexually transmitted infection. Both partners should undergo treatment, so it is important to know how thrush in men is treated.

In order to choose the most effective treatment for an infection, it is necessary to have a complete understanding of its causative agent and what symptoms it causes.

The causative agent of this disease is a fungus of the genus Candida, which is usually called a yeast fungus, although it is more correct to classify it as a yeast-like representative of the fungal kingdom. Five varieties of these fungi are constantly present in the human body, but in 90 out of 100 cases, inflammation of the genitourinary tract is caused by Candida albicans, or white candida.

For normal existence, these microorganisms require the presence of air (oxygen) and a large amount of glycogen. Therefore, one of the most suitable places for this yeast fungus is the mucous membrane of a woman’s vagina, and in men it feels more comfortable on the head of the penis, rather than in the urethral canal.

An important condition for the proliferation of candida fungi is the level of acidity of the environment: a favorable environment for this microorganism is within the range of 5.8-6.5 pH, that is, acidic. In alkali it quickly dies. Therefore, often increased growth of yeast fungus begins with an inflammatory process in the bladder, causing an increase in the acidity of urine.

The human body becomes infected with Candida fungus within the first minutes after birth. In this regard, there is constant debate about where thrush in men comes from: from the outside or from the inside.

Some experts are inclined to the point of view that the normal immune system is able to resist the pathogenic effect of this microorganism, and a balance is established between them. When the conditions of the external or internal environment change or when the immune system is weakened, yeast begins to rapidly increase the number of its colony, provoking an inflammatory reaction - this is how, in their opinion, candidiasis, or thrush, occurs, including in men.

Other doctors are confident that a man can get thrush only if his sexual partner has this pathology.

Thrush in men gives the most vivid clinical picture if the external parts of the genital organs are affected, in particular the glans penis and foreskin.

The first manifestation of candidiasis in men is a feeling of discomfort during or after urination. Usually the main subjective symptom of this infection is itching in the urethra, in the external urethral opening or on the head of the penis.

Some time after the first subjective signs of the disease appear, a characteristic objective picture of the disease develops:

• the surface of the head of the penis swells, becomes hyperemic, and often painful;
• the same thing happens with the foreskin;
• a dirty white cobweb-like coating appears, often combined with discharge from the urethra of the same color;
• areas of a brighter red color appear in the form of spots on the reddened surface; often such changes in the skin remain in the areas where plaque is removed;
• a sensation of itching and even burning spreads over the entire surface of the head and foreskin and loses connection with the act of urination;
• An unpleasant odor emanates from the penis.

It is necessary to take into account that such clinical symptoms occur only in the classical course of the inflammatory process, and in practice a blurred course is often encountered, which sometimes manifests itself in several or even one blurred sign.

If the walls of the urethral canal become inflamed, thrush manifests itself as severe itching and burning in the urethra and whitish discharge. Sometimes the external opening of the urethra changes, becoming swollen and reddened;

The main method for diagnosing thrush is microscopic examination. To do this, a scraping is taken from the head of the penis and from the urethral canal of men, applied to a glass slide, dried and, after special staining, examined using a light microscope.

The detection of a large number of microorganisms in their vegetative form (that is, during the process of reproduction) is considered clinically significant. Their combination with characteristic laboratory indicators of the inflammatory process serves as the basis for diagnosis and treatment.

In order for the treatment of thrush to bring a positive result as quickly as possible, it is necessary to follow several general principles for the treatment of sexually transmitted infections.

Regardless of where the thrush comes from, both partners should be treated. Otherwise, there will be constant re-infection of them from each other.

Even if both partners are undergoing treatment at the same time, sexual intercourse should be stopped. This eliminates the possibility of re-infection from the partner for whom treatment is slower to bring the expected result, and will help the tissues affected by thrush recover faster.

During the course of treatment, a special diet is followed, which involves enriching the diet with foods that shift the acid-base balance of the body to the alkaline side.

• dried apricots;
• grapefruits;
• dried figs;
• limes, lemons;
• mango;
• carrot;
• fresh cucumbers and tomatoes;
• celery;
• fresh beets;
• broccoli;
• jacket potatoes;
• bell peppers;
• parsley;
• asparagus;
• cauliflower;
• spinach.

Avoiding alcohol is mandatory, as it not only reduces the effectiveness of medications, but also causes a strong shift in the body’s environment to the acidic side, during which yeast multiplies intensively.

Such measures create a favorable background for the action of prescribed medications.

The basic drugs used to treat thrush are antifungal agents.

If thrush is localized only in the epithelial covers of the glans and foreskin of the penis, it is possible to use them in the form of preparations for local action (ointments, creams, gels). When microorganisms penetrate into the genital organs, antifungal agents for oral use are mandatory.

Currently, antifungal drugs from the following pharmacological groups are considered the most effective:

• azoles (itraconazole, fluconazole, ketoconazole, voriconazole, posaconazole, imidazole);
• echinocandins (caspofungin, micafungin);
• amphotericin;
• nitroimidazoles (nimorazole, nifuratel).

In severe cases of the inflammatory process, these drugs are used in the form of forms for both internal and local use simultaneously.

In addition, restorative medications (multivitamin-mineral complexes) and immunostimulants are mandatory.

The classic treatment regimen for men is as follows:

• morning and evening - hygienic lotion baths with a slightly pink solution of potassium permanganate;
• after the baths - apply a topical product;
• orally (if necessary) - an antifungal agent in the form of tablets, suspension or injections;
• in the morning - take a multivitamin;
• immunostimulant.

Instead of potassium permanganate, it is possible to use a weak solution of baking soda, which has an alkaline environment and allows you to destroy yeast-like fungi. Soda solution is also used as a lotion on the head of the penis.

In some cases, specialists, taking into account the existing symptoms, consider it necessary to prescribe the use of eubiotic drugs that normalize the microflora of the body as a whole.

Yeast in a smear discovered during a study of the vaginal microflora may indicate a pathological process in a woman’s body. Timely diagnosis and properly selected treatment will save the patient from unpleasant symptoms and dangerous consequences caused by fungi of the genus Candida (albicans, tropicalis, krusei, parapsilosis).

Thrush is not a sexually transmitted disease

Thrush (candidiasis) is caused by yeast-like fungi of the genus Candida, which live on vegetables, fruits, confectionery products and fly in the air. In the human body, along with other beneficial microorganisms, fungi can be found on the skin and mucous membranes (in the mouth, gastrointestinal tract or genital tract).

In normal condition and quantity, it is harmless and forms part of the microflora of the intestines, oral cavity and genitourinary system. This fungus helps various metabolic processes and can be found in the body of any person. These fungi also normally live in the vagina of a healthy woman without requiring treatment.

The disease “vaginal candidiasis” (this is exactly what the medical name for thrush sounds like) occurs when in the body, as a result of some health problems, these “harmless” fungi become larger than normal, they begin to multiply uncontrollably, and the disease begins - candidiasis. In this case, they no longer help, but begin to interfere and cause a lot of trouble.

Treatment is required when complaints appear: - the discharge is usually thick, creamy, white, often curdled, in lumps, with a sour odor; - itching and redness in the genital area, intensifying after sexual intercourse, water procedures, at night, during a certain phase of the menstrual cycle; - pain and burning during sexual intercourse

Visually, candidiasis of the mucous membrane (thrush) manifests itself in the form of white plaques (solid or in isolated areas). The affected areas are usually painless, but when plaque thickens and cracks form, there may be mild pain.

Symptoms of itching due to candidiasis are more pronounced in women who are predisposed to allergies. Usually the itching intensifies in the evening and in warm conditions (after a bath, in bed), and sometimes interferes with sleep. The burning sensation may interfere with sexual intercourse.

Candidiasis received its second name - thrush - not by chance. The white color of plaque and discharge, their cheesy consistency and sour smell are associated specifically with dairy products. But if thrush has become chronic, then these symptoms may not be clearly expressed, and sometimes even be completely absent.

Factors contributing to the development of thrush: - poor diet; - fasting; - hypothermia; - stress; - disease; - a certain period of the menstrual cycle (symptoms of thrush usually appear 1 week before menstruation);

Pregnancy.

Sometimes the symptoms go away on their own or with self-medication (various suppositories), but after a while they resume. During pregnancy, as a rule, candidal colpitis worsens. This is due to an increased level of female sex hormones, which leads to changes in the vaginal microflora and the creation of favorable conditions for the proliferation of fungi.

Candidiasis is not one of the classic sexually transmitted diseases (STDs); it is an internal condition, the causes of which may be a decrease in immunity, changes in hormonal conditions, taking antibiotics, or a change of sexual partner.

Therefore, with long-term, recurrent, difficult-to-treat candidiasis, it is necessary to look for pathology in the body that can cause immunodeficiency, manifested, in particular, by candidiasis.

Causes of persistent candidiasis: - The presence of chronic infection of the reproductive system or any other system of the body. The immune system is exhausted in the fight against chronic inflammation, and this also manifests itself in candidiasis.

Chronic diseases, for example, kidneys, liver, colitis, dysbacteriosis, also deplete the immune system. - Hormonal disorders: ovarian dysfunction, decreased thyroid function, diabetes mellitus, obesity.

As well as the hormonal state characteristic of the second phase of the cycle and pregnancy. - Taking hormonal drugs: birth control pills, prednisolone, metipred, dexamethasone (for the treatment of autoimmune diseases). - Genital herpes.

Taking antibiotics that cause intestinal dysbiosis. The reservoir of candidiasis in the body is the intestines, from there the fungi spread to other habitats.

Observations obtained in recent years have shown that the previously universally accepted prevention of candidiasis while taking antibiotics, i.e. simultaneous use of antifungal drugs with antibiotics, when there is no candidiasis yet, turned out to be ineffective. Therefore, today the approach is this: prevention of candidiasis is not necessary.

If it is not there, the prescription of antifungal drugs is not necessary; With rational antibiotic therapy, candidiasis develops infrequently, its prevention is ineffective. If there is candidiasis (after taking antibiotics or not), it is treated.

Inappropriate use of eubiotics in the treatment of disorders of the vaginal flora, such as bacterial vaginosis. Drugs containing lactic bacteria (lactobacterin) are often prescribed. These bacteria should normally live in the vagina, maintaining an acidic environment in it, and if there are sufficient numbers of them, alkali-loving bacteria that cause bacterial vaginosis cannot settle.

But fungi coexist perfectly with lactic bacteria in an acidic environment and multiply under these conditions. Therefore, it is possible to prescribe eubiotics only if the absence of fungi is confirmed (by smear or culture).

Poor nutrition, in particular, excess sweets, can also lead to the development of dysbiosis and the proliferation of fungi.

Why is thrush dangerous? This disease does not cause any particular harm to health. However, it causes a lot of anxiety to the patient and interferes with normal sexual life. In addition, thrush can be a sign of serious general diseases (for example, diabetes and HIV infection).

Having once consulted a doctor and received instructions on how to overcome thrush, many follow them again and again as necessary. This course of action will help in treating thrush once, twice, three times, but sooner or later the magic wand will break.

After all, the root of trouble is a weakened immune system, and thrush is only its external manifestation. Therefore, simultaneously with the treatment of thrush, it is necessary to look for and eliminate the cause of immunodeficiency and strengthen one’s own microflora.

Without this, thrush will appear again and again. In addition, the symptoms of thrush, discharge, itching and burning may not be so harmless. The same symptoms are characteristic of gonorrhea, trichomoniasis, gardnerellosis, genital herpes, chlamydia, mycoplasmosis, ureaplasmosis and other infections.

Therefore, when the described complaints bother you, you need to go to the doctor for examination and find out the causative agent, and not self-medicate, because advertised drugs are effective only against real thrush - candidiasis.

Thus, candidiasis is a marker of trouble in the body, and in addition to specific treatment with antifungal drugs, it requires a full examination and elimination of the root cause of immunodeficiency, hormonal and bacterial imbalance.

Occurring as an internal condition, candidiasis can be transmitted sexually. Therefore, both partners undergo treatment at the same time and a condom is used during treatment. Marital candidiasis (resulting from the transmission of Candida to a partner during sexual intercourse) is not as common.

Transmission of Candida from mother to newborn occurs in

The appearance of alarming symptoms requires taking urgent action - consulting a doctor. If pseudomycelium is detected in a woman’s smear during tests, this is a signal that the yeast-like fungus candida is beginning to actively multiply in the body. What symptoms are the infection characterized by, why does it occur, how to fight the causative agents of the disease - the answers to the questions are useful for everyone who wants to maintain their health.

What is candida fungus

The human body is inhabited by a huge number of bacteria that help it function properly. When there are no health problems, they are all in balance. Candida albicans - one of these microorganisms - lives in the normal intestinal microflora, on the mucous membrane of the vagina, and oral cavity. This is what he looks like in the photo. These pathogenic microorganisms:

• round shape;
• about 10 microns in size;
• live at temperatures up to 37 degrees;
• are resistant to adverse conditions.

When, for some reason, a decrease in immunity occurs in the body, rapid growth of yeast fungi begins. The normal microflora is disrupted. This situation causes:

• development of candidiasis - thrush;
• nail damage;
• spread of infection in the oral cavity;
• inflammation of the intestinal mucous membranes;
• disease of the respiratory system and nervous system.

How is it transmitted?

The main danger of candidiasis is that the infection spreads at high speed. Candida quickly affects the mucous membranes of the entire body. The fungal disease is sexually transmitted through unprotected sex. Possible infection through:

• Food;
• bed sheets;
• Houseware;
• poorly washed fruits and vegetables;
• kisses;
• toys;
• gaskets;
• personal hygiene items.

A yeast-like fungus can enter the body during medical intervention during a gynecological or dental examination with a poorly processed instrument. Candida albicans is transmitted by:

• from a woman to a child during childbirth;
• by airborne droplets;
• newborns through poorly washed diapers;
• when using other people's objects, clothes.

Symptoms of candidiasis

What is candidiasis? This is an infectious disease caused by the rapid proliferation of yeast-like fungi. The pathology is accompanied by symptoms depending on the location of the lesion. Patients with candidiasis experience:

• nail fungus;
• skin lesions;
• muscle pain;
• diarrhea;
• increased gas formation;
• nasal congestion;
• rashes on the lining of the oral cavity;
• redness of the genitals;
• headache.

The fungal disease candidiasis often has symptoms similar to other ailments:

• candida in the intestines provokes a deterioration in appetite, heaviness in the abdomen, inclusions in the stool, similar to cottage cheese;
• the growth of candida on the surface of the skin causes redness, papules, blisters, erosions;
• with oral candidiasis, there is a whitish coating on the surfaces of the gums, cheeks, tongue, and cracks on the lips.

Among women

Pathogenic microorganisms of the genus Candida affect the vaginal mucosa, causing a dangerous and serious disease. What is thrush in women? This is an infection of the external and internal genital organs caused by pathogenic microflora and the activity of a fungus. Factors that contribute to candida overgrowth:

• lack of normal immunity;
• allergic diseases;
• taking contraceptives;
• eating foods containing yeast, sugar;
• antibiotic treatment of viruses;
• chronic gastrointestinal diseases;
• diabetes.

When thrush develops, a woman experiences the following signs of candida infection:

• pain and burning during sex;
• menstruation disorders;
• curdled vaginal discharge;
• pain when urinating;
• the appearance of a specific kefir odor;
• decreased sexual desire;
• genital irritation;
• pain in the pelvic area;
• infertility.

In men

Men also suffer from fungal activity. This is facilitated by toxins formed as waste products of bacteria. Candida affects the skin and affects the genitals. Men experience symptoms of thrush similar to women's symptoms:

• pain when urinating;
• the appearance of a rash, a whitish coating on the genitals;
• formation of papules.

A fungus of the genus Candida affects the skin in the groin area. The presence of an infectious disease in men is indicated by:

• inflammation, redness of the head of the penis;
• the appearance of a rash;
• bubble formation;
• pain during sexual intercourse;
• unbearable itching;
• burning sensation;
• development of prostatitis;
• the appearance of impotence;
• decreased sex drive.

Classification

When pseudomycelia are detected in tests, depending on the rate of fungal reproduction and the severity of the disease, the types of candidiasis are distinguished:

• superficial – initial stage – treatable, pathogenic bacteria act on skin tissue, nails, mucous membranes;
• systemic type - penetrates the epithelium, can affect the respiratory system, digestive organs;
• sepsis is a condition in which candida is detected in the blood, poisons the entire body, and death is possible.

There is a classification of candidiasis according to the form of the fungal disease:

• Acute - has pronounced symptoms, with timely diagnosis it is quickly cured. When neglected, it is called terry and infects epithelial tissues.
• Chronic – appears due to improper treatment, lack of sensitivity to drugs.
• Candida-bearing - tests show the presence of a huge amount of candida without external manifestations of the disease. A person is a carrier of the fungus and can infect others.

Complications of candidiasis

If the infection is not treated promptly, yeast-like candida fungi grow deep into the body, affect blood vessels, and enter the blood. After this, pathogenic microorganisms spread throughout the body. In this case it is observed:

• the emergence of new foci of the disease;
• development of bleeding;
• sexual dysfunction;
• spread of infection to neighboring organs.

Fungal overgrowth if left untreated causes:

• abortion;
• infection of the fetus during childbirth;
• damage to the digestive organs;
• the occurrence of allergic reactions;
• kidney dysfunction;
• cystitis;
• infertility;
• the appearance of adhesions in the vagina;
• damage to the cervix that causes cancer;
• development of purulent infections;
• death.

Diagnosis of candidiasis

There are more than 150 varieties of Candida. Correct identification of the causative agent of the infection helps to quickly stop the growth of fungi. Diagnosis begins with interviewing the patient and external examination of the characteristic signs of candidiasis. To determine the infection, a microscopic examination method is used, in which the candida fungus is clearly visible. To do this take:

• smear from the site of the lesion;
• pieces of skin tissue;
• samples of material from mucous membranes.

The diagnosis is confirmed by performing a culture test. To perform the analysis:

• take biological material from the affected area;
• sown on a nutrient medium;
• by the nature of the growth of the fungal colony, the presence of pseudomycelium and the genus Candida are determined;
• special test systems reveal the sensitivity of the species to drugs.

Blood analysis

Blood tests play an important role in diagnosis. The main purpose of the analysis is to determine immunoglobulins. Their presence and appearance characterize the stage of the disease. If a blood test reveals:

• Immunoglobulin IgM is an acute disease that has appeared recently.
• The simultaneous presence of IgM and IgG means the duration of the disease is more than a week. The body has formed long-term immune cells that counteract further growth of fungi.
• The presence of only IgG is evidence of chronic pathology.

Treatment

To remove the fungus, it is necessary to boost immunity and cure chronic diseases that weaken the defenses. An important role is played by the restoration of the normal microflora of the body. How to treat candidiasis? Doctors prescribe:

• immunomodulators;
• vitamins C, group B;
• for local use - antimycotic vaginal suppositories, ointments;
• inside – antifungal capsules, tablets;
• proper nutrition;
• restriction of sexual contacts;
• disinfection of linen;
• performing hygiene procedures;
• treatment of the sexual partner.

What kills candida in the body

In order for the body to get rid of the infection, it is necessary to act on the fungus. Medicines with a fungicidal effect, which damage bacteria and spores of microorganisms, help to cope with pathology. Dermatologists prescribe:

• inside the vagina - suppositories Livarol, Lomexin;
• for external treatment – ​​Clotrimazole ointment, Triderm cream;
• if nail fungus is detected - Fungoterbin, Diflucan;
• if the intestinal walls or respiratory organs are damaged, take Fluconazole or Nystatin tablets orally.

Medicines

In the presence of a disease, when the cause of infection is a fungus, therapy involves the use of medications. Their action solves various problems. Doctors prescribe:

• Candide - the active ingredient clotrimazole, available in the form of cream, powder, solution, treats fungus on the skin, genitals, and mouth;
• Pimafucin – has antifungal and antiviral effects, effective against thrush;
• Linex is a probiotic, restores microflora and bacterial balance;
• Viferon - activates the immune system, prevents cell division.

Food

To destroy the fungus in the body, you need to eat right. You should eat more leafy greens, lentils, and beans. There is cabbage, zucchini, bell peppers, and fresh fruit. It is necessary to exclude products that cause fermentation, contain yeast and substances that provoke fungus:

• refined sugar;
• baking from yeast dough;
• pickled preparations;
• wine;
• beer;
• vinegar;
• sauces;
• mushrooms;
• smoked fish;
• fruit juices;
• grape.

Treatment of candida fungus with folk remedies

For the complex treatment of fungal infections, folk recipes are used. It is important that the use is agreed with the doctor and takes place after diagnosis. It is recommended to drink a spoonful of wormwood root decoction a day - 20 g of leaves per glass of boiling water. Baking soda is widely used - the alkaline environment destroys the fungus. Add one spoon per liter of boiled water. Apply:

• in the form of baths daily for candidiasis on the penis;
• as a lotion several times a day - for fungus in the mouth;
• for thrush in women - for douching every other day.

Prevention

To exclude fungal infection, preventive measures are necessary. This will help avoid relapse after successful healing. Rules to be followed:

• avoid sexual intercourse during treatment;
• follow hygiene rules;
• support immunity;
• treat chronic diseases in a timely manner;
• have sex with a regular partner;
• adhere to the correct diet;
• use natural linen;
• avoid hypothermia;
• stop smoking;
• avoid stress.

Video

In most cases, women who do not complain and have no signs of candidiasis do not require treatment, even if mycelium and hyphae of the fungus are found in the vaginal discharge.

Medical progress means improved knowledge about diseases, examination methods, treatment regimens and preventive measures. This also means that many diseases that were not curable in the past can now be successfully treated. But with regard to candidiasis, the situation has hardly changed. What is this connected with? Is this really not a curable disease? First, you need to understand and accept the fact that a huge number of fungi are representatives of the normal flora of the human body, and Candida is no exception.

Candidiasis: causes, treatment and prevention

Candida spp. They are among the first to settle in a newborn - even during his birth through the birth canal. This is the norm. Billions of bacteria and fungi live in the human intestine, especially the thick intestine, where feces are formed. Without yeast, a person will not be able to function normally. Fungi are found on the skin and mucous membranes, in the vagina, urinary system, nasopharynx - almost everywhere.

For a healthy person, fungi are not dangerous due to a certain balanced symbiosis, when there are no conditions for increased reproduction and growth of fungi. However, there is no person in the world who has not encountered a fungal infection of the skin or mucous membranes at least once in their life. More than 75% of women can remember at least one episode of vulvovaginal candidiasis, which is popularly called thrush. Most often, this disease is not registered by anyone because in most cases, thrush goes away without any treatment within a few days, which means there is no need to consult a doctor for help.

Also, a large number of women self-medicate. Every second woman experiences relapses of candidiasis, and in 8% exacerbations occur more than 4 times a year. Modern women encounter candidiasis more often due to the abuse of antibiotic therapy, as well as due to the use of hormonal contraception. Doctors of the old school often prescribe antibiotics without justification, in large quantities and for long courses, which leads to the emergence of antibiotic-resistant strains of bacteria. But quite often the doctor also prescribes antifungal drugs, supposedly to prevent fungal infections due to taking antibiotics. This leads to the fact that fungi have become more resistant to antifungal drugs.

Different types of candida live on the skin of the perineum and in the vagina of a woman. They are found in the vaginal secretions of 80% of women. But this does not mean that the woman suffers from candidiasis. In almost 95% of cases, the yeast fungus Candida albicans lives in the vagina. Candida glabrate is also often detected (up to 20% of cases). And in the occurrence of vulvovaginitis, completely different types of fungus are most often involved: Candida parapsilosis, Candida tropicalis and Candida krusei. These fungi are also more resistant to antifungal medications.

Typically, yeast in the vagina is in a spore state (blastospores or blastoconidia). In this form, there are no signs of inflammation, and women have no complaints. When the fungus begins to grow, mycelium (hyphae) is found in the secretions, which is also accompanied by complaints and symptoms.

Why is it that in some cases the abundant growth of candida does not cause symptoms or complaints, while in others even a slight growth of fungi is accompanied by itching and other unpleasant symptoms? Why do relapses occur? There are still no clear answers to these questions, because the mechanisms of life, growth and reproduction of fungi have not yet been studied in detail, not in the laboratory (in vitro), but in real conditions - in the human body (in vivo), including vagina. It is assumed that there may be a genetic factor that predisposes the body to more frequent damage to the body by fungal infections due to disruption of the production of certain substances by cells of the skin and mucous membranes.

There are several factors that inhibit the growth of fungus in the vagina. For example, it has been observed that Candida albicans often attaches to the surface of epithelial cells, while other types of fungus do not. Whether epithelial cells inhibit fungal growth through this interaction is unknown. But epithelial cells produce a number of substances that can suppress the growth of the fungus: lectin, lactoferrin, etc. The role of lactobacilli in suppressing the growth of the fungus has not been studied in detail, but it is believed that they are competitors of candida in terms of nutrients necessary for their growth. Some types of lactobacilli increase the acidity of vaginal contents, which inhibits the growth and budding of fungi. The role of leukocytes is not clear, although polymorphic leukocytes are more common in vulvovaginitis. With candidiasis, the level of a number of antibodies, both humoral immunoglobulins and systemic (S-IgA, IgM, IgG), increases, but their role in the occurrence of a protective reaction is not known. At the same time, women with frequent relapses of candidiasis have increased levels of antibodies to candida in vaginal secretions (IgG, IgA, IgE). Very little is known about the role of T cells, especially in systemic candidiasis.

Thus, the mechanisms of protection and control of Candida in the human body are still being studied.

Regardless of the fact that candidiasis can occur in any woman, risk factors have been identified that provoke increased growth of the fungus. They must be taken into account in the analysis of the situation and recommendations to women, especially in cases of frequent relapses of candidiasis.

Risk factors that provoke increased fungal growth

Conditions and diseases of women

Diabetes

Pregnancy

HIV infection

Systemic diseases

Taking hormonal contraceptives, hormone replacement therapy

Taking antibiotics

Taking steroid drugs.

Genetic factors

Lewis blood type (non-secretory state)

Gene polymorphism

Black race

Family history.

Behavior

Using IUDs and sponges

Frequent change of sexual partners

Orogenital sex

Frequent sexual intercourse.

Failure to maintain hygiene of the body and external genitalia is excluded from the risk factors since data from recent clinical studies have refuted the association of poor hygiene with an increase in the incidence of vulvovaginal candidiasis. However, the use of a number of chemicals as hygiene products, as well as for douching, increases the level of inflammatory processes in the vulva and vagina, including candidiasis.

Diagnostics

Although candidiasis is accompanied by itching and discharge with inclusions resembling cottage cheese, confirmation of the diagnosis requires microscopic analysis of vaginal contents.

The most optimal is a fresh, unstained smear using saline or 10% potassium hydroxide solution. It allows you to identify yeast cells, mycelium, Trichomonas and key cells.

The second diagnostic method is to determine the pH of the vaginal contents. Normally, the pH is 4.0-4.5, with candidiasis it is more than 4.7. Culture isolation (culture) is used in cases where a woman has complaints and signs of vulvovaginitis, and the smear is negative for the presence of fungal cells. There are several media for growing fungus, but they do not have any advantages.

Other types of diagnostics are rarely used.

Treatment

Despite the availability of a large number of antifungal drugs, Not all women need treatment. In most cases, women who do not complain and have no signs of candidiasis do not require treatment, even if mycelium and hyphae of the fungus are found in the vaginal discharge.

In the presence of acute symptoms of candidiasis The choice of treatment will depend on the severity of symptoms and the woman's preference. Preference should be given to modern antifungal drugs. Many women like short-term medications that do not require much effort to follow the doctor’s recommendations. Therefore, single doses of oral medications (fluconazole) or 3-day courses of vaginal forms of medications (creams, suppositories, tablets) are popular. Such short treatment is not effective in cases where candidiasis occurs with severe complaints and symptoms. Therefore, it is recommended to take the drugs for 5-7 days.

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If vulvovaginitis is not accompanied by frequent relapses, if the woman does not suffer from diabetes, autoimmune and systemic diseases that suppress the body’s defenses, if she is not pregnant, then the choice of the form of the drug does not matter - Both vaginal and oral forms are effective, without any advantage over each other. However, oral medications have more side effects and are therefore less tolerated than vaginal forms.

The combination of different forms of antifungal drugs is not justified in mild and moderate cases of candidiasis.

During pregnancy They prefer vaginal forms.

Frequent relapses of candidiasis require a detailed study of the case to clarify the presence of risk factors. Without reducing or eliminating these factors, any treatment will not be effective.

Usually, before prescribing re-treatment, a culture is isolated and the type of fungus is determined. The duration of treatment can be up to 14 days. In 50% of cases, relapse of candidiasis will occur within 3 months, so preventive courses are effective - single doses of oral medications every week for 3-6 months.

• Daily consumption of yogurt as a food product situation with recurrent vulvovaginal candidiasis don't improve.
• Partner treatment too not an effective method prevention of repeated episodes of candidiasis.
• The use of vaginal forms of lactobacilli is not successful.
• The antifungal vaccine and antibody administration have only been studied in rodents.

Candidiasis is still an open book in medicine, requiring clinical research, studying the characteristics of fungi at the genetic and molecular level, understanding the mechanism of interaction of fungi with the host (human body), and searching for new drugs, especially taking into account the increasing resistance of candida to drugs. published .

Elena Berezovskaya

P.S. And remember, just by changing your consciousness, we are changing the world together! © econet

If, after analysis, a woman is found to have yeast-like fungi in a smear, then she should immediately begin a course of therapy. Pathogenic flora when multiplying in the intimate area causes discomfort. You can identify a fungus in the vagina by the following symptoms:

• pain when urinating and during sexual intercourse;
• itching in the genital area;
• white discharge with an unpleasant odor;
• redness, burning sensation in the external genitalia.

When the normal microflora of the intestines and vagina is disrupted, itching and irritation are present. In rare cases, you may notice vaginal discharge with a characteristic yeasty odor. This sign indicates an advanced form of thrush and the active growth of fungi in the vagina. If you detect discharge with a pungent odor of yeast, you should start treatment or reconsider it. The symptom appears due to the release of products of the fungal cells’ own decay.

Otherwise I need a doctor and the head of the department. in leather The dispensary said the main reason was a reaction to diapers, although my daughter sleeps in them at night and wears panties during the day. I noticed that when I applied Advantan at night and put on a diaper, the rash decreased significantly in the morning. And in the evening before going to bed, on the contrary, it was larger and redder than in the morning.

PCR is another important and effective method for isolating this pathogen. But this is an expensive test that is rarely performed in public clinics. Most often, this test is taken by pregnant women, who are more susceptible to recurrence of thrush than others. If the test shows Candida albicans, what is it?

In order to make a diagnosis, it is usually sufficient to ask the woman about her complaints and the presence of factors that may contribute to the development of the disease, and a gynecological examination.

You can apply Advantan and leave without a diaper for an hour.

Thrush (candidal colpitis, genital candidiasis, yeast colpitis) is a disease that 75% of women encounter at least once in their lives.

In addition, it is necessary to find and eliminate those factors that contribute to the development of thrush. Cases of ineffective therapy can be explained by intestinal dysbiosis and colonization of the intestine by fungus. In such cases, the drug Pimafucin helps to sanitize the intestines (four times a day, 1 tablet, 10 days).

Treatment of this disease is local and general. It is prescribed by a dermatovenerologist or obstetrician-gynecologist.

Interesting! A smear is taken from three points at once: the vagina, cervical canal and urethra. Then the results are indicated in the analysis separately for three points.

Hexicon candles – 1 candle twice a day (10 days);

There are three main forms of candidiasis. The first form is carriage, that is, the absence of complaints and clinical picture. The second form is acute candidiasis, it is characterized by bright manifestations of inflammation and the manifestation of the full clinical picture of this disease. The third form, chronic candidiasis.

In case of mild disease, either general or local treatment is sufficient. But for a guaranteed result, they usually use a one-time tablet drug in combination with local treatment.

Thrush is not easy to cure. Often the disease returns after a certain period of time, in particular, with a repeated decrease in immunity. Medicines for fungus are divided into 2 types: local and systemic. In severe cases, with advanced disease, doctors prefer the second type of treatment. Taking the tablets affects the main focus of fungi.

To maintain normal microflora, you need to correctly follow the rules of hygiene. For example, frequent douching is harmful because it washes out lactobacilli, thereby reducing the protective barrier.

Clotrimazole vaginal tablets - one at night in the vagina (6-7 days) or one twice a day (3 days);

A smear for candidiasis is a mandatory procedure if this disease is suspected in men. women and children.

Thrush in a smear indicates that the causative agent of this disease is present in the mucous membrane. Scientifically, thrush is called “candidiasis” and this name comes from the genus of fungus Candida, which causes this disease. The main first symptoms of thrush include itching and burning in the intimate area, pain in intimacy, dry vagina, and there may also be a discharge that resembles cottage cheese with an unpleasant odor.

It sometimes happens that only diet and hygiene are enough for a disease such as thrush to disappear forever. This is only possible when the disease is at the first stage and has not yet developed. This option, of course, is better for a pregnant woman, because she is so vulnerable. Because in this case there is no need to use drugs that can adversely affect the fetus inside the woman.

How to recognize thrush in a smear

In medical practice, the process of examining a smear is called bacterioscopy. It helps identify pathogenic bacteria in the body, inflammatory diseases, and high levels of leukocytes. Bacterioscopy has found wide application in practice; it helps to diagnose pathologies effectively, quickly, and inexpensively. Yeast fungi in a smear (threads of pseudomycelium, blastospores, mycelium, etc.) indicate the presence of infections caused by pathogenic bacteria.

Thrush often causes active proliferation of pathogenic microflora. If the disease is not treated promptly, it can cause serious complications and be transmitted to a sexual partner. Fungi of the genus Candida in a smear indicate a disruption of the normal microflora of the vagina. As a result, ideal conditions are created for the development of cancer cells. In addition, thrush often leads to the development of cervical erosion in women.

For the female body, pregnancy is a serious test. Hormonal levels change significantly during pregnancy. Physiological and chemical processes can lead to the fact that pathogenic bacteria begin to multiply on the surface of the vaginal mucosa of the expectant mother. If during pregnancy a woman has blastospores, filaments of pseudomycelium, mycelium or yeast spores in a smear, a detailed diagnosis is carried out (to exclude sexually transmitted infections).

It is worth noting that treating thrush in pregnant women is associated with risks. Most antifungal drugs can, due to their toxicity, negatively affect the condition of the fetus. Expectant mothers are prescribed local therapy with suppositories, ointments, and creams. In addition, you can use douching with antiseptic solutions. All manipulations must be agreed upon with a gynecologist.

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 at the slightest decrease in immunity. If the patient is constantly bothered by the main symptoms of candidiasis, such as burning, itching and pain, it means that the disease has already entered the active phase and tissue inflammation has begun.

If treatment is not started in time, the cells lose their strength, which contributes to traumatization of the vaginal mucosa during daily hygiene procedures or during childbirth. Active formation of spores in a smear indicates a decrease in immunity, which can be caused by another, more dangerous disease, for example, HIV. Therefore, consultation with a doctor is necessary.

The mycelium of the fungus in the smear can only be seen by laboratory workers. This is a cluster of thin threads with branches. These threads are both the nutritious and vegetative part of the fungus. If the smear contains only spores, then the disease is asymptomatic or the woman is simply a carrier of candidiasis.

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Candida mycelium - consultation with a doctor. How to eliminate Candida mushrooms. Mushroom mycelium in a smear - Question to the gynecologist - 03 Online. Yeast in the smear: causes. When attacked, the fungus usually acquires resistance. Site news. Yeast fungus in women during pregnancy. - blog My BeTeshka.

At the beginning of Dec. My daughter (17 months old) developed a red rash on her labia that looked inflamed. The analysis showed an excess of yeast, before that we took a little Anaferon and Viferon. They prescribed Advantan and did chamomile and series baths themselves. 3 weeks have passed. At the beginning of Jan. got sick, got antib injections.

Hilak Forte, later they took enterozermina. At this time, the rash reappeared and spread to the folds between the legs. Today the analysis showed threads of mycelium. The doctor said mushrooms and prescribed clotrimazole and parlazine. Please tell me why these very threads appeared, what they are and how in the future it can affect the girl’s health?

The most unpleasant symptom of thrush is itching in the vaginal and vulvar areas. It can bother a woman either throughout the day or occasionally. As a result, nervousness, irritability, and sometimes insomnia appear.

natta. Did you go to the dermatologist with the results? Apparently we are talking about lichen. The cat also needs to be treated. A dermatologist should tell you what measures to take to prevent other family members from becoming infected. Get well.

It should be noted that medications containing fluconazole are contraindicated during pregnancy and lactation. The only tablets you can take are Pimafucin. For local treatment, suppositories Betadine, Hexicon, Pimafucin and Livarol are approved for use (the course of treatment is of the same duration as for non-pregnant women).

Vaginal tablets Klion D - 1 tablet in the vagina at night (10 days).

In newborns whose mothers suffered from thrush during pregnancy, they must take a swab from the throat for candida. Such children have a 35 times higher chance of detecting candida spores in an oral swab than children born to a healthy mother. In such cases, the child’s saliva is taken to analyze the candida in it, and if a white coating is visible on the pharynx, it is removed using an applicator for further research.

because hormonal ointments should be used according to indications. If there is severe inflammation that cannot be controlled by an antibacterial or antifungal drug, then it is reasonable to use a hormonal ointment in addition. If you can do without it, then it’s better to do without it.

Candida Fungus Spores in a Smear is a fungal disease, the causative agent of which in most cases is a yeast fungus of the genus Candida. Symptoms What is Candida fungus? Thrush during pregnancy They found Candida in the smear, nothing else, BUT nothing bothers me, no itching, no discharge, just stretching the stomach, the doctor prescribed Diflucan and Candidiasis.

Thrush is a disease caused by a single pathogen - a fungus from the genus Candida. Thrush during pregnancy | Forum. The main disease with an excessive amount of candida fungi in Pro thrush. If spores or mycelium (body) of fungi are detected in the smear, a diagnosis of candidiasis is made - true thrush. Important!

If fungal mycelium is detected in the smear, this reflects the activity of the process of infection of the body with fungi of the genus Candida. Candida fungus can be treated. Candida fungus in women as a causative agent of thrush. Candida fungus. White blood cell norm - White Clinic. In the same case, if the disease occurs in an asymptomatic latent form, fungal spores will be visualized in a smear on the flora.

Yeast in a smear: causes, symptoms and treatment. Smears for microscopic examination are taken from the cervical canal (C), vagina (V) Culture for Candida fungi | About Analyzes. How to treat fungal mycelium in gynecology. If there are no complaints, then there is no candidiasis. and the presence of fungal spores in a smear does not indicate a disease, rather the opposite!

About thrush, photos of thrush in women during pregnancy. If fungal spores are found in the smear, this indicates that the disease is asymptomatic, or the woman is absolutely Laboratory tests in gynecology: what they can tell. After childbirth, erosion appeared on the cervix, fungal spores and leukocytes were found in the smear.

Features of the existence of trichomonas and fungi of the genus Candida in the body. The presence of yeast fungus of the genus Candida in the smear clearly indicates that the woman has an acute attack of thrush or, as its Infectious agents. This fungus is present in small quantities in women and is normal, but the disease develops when the fungus begins to multiply intensively. Fungal spores indicate latent (dormant) candidiasis.

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

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When a woman is pregnant and has thrush, some folk remedies can be used. The most famous recipe is washing with a solution of soda, because it disinfects. Or you can brew oak bark, calendula, or dilute a tetraborate solution.

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

Now every other day I apply clotrimazole and some kind of ointment, specially prepared in a pharmacy according to a doctor’s prescription (it’s not clear whether it’s a cream with HRP or something else). After it in the morning, the skin is more or less cleaner. But again, I apply it before bed and then put on the diaper a little later.

In this case, nettle is ideal; it needs to be boiled for five to ten minutes over low heat. The resulting decoction is used as a douche - this is a very useful recipe for pregnant women.

Thrush is considered a common ailment that affects both women of different ages, 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 areas of the skin and mucous membranes of the human body. Most often found on the genitals. When a smear was taken from the girls at a gynecologist’s appointment, the test result may indicate the presence of yeast spores or fungal mycelium (body) in the lubricant. In this case, the patient is diagnosed with thrush.

What does spores in a smear mean?

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

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Why do disputes arise?

The development of thrush is influenced by certain factors. It often occurs in pregnant women. During pregnancy, the level of female sex hormones increases, which leads to changes in the microflora of the vagina. As a result, conditions are created for the growth and reproduction of the fungus, and a physiologically weakened immune system, whose strength is devoted to protecting 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 considered to be:

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

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Are spores in a smear dangerous?

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 at the slightest decrease in immunity. If the patient is constantly bothered by the main symptoms of candidiasis, such as burning, itching and pain, it means that the disease has already entered the active phase and tissue inflammation has begun. If treatment is not started in time, the cells lose their strength, which contributes to traumatization of the vaginal mucosa during daily hygiene procedures or during childbirth. Active formation of spores in a smear indicates a decrease in immunity, which can be caused by another, more dangerous disease, for example, HIV. Therefore, consultation with a doctor is necessary.

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Possible symptoms

Thrush can be recognized by some symptoms, but the disease can also be asymptomatic. Differential diagnosis of early stages is complicated by the similarity with other infectious diseases. Possible symptoms are:

• presence of cheesy discharge;
• itching, burning and redness of the genitals;
• pain during intercourse;
• white coating on the genitals;
• pain when urinating.

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What treatment should I use?

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

Preventive measures are also important to prevent relapse of candidiasis. You need to choose loose underwear, be less nervous and not take long or frequent courses of antibiotics, change your diet. During the therapeutic diet, completely eliminate alcohol. Remove foods containing yeast, cheeses, canned food and sweets from the diet menu (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 fermented milk products. It is important to drink more water.

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Indications for the study

A smear on the flora of women is taken during a routine preventive examination by a gynecologist, planning a pregnancy, registering with an obstetrician, as well as if infectious inflammation of the genital organs is suspected and in order to monitor the effectiveness of treatment.

During pregnancy, this study plays a particularly important role, since due to changes in hormonal levels (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 miscarriage, premature birth, or infection of the child during passage through the birth canal.

During pregnancy, examination of the vaginal microflora is usually prescribed three times at certain intervals, and more often if infectious inflammation is detected.

The main symptoms that serve as a reason for prescribing a smear for flora:

• painful sensations in the lower abdomen (spontaneous or during sexual intercourse);
• itching and/or discomfort in the external genital area;
• unusual discharge from the genital tract;
• painful urination;
• menstrual cycle 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 a latent course. It is also recommended to take a preventive smear for flora if a woman has had unprotected sexual contact with a dubious partner.

Where can I get a smear for flora and how long does it take to test?

A smear for flora can be taken at a antenatal clinic, at a local clinic, at a private specialized clinic, or at the collection room of some laboratories.

Typically, a smear test takes one business day, but it is better to check with your doctor about the time frame for obtaining the result, since the turnaround time for preparing the test may vary in different laboratories.

Preparing for the study

Usually a smear for flora is taken on the fourth or fifth day of the menstrual cycle, unless otherwise indicated. It is not advisable to take a test during menstruation, since it is inevitable that menstrual blood will get into the material, which is highly likely to distort the result.

If the patient is undergoing anti-infective therapy, it should be completed first and only then taken for analysis. A smear for microflora is taken no earlier than three weeks after the end of treatment with antibacterial and antimycotic drugs (unless other instructions have been received from the attending physician). The use of antibacterial, antifungal, anti-inflammatory drugs and contraceptives may cause false negative test results.

It must 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.

For 1-2 days before submitting the material for analysis, it is necessary to exclude sexual contact, and during this period you should not use vaginal suppositories, ointments, or douche. The day before and on the day of delivery of the material, you cannot use intimate hygiene products. This analysis does not require restrictions on physical activity and nutrition.

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

How to take a smear for flora

Before taking material for research, the patient undergoes a routine gynecological examination using speculum. The doctor visually evaluates the vulva, vaginal walls and the vaginal part of the cervix, then, using a sterile spatula, takes material from three areas - the vaginal wall, the external opening of the urethra, and the cervix. In some cases, 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 areas is applied with a spatula onto a glass slide separately from each other, marked (V - vagina, U - urethra, C - cervix), dried and sent to the laboratory.

For a detailed introduction to the technique of collecting material, you can watch the corresponding video on how to take a smear on the flora of women.

Read also:

Common female diseases and their symptoms

7 regular checkups a woman should undergo

9 myths about uterine fibroids

Vaginal microflora: normal

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

For 1-2 days before submitting the material for analysis, it is necessary to exclude sexual contact, and during this period you should not use vaginal suppositories, ointments, or douche.

Depending on the nature of the microflora and cellular contents, there are 4 degrees of vaginal cleanliness:

1. A large number of Dederlein rods, a small amount of squamous epithelium in the preparation. Determined in clinically healthy women.
2. A small number of cocci are detected, but Dederlein's rods predominate. It is not a sign of pathology and is observed in many clinically healthy women.
3. The specimen reveals a small number of Dederlein bacilli, a diverse coccal flora predominates, and the number of leukocytes is more than 10 in the field of view. Observed during inflammatory processes.
4. Dederlein's rods are practically absent in the smear; a large number of cocci and leukocytes are detected. A sign of bacterial vaginosis.

Normal values ​​of indicators for women of reproductive age are shown in the table.

Decoding indicators

When deciphering the results of a smear for flora in women, first of all, the number of leukocytes is assessed (depending on where the material was collected from), the nature and quantity 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 assessing 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 other instructions have been received from the attending physician).

Lactobacilli

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

Flat epithelium

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

When interpreting 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 smear reveals a moderate amount of mucus (it may be completely absent in material from the urethra), an increase in its amount may indicate the presence of an infectious-inflammatory process.

Bacteria

Normally, pathogens of sexually transmitted diseases should be absent from the test material. Their identification indicates the presence of one or another infection. Thus, the detection of gonococci indicates gonorrhea, trichomonas are detected in trichomoniasis, etc.

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

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

However, it is also necessary to take 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 of detected microorganisms to antibiotics or antifungal drugs. To do this, a cultural analysis (tank culture) with an antibiogram is performed.

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 when receiving smear test results that go beyond the norm, a diagnosis is usually not made - this requires a comprehensive diagnosis, as well as a 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 consequence, 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 taking a smear for flora

In addition to taking a test during a routine examination with a gynecologist, a smear for flora must be submitted to following cases:

• with heavy discharge (possibly with an unpleasant odor), accompanied by pain in the lower abdomen;
• for any unpleasant sensations in the genitals (itching, burning in the vagina, urethra);
• when having 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 smear test?

A flora smear can be taken on any day of the cycle except menstruation. Blood during sampling may distort the results obtained. The best time to take the test is the first day after the end of your period or the day before it starts. At this time, natural immunity decreases slightly, which makes it possible to identify all pathogenic microorganisms.

No special preparation is required to take a smear for flora. Gynecologists only advise a few days before going to the doctor to refuse any local remedies (vaginal suppositories, creams, lubricants) and not to have sexual intercourse or douche the day before. On the day of going to the doctor, you can take a light shower without using intimate hygiene gels. It is advisable not to urinate for a couple of hours before taking a smear.

Deciphering a smear for flora. Norm of smear for flora.

After receiving the results of a flora analysis, not everyone is able to decipher it on their own. In fact, there is nothing complicated about it. It's enough just to know designations and standards:

1. Place of taking a smear:

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

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

"U" — urethra(urethra, urethra) - transcript 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.zr. in the cervical canal, up to 10 in the vagina and up to 5 in the urethra. Exceeding these indicators indicates the development of an inflammatory process and requires further diagnosis and treatment. The exception is pregnant women. For them, the norm of leukocytes in the analysis is slightly higher.

3. Ep. - squamous epithelium

Squamous epithelium is the 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, ending up in the vaginal secretion, as a result of which an optimal balance of genital flora and mucosal health are maintained.

Normally, the amount of squamous epithelium should not exceed 5-10 units of vision. If your test result 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 estrogen.

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 the 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 turn blue and pink under the influence of a special dye.

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

Gram-negative cocobacillus (Escherichia 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 the sexual partner.

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

The Doderlein bacillus (Lactobacillus) is a large and immobile gram-positive rod - the main representative of the normal microflora of the vagina, helping to maintain the optimal balance of the intimate sphere. Normally, they should make up the majority of the female flora (90-95%), and their lack indicates vaginal dysbiosis and the danger of developing an inflammatory process.

The remaining 5% are accounted for by other opportunistic microorganisms (Escherichia coli, enterococci, streptococci, staphylococci, corynobacteria, etc.), which in small quantities do not pose a danger, but 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. If the coccal flora predominates in the smear, the entry “mixed flora” or “coccal flora” is written. If there is no increase in the number of leukocytes or mucus, then the situation is worth observing.

If there are signs of an inflammatory process in the smear, it will be necessary to do an additional study of vaginal discharge using bacteriological culture 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 “sparse mixed flora” or “abundant mixed flora”. This means the degree of contamination with opportunistic bacteria. If the flora is poor, suppositories with beneficial bacteria may be prescribed ( Atsilakt, Vagilak, Laktozhinal), if the flora is abundant, then the doctor prescribes suppositories with an antimicrobial and antibacterial effect ( Polizhinaks, Terzhinan and etc.).

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

If yeast and candida are found in a flora smear, 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 copious cheesy discharge with a sour odor, itching of the genitals, and their redness.

Frequent relapses of thrush may indicate the presence of a permanent provoking factor in the form of a sexually transmitted infection or some chronic disease. To treat thrush, medications containing fluconazole and vaginal suppositories are usually prescribed ( Pimafucin, Neo-penotran, Clotrimazole and etc.). How to get rid of thrush, read here.

8. Trich. - Trichomonas

Trichomonas vaginalis is a single-celled microorganism that causes urogenital trichomoniasis, a very unpleasant sexually transmitted infection. Symptoms of trichomoniasis are profuse watery foamy discharge of a greenish or yellowish color, itching, hypermia and swelling of the genitals.

Trichomonas is not always detected in a smear for flora, therefore, for a more accurate diagnosis, if you suspect infection with trichomoniasis, you should additionally take a trichomonas test using the PCR diagnostic method.

9.Gn. - gonokki

Gonococci are gram-negative pyogenic bacteria of the genus Neisseria gonorrhoeae - the causative agents of gonorrhea. An absolute pathogen, normally there is no gonococcus in the flora smear. Symptoms of the disease are usually profuse purulent vaginal discharge, burning, swelling and hypermia of the mucous membrane. Detection of this bacterium is a 100% indicator for examining the entire family, treating 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 adhered to them. Most often, these bacteria are Gardnerella vaginalis, which belongs to the opportunistic flora. Detection of key cells in a smear is a sign of vaginal dysbiosis (bakvaginosis).

Symptoms of gardnerellosis are profuse grayish or yellow discharge with a fishy odor, burning sensation 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 not normally sterile..

A large number of different microorganisms live there, all together they constitute the vaginal flora. Among these microorganisms there is constant competition for space and food.

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

In many ways, they themselves determine their habitat., releasing alcohols, peroxide, acids, including lactic acid, in the process of their vital activity, as a result of which the pH of the vaginal environment has a value in a smear on the flora, characterizing an acidic environment.

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

So what does a smear reveal for flora in women?

Leukocytes and red blood cells

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

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

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

Here you 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 flora smear? Phagocytosis is the process of capture and destruction of foreign cells (for example, pathogenic bacteria) by leukocytes. Incomplete phagocytosis may be detected in the smear– 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 the excessive proliferation 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 on the 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 normal subject to a certain type and quantity.

It is considered normal to have 5 to 10 squamous epithelial cells in the selected sample.

When taking a smear test for flora at a gynecologist, the following are considered deviations from the norm:

1. Decreased or absent epithelial cells, which shows the death of the epithelium due to an increase in testosterone levels and/or a decrease in estrogen levels.
2. Significant excess of epithelial cells may appear in a smear 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

In healthy patients, mucus can be found exclusively in a vaginal smear. If mucus is found, for example, in the urethra, then this indicates inflammation. A vaginal sample may normally have moderate or low amounts of mucus, designated ++ and +, respectively.

Doderlein sticks

Doderlein bacilli should normally predominate in the vaginal microflora.

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 prevents other bacteria from multiplying.

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

As a result, inflammation may occur.

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

Opportunistic flora

In gynecology, opportunistic microbes are those microbes in a flora smear that may not cause any diseases until they begin to multiply excessively. The main types of such microbes are:

Cocci

Cocci are round shaped bacteria.

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

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

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

Ureaplasma

These are very small bacteria that when multiplied above 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. Leptothrix itself in a flora smear is dangerous only during pregnancy, – and it is believed that it is capable of causing 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 can be present in a 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. In case of moderate amounts, a course of drug treatment is prescribed. If corynebacteria are more than a certain threshold, then additional research needs to be carried out for the presence of other infections, since these bacteria are often associated with others.

Klebsiella

Being a representative of the UP flora, Klebsiella under certain conditions (most often when immunity is reduced, in particular during pregnancy) may cause urinary tract diseases.

Candida mushrooms (soor)

What does a positive soor in a flora smear give? If fungi of the genus Candida are 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 caused by decreased immunity. With candidiasis, a smear on the flora can be found:

Pseudomycelium is represented by filamentous growths of blastospores with constrictions:

If the analysis of a vaginal smear for flora reveals an indicator such as blastospores, This means that this woman’s body is affected by candidiasis. The number of blastospores varies depending on the prevalence and stage of the disease. Blastospores are embryonic cell forms formed by budding from maternal cell forms.

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

Key (atypical) cells

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

Scarcity and abundance

Based on a smear sample, the type of microflora is determined:

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Preparatory activities

Before taking the analysis, you need to prepare:

• do not take antibiotics within 14 days before the study;
• three days before - do not administer vaginally drugs that have contraceptive, antiseptic and antibacterial effects;
• two days in advance - do not have sexual intercourse;
• the day before going to the doctor, do not take a bath;
• do not douche;
• before visiting a doctor, perform hygiene procedures for the genitals;
• three hours before the procedure, do not empty your bladder;
• Do not get tested during menstruation.

In the case of constant drug treatment, a woman should notify her doctor and tell her what medications she is taking.

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

Collection of biological material

To conduct research and interpretation, a gynecological smear is taken from the urethra, cervical canal and vaginal walls. The microflora is examined and the degree of purity is determined.

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

• preventive examination;
• medical examination;
• women's complaints: burning and itching sensation of the genitals, pain near the pubis, discharge.

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

Gynecological smear: explanation. 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 detected. Lactic acid maintains an acidic environment in the vagina and quickly suppresses pathogens.
Another part of the flora is Klebsiella, Escherichia coli, Corynebacteria, Staphylococcus, Gardnerella, Myrococcus, Peptostreptococcus, Eubacteria and others. The presence of a minimum amount of Candida fungi is also acceptable.

Reasons for deviations from the norm

In some cases, immunity decreases (menopause, pregnancy or other hormonal imbalance, stressful situations), in which case the doctor may prescribe a gynecological smear for general flora. Decoding 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, E. coli, staphylococci. With a weak immune system, pathogens multiply at high speed and actively suppress milk microorganisms. As a result, pathology develops: gardenellosis, candidiasis or vaginal dysbiosis, which provokes:

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

For what purpose is the analysis prescribed?

The examination and interpretation of a gynecological smear allows for the timely diagnosis of various diseases of the woman’s genital area, as well as the assessment of 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 examination is called the gold standard for identifying bacterial vaginosis.

Vaginal dysbiosis: main causes

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

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

Analysis results

A gynecological smear is examined in the laboratory of a medical organization. Explanation:

• Leukocytes. For the cervical canal, it is considered normal to have up to 30 cells in the field of view, for the urethra - within 5, for the vagina - no more than 10. A small number of white blood cells protect 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 detected in the urethra, inflammation is suspected.
• Epithelial cells, which normally should be no more than 15. In the vagina - squamous epithelium, in the cervical canal - cylindrical epithelial cells. If a gynecological smear was taken and its interpretation showed the presence of epithelium above normal, then this indicates an acute or chronic inflammatory process in the genital organs.
• Microorganisms. The vagina normally contains: 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. There should be no microflora in the urethra. If there is a pathogenic or conditionally pathogenic flora, then vaginal dysbiosis or inflammation is diagnosed.
• Trichomonas, gonococcus, key cells, the detection of which implies the following diseases: trichomoniasis, gonorrhea, gardnerellosis. Normally they shouldn't be there.
• Candida fungus. Mycelium and spores are identified. The latter suggest carriage of this type of fungus and can be present in a practically healthy woman. The appearance of mycelium means that the woman has an active infectious process caused by candidiasis, or thrush.

Degree of purity of a gynecological smear: decoding

Based on the degree of purity of the gynecological smear, and there are only four of them, the presence of an inflammatory process in the female body is determined:

• First. This degree of purity is found in two categories: in practically healthy women (there are no chronic or acute inflammatory diseases of the genital organs) and in girls who are not sexually active. Indicators: sufficient amount of lactobacilli, acidic vaginal pH, leukocytes 0-5.
• Second. At this degree of purity, therapy is not prescribed. Preventive measures are recommended to improve 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 vaginal pH, five to ten leukocytes, moderate amount of mucus and flat epithelial tissues.
• Third, this means that there is an inflammatory process in the woman’s genitals 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.
• The fourth degree is a high level of danger. Based on the results of laboratory tests, the doctor prescribes an additional examination in order to exclude dangerous diseases, including cancer, of the woman’s genital organs. Indicators: lactobacilli are not sown, alkaline vaginal pH, microflora is completely pathogenic, a huge number of leukocytes.

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

Flora smear during pregnancy

This analysis is taken from pregnant women upon registration at the antenatal clinic, as well as at 30 and 38 weeks in order to monitor the degree of vaginal cleanliness throughout pregnancy.

Women planning children are advised to first take care of themselves and the health of the unborn baby, and undergo a gynecological smear for flora before the expected pregnancy. Explanation: normally, 95% of all bacteria are lactobacilli, 5% are opportunistic 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 changes in microflora is pregnancy.

Throughout the entire period of bearing a baby, a woman has a different hormonal profile. There is an increased production of the hormone progesterone, and a minimal amount of estrogen. Thanks to this restructuring of the body, the number of Doderlein bacilli (lactobacteria) increases approximately tenfold in order to protect the fetus from infection during pregnancy.

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

Cytomorphological analysis of smears

This type of study is prescribed after a gynecological smear for flora has been prescribed. Interpretation (normal or pathological) of the results will help in making an accurate diagnosis. Using this analysis, oncology or dysplasia of the cervix and 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 mild dysplasia. In this case, the doctor prescribes anti-inflammatory drugs, and after a full course of treatment, a repeat cytology test.
• Type 3 is severe or moderate dysplasia. When such a result is obtained, an additional examination is prescribed, namely a biopsy of cervical tissue and their cytomorphological examination, colposcopy, with the help of which lesions of epithelial tissues are identified, their location and nature.
• Type 4 is characterized as a precancerous condition. As with the third type, a new examination and consultation with a gynecological oncologist is recommended.
• Type 5 is an oncological disease. All examinations and treatment take place in a specialized medical institution.

Preparation for cytological examination

The information content and accuracy of the result depends on proper preparation:

• take the test no earlier than the fifth day of menstruation and no later than five days before the next menstrual cycle;
• 24 hours before collecting biomaterial, it is not recommended to use medications, including contraceptives;
• You should abstain from sexual intercourse at least 24 hours before going to the doctor.

Conclusion

Thus, a gynecological smear for flora (the explanation of which is given above) and a smear for cytology makes it possible to identify various diseases of the female genital area and, with properly prescribed therapy, gives a great chance for a rapid recovery.

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When to get tested

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

• aching or paroxysmal pain in the lower abdomen, unpleasant pain or a feeling of heaviness;
• increased mucus secretion 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.

Analysis is necessary for long-term treatment with antibacterial drugs or hormonal agents. It is important to take a smear test for flora when changing sexual partners.

What does a smear show on the flora?

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

• quantity and quality of white and red blood cells (leukocytes and red blood cells);
• identify various cocci, trichomonas or fungal infections;
• number of lactobacilli.

The analysis allows us to determine the cause of a woman’s illness 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 collecting biological material are integral components of reliable results.

Preparing for the study

A woman needs to carefully prepare for an analysis to study the vaginal microflora.

1. Avoid sexual intercourse for 48 hours.
2. Hygiene procedures should be carried out without special means or douching for 2 days before the test. Do not use vaginal suppositories or ointments.
3. Do not visit the toilet 2.5–3 hours before the smear test.

How to take a smear

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

1. Using a disposable spatula or spatula, the doctor removes part of the discharge from the urethra, cervical canal and vagina.
2. The material is placed on a sterile glass slide and sent to the laboratory.

The process of collecting gynecological material does not bring discomfort to the woman and takes 5–10 minutes. The 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 quantities.

Table “Reference values ​​of smear for flora”

Transcript of research

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

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

1. Blastospores. Immature cells of pseudomycelium show active reproduction of candidiasis pathogens (thrush).
2. Increase in key (atypical) cells. The flat epithelium begins to grow, which indicates abnormal disturbances in the microflora and the appearance of bacterial vaginosis.
3. 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, and leptotrichiasis.
4. Coccal flora. The smear may contain gonococci, which indicates gonorrhea.
5. Trichomonas. Pathogenic cells indicate the development of a sexually transmitted infection - trichomoniasis.
6. Fibrin threads are evidence of inflammation.

When examining a smear, a lot of attention is paid to detritus - dead cells. The substance is an integral part of healthy microflora in both women and men. It consists mainly of a small number of obsolete epithelial cells. If this indicator increases, we may be talking about inflammation in the cervix or infectious pathologies that provoked massive 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 permanent composition of the flora.

1. A decrease in Dederlein's bacilli and an increase in leukocytes indicates a decrease in local immunity and the development of inflammation in the reproductive organs.
2. Changes in epithelial cells. If squamous epithelium is absent, we are talking about atrophy of the uterus or cervical canal. An increase in such cells indicates inflammatory processes.
3. Excessive appearance of columnar epithelium - infectious foci in the uterine tubes, malignant tumors in the cavity of the reproductive organ or cervical canal.
4. 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:

1. Poor flora - the biological material is dominated by gram-positive rods (95%), there are some opportunistic bacteria (5%), there are single leukocytes, the environment is acidic. The woman is completely healthy.
2. Moderate flora – a large number of lactobacilli, a slight increase in leukocytes (7–10), moderate presence of opportunistic microorganisms. The condition is not painful, but local immunity is slightly weakened, which indicates increased sensitivity to harmful cells.
3. 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 environment is slightly acidic. The woman develops inflammatory processes and has a vaginal infection.
4. Abundant bacillary environment - homogeneous mucus contains a large number of leukocytes, there are traces of phagocytosis, and a complete absence of gram-positive rods. High concentration of aerobic or anaerobic bacteria. The amount of fluid released with an unpleasant odor increases. The environment is alkaline. In the genitourinary system there is pronounced inflammation, the presence of a dangerous urogenital infection.

It is necessary to understand that if deviations are detected that are identified as 3 or 4 degrees of purity, it is important to begin treatment immediately. Otherwise, there is a high probability of severe complications.

Treatment

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

Table “Treatment of possible abnormalities in the flora smear”

Tampons and vaginal suppositories with probiotics can be used to restore flora and strengthen local immunity.

The most effective are:

• Lactobacterin;
• Acylak;
• Bifidobacterin.

Adequate treatment is prescribed exclusively by a doctor. The specialist evaluates the results of the 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.

Studying a smear for 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 abnormalities and identify the causative agent of pathological processes. Proper preparation and compliance with the requirements for collecting biomaterial allows you to obtain reliable results the very next working day.

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Reasons for performing culture in gynecology

1. If the smear contains a moderate or large number of leukocytes, but the causative agent of the infection is not known. Since with microscopy there is a lower limit for the detection of microorganisms: 10 to 4 - 10 to 5 degrees.
2. If a microbe is identified, to determine its sensitivity to antibiotics.
3. If there are signs of a fungal infection. To accurately determine the type of fungi and prescribe an effective antimycotic drug.

   Other types of Candida fungi do not need to be treated if there are no pathological symptoms.

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

What are the differences between bacterial culture, flora smear and degree of vaginal cleanliness?

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

That is, if we are talking about a rapid analysis, you will only be given a conclusion about 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 assesses the relationship between normal, opportunistic and pathogenic microflora.

Classic assessment of vaginal cleanliness.

Updated table

What doctors don't see with microscopy

1. Pregnancy. 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!
2. 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.

   CC and other pathologies (erosion, 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.

3. Does not show infections (STDs) such as:
   • herpes;
   • chlamydia (chlamydia);
   • mycoplasmas (mycoplasmosis);
   • ureaplasma (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.

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?

Is it possible to take a smear while taking antibiotics or immediately after treatment? It is not advisable to do this within 10 days after using topical drugs (vaginal) and one month after taking antibacterial agents orally.

Microscopic examination is prescribed:

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

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

To begin with, we present to your attention a table that displays the indicators of the so-called first degree of purity. There is no mention of the urethra (although material is taken from there too), 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, since this has no diagnostic value. But too scanty an amount of epithelium indicates an atrophic type of smear - which happens in women during menopause.

Leukocytes - counted in the “field of view”:

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

Mucus (mucus strands)- should be present normally, but a large amount occurs during inflammation. There should be no mucus in the urethra.

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

Trichomonas, gonococci and key cells in a healthy woman there should not be any in the cervix and vagina. Candida is also normally absent. At least in a significant amount, which is detected when analyzing the flora.

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

Results are usually valid for 7-14 days. Therefore, if you need to take it before surgery, do it 3 days before entering the hospital. The last of the prescribed tests.

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Normal vaginal microflora

A healthy woman's vagina is not sterile. It contains many types of microorganisms, their totality is called microflora. Bacteria constantly compete with each other for habitat on the walls of the vagina and for food.

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

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 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.

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

How to make a smear on the vaginal microflora?

A smear is taken in the gynecologist's office. A woman can also undergo this test in a private laboratory.

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.

Often, a smear is taken from three points at once:

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

The anatomical proximity of these areas leads to the fact that infections and inflammations occur interconnectedly. For each area, use a separate sterile spatula, brush or cotton swab. The taken material is applied to 3 sterile glass slides, separately for each area.
A vaginal flora smear is an absolutely harmless procedure that is allowed, including for pregnant women. During the collection of material, the mucous membrane is not injured, so there are no restrictions after the procedure. It is allowed to take a bath, swim, have sexual intercourse, 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 the smear can interfere with the results. The optimal period is considered to be from the 10th to the 20th day of the cycle.
The result of the analysis will be as reliable as possible if you adhere to the following rules.

• 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?

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

• 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.

The flora smear evaluates the following indicators:

4 degrees of vaginal cleanliness

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

In smear microscopy for flora, the following is considered normal:

• 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.

The smear should not contain:

• 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 .

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

What do leukocytes indicate in a smear on vaginal flora?

Leukocytes- These are white blood cells that are designed to fight infection. They can exit through the wall of blood vessels and move independently. Leukocytes have the ability to phagocytose - they engulf bacteria and digest them. Once the bacterium is digested, the white blood cell is destroyed. This releases substances that cause inflammation, manifested by swelling and redness of the mucous membrane.
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 sensitivity to antibiotics performed when examining a smear?

Antibiotic sensitivity or antibiogram- determining the sensitivity of bacteria to antibiotics. The study is carried out simultaneously with smear culture if pathogenic bacteria that cause inflammation or sexually transmitted infections are detected 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 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.

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

How is antibiotic sensitivity testing performed?

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), 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?

Smear culture or bacteriological culture (bacteriological culture) of a smear is a laboratory test in which the contents of the vagina are placed in a nutrient medium and optimal conditions are created for the growth of bacteria.

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.

In what case is smear culture prescribed?

• 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”.

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

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