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Diseases of the urinary system and genital organs very often worry the mature population. The situation is complicated by the fact that many of the diseases are transmitted during sexual intercourse, recur and become chronic.

Each of these ailments has its own pathogens, special symptoms, as well as a specific diagnostic and treatment regimen. One of the most common diseases of the urinary system and genital organs is ureaplasmosis.

Ureaplasmosis

Complications

Diagnostics

Objectives of the study

Direction for bacterial culture

What is bacterial seeding?

Preparing for sowing

Sowing

Ureaplasmosis

Can be transmitted in several ways:

This disease affects both women and men, and can also have a negative impact on a person of any age.

Very often, people do not even suspect that they are carriers of ureaplasmosis, since the microbe does not manifest itself for a long period of time. The catalyst for the development of the disease itself can be a sharp decrease in immunity, the occurrence of concomitant diseases, etc.

Complications

If the number of microbes in the human body is insignificant, then, as a rule, the doctor does not prescribe treatment. If the disease has turned into an acute form, then you cannot delay in response measures, since ureaplasmosis can lead to infertility in both sexes, and is also the cause of the development of many concomitant diseases in both women and men.

Mandatory treatment is prescribed to women who are planning a pregnancy, or directly to pregnant women, in order to eliminate the high likelihood of developing pathologies.

Diagnostics

It is carried out only by an experienced specialist in laboratory conditions - bacteriological culture is examined.

During an external examination, you can notice the main symptoms of the disease, but this is not enough to make a correct diagnosis.

Objectives of the study

Bacterial culture research is carried out in order to:

• identify the causative agent of the disease;
• detect the presence of possible concomitant diseases;
• prescribe the correct treatment that will help fight all problems of the genitourinary system;
• Conduct a preventive examination as planned or after completion of treatment.

Direction for bacterial culture

A doctor may issue a referral for a bacteriological culture test in several cases:

• During an examination, if a woman is planning a pregnancy;
• When a disease is detected in a sexual partner;
• With frequent promiscuous sexual intercourse;
• During pregnancy problems - miscarriages, premature birth, ectopic pregnancy;
• During the therapeutic course of treatment, as well as a month after its completion.

What is bacterial seeding?

Otherwise, bacterial culture is called a cultural study, which is carried out in laboratory conditions in order to determine the causative agent of the disease, its type, and determine its sensitivity to antibiotics.

For this purpose, an antibiogram is additionally prescribed. The fact is that frequent treatment with medications and the individual characteristics of the body lead to the fact that bacteria can lose sensitivity to many drugs, so the treatment will not improve the patient’s condition. During the analysis process, bacteria taken from a person are placed in a special environment nutritious for bacteria. If the test is positive, the microbes will begin to multiply. The degree of concentration of ureaplasma in the human body is determined by the number of colonies, and the colonies themselves are used to conduct an antibiogram.

They are placed on a nutrient medium containing certain antibacterial agents. Their behavior determines sensitivity to each group of drugs.

Bacteria grow within three days, so analysis results can be obtained no earlier than 3-5 days.

Preparing for sowing

The reliability of the results obtained during the study depends on how correctly the preparation for the analysis was carried out.

In order for the bacterial culture study to give correct results, it is necessary to adhere to the following rules:

• 2 days before the test, you should not take antibiotics, antifungal medications, or antiseptics. If this rule was not followed, then you should inform the doctor who takes the analysis;
• Approximately 2-3 hours before taking the test, you should not empty your bladder;
• Women should get tested only a week after the start of their menstrual cycle, since during menstruation the acidic environment of the inner vagina changes and may go beyond normal values.

Sowing

In men and women, the procedure for collecting biological material differs due to the characteristics of physiology.

For women it is carried out:

• scraping of the mucous membranes of the vagina;
• scraping of the cervical canal;
• scraping of the urethra.

For men it is carried out:

• scraping of the mucous membranes of the urethra;
• analysis of the state of the ejaculate.

Both men and women additionally undergo a urine test.

Results of the research

Any research results include an indication of the presence of ureaplasma in the test material, as well as the number of colonies and their behavior. If microbes are found in the culture, then the value of CFU is indicated - colony-forming units, which determines carriage or ureaplasmosis.

A negative result indicates that everything is normal - there is no this microbe in the human body, he is not sick with ureaplasmosis and is not a carrier of the infection.

A positive result with a CFU coefficient of 10,000 or less indicates that the person is a carrier of ureaplasma, but their condition is not active, so additional antibiotic sensitivity tests cannot be carried out. In this case, treatment is prescribed only when planning pregnancy or in conjunction with treatment of another disease.

A positive result with a CFU coefficient exceeding 10,000 indicates the presence of an inflammatory process. Additionally, sensitivity to antibiotics is tested. With such results, the doctor prescribes comprehensive treatment for the disease.

Ureaplasmosis is most often transmitted sexually, so the natural prevention of the disease is protected sexual contact and the absence of promiscuity. If you have a permanent healthy sexual partner, it is almost impossible to become infected with ureaplasmosis.

If the disease is detected in one of the partners, then both need to undergo treatment, since the risk of re-infection is very high.

In any case, with this disease, self-medication must be completely avoided, since microbes are not sensitive to many medications.

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What is ureaplasma

The habitat of the bacterium is considered to be the genitourinary system, lung tissue, and in people who do not complain of health. Statistics show that women are more likely to become carriers of the disease than men. At the same time, harm to their body is caused in cases of decreased immune functions of the body, sexual relations without protection.

Diseases of the reproductive system (inflammation of the cervix, fallopian tubes, etc.) are considered factors that provoke the proliferation of ureaplasma in women. In men, an increase in the number of bacteria is recorded against the background of prostatitis, inflammatory process of the urethra, disorders of spermatogenesis and others. However, the presence of chlamydia and gonorrhea has a stronger influence on the appearance of ureaplasmosis than others.

The disease is transmitted from mother to fetus during gestation and passage through the birth canal.

The disease may be asymptomatic, but when they appear, complaints similar to signs of sexually transmitted diseases are recorded. These include unpleasant sensations in the urethra, reproductive organs, and discharge with an unpleasant odor (may be absent). In this case, the doctor prescribes tests for ureaplasmosis, PCR, ELISA, and bacteriological culture.

Types of tests for ureaplasma

Their difference lies in the method of studying the biomaterial, the time it takes, and the accuracy. The collection of material also takes place in different ways, and each of them requires the fulfillment of certain rules before inspection. Immunofluorescence analysis involves taking blood from a vein. The doctor gives you a referral to come to the laboratory in the morning. Before the study, stop taking antibiotics 7 days before the study. You will also have to skip breakfast.

In this case, antibodies to pathogens are detected in the patient’s blood. Doctors call them immunoglobulins. The interpretation of ELISA consists of the detection of two types: immunoglobulin M (img), produced in the human body 2-3 weeks after the attack of the microorganism, and immunoglobulin G (igg), which persists in the biomaterial for several years.

Decoding tests for ureaplasma in women takes into account a combination of indicators, but close attention must be paid to the numbers. Of course, each laboratory has its own determination scale, but the guideline is the amount of antibodies. There is no fundamental difference when diagnosing ureaplasma in men. However, this method of blood testing is not a reason to make a diagnosis and additional tests will be required in the future.

It is also called the cultural research method. It has sufficient effectiveness of indications compared to blood sampling, and in women, biomaterial is collected from the vagina, uterine and urethra. In men, the test is taken from the urethra. Urine or gland secretions are used less frequently.

The collected materials are placed in a specific environment. And if ureaplasma is present, then the quantitative growth of the bacterium can be observed. And also, tank sowing is necessary because it is used to determine the sensitivity of a microorganism to various antibiotics.

The analysis is carried out a few days before menstruation or in the postmenstrual period (up to 7 days). When the appointed day of the examination coincides with the beginning of the cycle, the trip to the doctor will have to be postponed to a later time. Preparation involves:

• Refusal of sexual contact 2 days before scraping;
• Stopping washing with intimate hygiene products, douching, and using local contraceptives (creams, suppositories, tablets);
• 7 days before the day of the analysis, you should stop using topical medications unless they have been agreed upon with your treating specialist;
• Swimming should be moved to the evening, but it is prohibited in the morning. Washing must take place without the use of hygiene products;
• The last trip to the toilet should take place 3 hours before the smear (generally, the rule applies to the stronger sex).

PCR or polymerase chain reaction

This method of examination shows 98% effectiveness. During the study of the material, it is possible to identify even single bacteria of the pathogen, but a blood test does not detect them at all. And also, he is the fastest among all. Its duration is 5 hours.

It detects ureaplasma DNA, but this method has disadvantages. Among them: lack of information about the activity of the infection, a false positive result in the case of a dirty sample, and vice versa - a false negative result when the patient undergoes antibiotic therapy a month before the test. The site of material collection is the cervical canal of the cervix. Among the limitations described above, there is also the inability to perform a smear immediately after a colcoscopic examination for neoplasms on the cervix.

After receiving the results, the doctor evaluates the indicators, and even if the bacteria is present in small values, treatment may not be necessary. Self-diagnosis is not advisable.

The ELISA blood test has its own values ​​in each laboratory. Qualitative, when the results column contains positive or negative values; quantitative implies an exact numerical designation, and semi-quantitative - approximate numbers or titles.

By titer we mean the dilution of the blood with the maximum amount of liquid and the fixation of antibodies by the test system.

PCR research is easier to analyze, since normally the value should not be more than 10 4 CFU per 1 ml. When the value is exceeded, a diagnosis of ureaplasmosis is made. It is worth remembering that different laboratories use their own scale of numerical values, so basically, attention should be drawn to the numerical value, not the verbal one.

Indications for testing

During a routine visit to the doctor and a smear test, pathological flora can be identified. This may prompt further inspections. But if you have complaints that are similar to the symptoms of sexually transmitted diseases, you will also have to undergo additional examinations.

As well as the presence of such diseases:

• Failure to carry the fetus to term and frequent miscarriages;
• Pain in the pelvic area;
• Chronic colpitis with erosion;
• Pregnancy with complications;
• Contact with a partner who has a disease;

Reasons to undergo testing include frequent changes of sexual partners.

It is recommended to undergo blood tests and smears at least once a year. An analysis for ureaplasma helps a specialist identify pathologies associated with the patient’s genitourinary system, the causes of inflammatory processes and disorders of the microflora of the genital organs. The bacteria are most often carried by women, but its presence can be determined by urine sediment in men. The latter may not even be aware of this disease, since it is practically asymptomatic.

Signs include:

• Unpleasant or painful sensations when emptying the bladder;
• Discharges of a pathological nature;
• General lethargy, apathy.

When planning a pregnancy, the doctor prescribes blood or mucus tests for ureaplasmosis to prevent problems with pregnancy. Both family members must undergo it. Infertility can cause the presence of ureaplasma in the body of both the weaker and stronger sex.

Thus, it turned out that to identify the disease, one would have to donate either a smear or venous blood. Ureaplasma is only one infection among many for which it is necessary to be tested regularly. This especially applies to people who have a history of pelvic organ diseases, low immunity, and frequently changing sexual partners.

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What is ureaplasma and why is it so dangerous?

The size of ureaplasmas is close to viruses, but the composition of cells is close to bacteria, which have DNA and RNA. This is rather a transitional stage from microorganisms to unicellular organisms. Pathogens do not penetrate into the nucleus or cytoplasm (liquid part of the cell) of the host cell, but are located on the surface of cell membranes, penetrating into them. Thus, ureaplasmas “escape” phagocytosis (attack by immune cells), which determines their ability to live in the body for a very long time. This condition is called persistence.

Ureaplasmas were previously classified as similar microorganisms - mycoplasmas, but due to their distinctive ability to break down urea, ureaplasmas were placed in a separate group. At the same time, the ability to form ammonia from urea is the main reason for the harmfulness of these microorganisms. Ammonia has a toxic (poisonous) effect on the cells of the urogenital tract in men and women and disrupts the biocenosis (composition of living flora) of the vagina, reducing local immunity. This is associated with torpid (acute) and recurrent (repeated) course of urethritis and vulvovaginitis.

Disputes still continue over the true classification of the pathogen. In Russia, in 2000, Order No. 315 of the Ministry of Health of the Russian Federation was issued, excluding ureaplasmosis from the list of sexually transmitted infections - i.e. the disease is not classified as an STI. But according to the WHO (World Health Organization) classification of sexually transmitted infections, in 2006 the subspecies Ureaplasma urealyticum (ureaplasma urealyticum) was specifically classified as a causative agent of sexually transmitted infections. Therefore, we can say what is included in the spectrum of examination for sexually and non-genital infections.

Why do you need to get tested for ureaplasmosis?

A gynecologist or urologist refers patients for tests, suggesting that this pathogen is the cause of inflammation in the genitourinary system. The reason is an ongoing treatment that is not yielding results.

Due to the absence of a cell wall - it was replaced by a three-layer cell membrane, ureaplasmas are resistant (resistant) to drugs that destroy pathogens precisely through their effect on cell walls. The number of drugs that cannot cope with ureaplasma includes penicillin and its derivatives, which are the main drugs prescribed for the treatment of most sexually transmitted infections.

A complete test for ureaplasmosis identifies the microorganism itself, determines its concentration, and checks the resistance of ureaplasma to various drugs. Treatment will be prescribed after identifying a drug that can affect the pathogen.

When is a test for ureaplasmosis necessary?

The analysis is prescribed in the absence of other possible causes of inflammation. The main indications for determining ureaplasma: diagnosis of ureaplasma infection, urethritis, pelvic inflammatory disease, infertility.

This analysis is necessary to identify the etiological (main, determining) factor of chronic inflammation in the genitourinary system, for differential diagnosis (comparison when clarifying the diagnosis) with chlamydia, gonorrhea, mycoplasma infection, for choosing antibacterial therapy, assessing the results of taking antibiotics, and conducting a preventive examination.

What tests are taken for ureaplasma?

Culture for ureaplasma does not determine its type, therefore, if it is necessary to clarify which pathogen - U. urealyticum or U. parvum is present in the body, you need to take a PCR test. Material for inoculation for ureaplasma urealiticum - discharge of the urogenital tract.

Ureaplasma (U. species) is considered as a cause of inflammation in the genitourinary tract, if tests do not reveal other pathogenic microorganisms that cause these diseases. For accurate diagnosis, the method of cultivation on nutrient media (seeding is done) is suitable. Practice shows that in 80% of cases with ureaplasma, other pathogens are also detected - mycoplasma, chlamydia, and other anaerobic (not requiring oxygen) flora.

How does a person become infected with ureaplasmosis?

The source of infection is a patient with ureaplasma infection or a carrier of ureaplasma. You can get infected in several ways:

• Antenatal- intrauterine. Up to 23% of unborn children become infected from sick mothers.
• Intrapartum- infection during childbirth. Only 50% of newborns have a chance to remain healthy. Once in the genital tract of a newborn, ureaplasma can remain there in an inactive state for an unlimited time. If there is a normal microflora - a kind of physiological barrier, the infection does not manifest itself in any way.
• Contact and household- this happens very rarely, since the pathogens are not viable in the external environment. And yet, this is possible if the microorganism is in humid, warm conditions, with poor air access, for example, in a public shower that is not cleaned or ventilated. Slippery walls, slimy from dampness, which do not get hot water, are very reminiscent of the conditions in the body.
• Sexual- the main route of infection. A sick person can infect a healthy partner during sexual intercourse. Most often, carriers of ureaplasmosis are women.

Infection is not yet a disease, but already a carrier state. Those. a person is already capable of infecting sexual partners.

Reasons for activation of ureaplasma

The cause of infections is conditions associated with immunodeficiency (decreased immunity). For example, vaginal dysbiosis as a consequence of bacterial vaginosis in women, impaired production of prostatic antimicrobial factor in chronic prostatitis in men, impaired local immunity, concomitant infections - gonorrhea, chlamydia, etc.

Symptoms of ureaplasmosis

Symptoms of ureaplasmosis are minor, sometimes they do not appear at all. 20-30 days after infection, the patient may experience itching and burning when urinating. Men may experience discomfort in the groin area, and sometimes there is mucous discharge from the urethra.

Women are much less likely to experience symptoms of the disease: pain in the lower abdomen, burning during urination, vaginal discharge. The symptoms of ureaplasmosis are similar in many ways to other inflammatory processes. Advanced ureaplasmosis in women often causes inflammation of the appendages, vagina and uterus, can lead to complications of pregnancy and infertility, and in men cause urethritis and prostatitis. Consequently, patients experience new symptoms of urological diseases.

If the patient’s immunity is very weak, then ureaplasma spreads higher up the genital tract (ascending route). The result of this is inflammation of the uterus (endometritis) and appendages (adnexitis). Signs of widespread inflammation are menstrual irregularities with intermenstrual bleeding. Critical days become abundant and long. An important sign is nagging pain in the lower abdomen.

Why is ureaplasmosis dangerous for men and women?

In men ureaplasma is the cause of inflammation of the urethra (diagnosis - non-gonococcal urethritis), bladder (acute and chronic cystitis), prostate (acute and chronic prostatitis), damage to the testicles (orchitis), and epididymis (epididymitis). Also, ureaplasmosis impairs the quality of sperm, causing a weakening of sperm motility and number, and this is guaranteed infertility. Ureaplasma also affects other organs, causing reactive arthritis and urolithiasis.

Among women Ureaplasma is a common cause of inflammation of the vagina (vaginitis), cervix (cervicitis), and neoplasms. With weak immunity, inflammation of the uterus (endometritis) and its appendages develops (adnexitis with complications of the fallopian tubes (development of adhesions). This guarantees ectopic pregnancy and infertility. In addition, ureaplasmosis is the cause of cervical insufficiency, miscarriages, chorioamnionitis, the birth of premature, malnourished children ( less than 2500 g), as well as bronchopulmonary diseases (pneumonia, dysplasia), bacteremia and meningitis in newborns.

The problem with ureaplasmosis during pregnancy is that when ureaplasma is detected, the gynecologist has to choose between two dangerous consequences:

• If ureaplasmosis in a pregnant woman is not treated, then there is a risk that the child will be born sick immediately or the infection will manifest itself later.
• If ureaplasmosis is treated, and for this it is necessary to use a strong antibiotic, then the newborn can also expect consequences only caused by the drugs. Antibiotics can also cause miscarriage.

This is why gynecologists prescribe tests for ureaplasmosis when planning pregnancy and in the earliest stages. If ureaplasma is detected before 6 weeks of pregnancy, a woman can have a safe medical abortion by planning a pregnancy after treatment.

Danger for children

In children infected by their mothers, ureaplasmosis is activated with weak immunity. The immune system is quickly weakened by colds, congenital pathologies, poor nutrition, living in a poor environment, etc. Ureaplasma is found in the lungs of premature babies with pneumonia, respiratory distress syndrome, and bronchopulmonary dysplasia. Its isolation from the spinal fluid (cerebrospinal fluid) in the absence of pleocytosis, with meningitis, and hemorrhages in the ventricles of the brain has been described.

It has been established that in children infected in utero with Ureaplasma urealyticum, in the first 7 years of life, the level of nonspecific inflammatory diseases of the respiratory system and gastrointestinal tract (gastrointestinal tract) is increased almost 4 times. But at the same time, determining ureaplasma in a child without signs of pathology is not an indication for prescribing an antibiotic. Treatment is carried out only for manifest disease with culture isolation.

When and what tests to take for ureaplasmosis

The peculiarity of ureaplasmosis is that it can be asymptomatic. That is why the infection is most often detected through laboratory testing. Examination of ureaplasmosis is done if there are compelling reasons for this: threat of miscarriage, before pelvic surgery, in case of infertility, miscarriage, etc.

This disease is detected using methods:

• serological method;
• PCR (polymerase chain reaction);
• bacterial culture;
• immunofluorescence reactions (RNIF, RPIF).

For a more accurate diagnosis, it is better to use several methods simultaneously. This will make it more likely that you have an infection. The most common and primarily prescribed are two test options:

• Bacterial culture. It helps identify two types of virus (U. parvum and U. urealyticum) and determine the number, as well as their sensitivity to certain antibiotics. For analysis, a smear is taken (from the cervix, urethra or vagina) and a culture is done.
• PCR analysis, for which scrapings from mucous membranes or blood from a vein are used as the test material.

Preparation for analysis

For the serological diagnostic method, blood is taken from a vein on an empty stomach in the morning. Within 5-7 days, the titer of antibodies of various classes can be determined. To ensure that the test is accurate, it is not recommended to perform it while the patient is taking any medications. One or two days before the serological examination, you need to exclude fatty, “heavy” foods and alcohol from your diet.

For PCR diagnosis of ureaplasma, smears are taken from the vagina, urethra and cervical canal in women 2-3 days after the end of menstruation. Before taking material, it is not recommended to douche, use vaginal ointments or suppositories. Men can be examined no earlier than 3 hours after urination, so that the pathogen is not “washed away” along with the urine. Before the test, patients are advised to abstain from sexual activity for a day or two.

For bacteriological culture for ureaplasma, smears from women are taken from the vagina, cervical and urethra. In men, the urethral mucosa, prostate secretions and urine are examined. For the study, morning urine is taken in a volume of 40-50 ml. Before the examination, it is recommended to abstain from sexual relations and alcohol. In this case, not only the pathogen itself is identified, but its sensitivity to antibiotics is also determined.

Immunofluorescence reactions (RNIF, RPIF), in which smears from the genitourinary tract are also examined. Preparation for them is similar to that recommended for bacterial culture and PCR diagnostics.

Decoding the analysis for ureaplasma

To diagnose ureaplasmosis, several types of tests are used: serological method, PCR (polymerase chain reaction), bacterial culture for ureaplasma, immunofluorescence reactions (RNIF, RPIF).

Interpretation of the results of serological examination

A serological examination of blood determines the presence of immunoglobulins in it. The decoding must indicate each of their types, as this is very important for diagnosis:

• Presence of class M antibodies means that the disease is still in the development stage and a protective reaction to ureaplasma is being formed.
• Detection of immunoglobulins G indicates that the infection has been present in the body for a long time. Sometimes a positive result can persist even after recovery. Sometimes the presence of G-antibodies indicates that the disease has already been cured, for example, when taking antibiotics for another disease.

In addition to the presence of immunoglobulins, the analysis also indicates their quantity. If the result is negative, there are no antibodies in the tests.

Explanation of PCR analysis

In this case, the result of the analysis indicates whether Ureaplasma urealiticum is detected. This method is very accurate, but it requires care and experience. If the test is performed incorrectly or low-quality reagents are used, the result may be false positive or false negative.

With a deeper localization of the pathogen (ovaries, uterus) or the use of antibiotics, the PRC study may not diagnose the presence of ureaplasma even if it is present.

Interpretation of bacterial culture results

The material is sown in a nutrient medium, and the maximum concentration of microorganisms should not exceed 10*4 CFU/1 ml. (ureaplasma 10 to 4 degrees is the norm). This type of research also makes it possible to identify pathogen resistance to antibiotics. Which antibiotic will help with ureaplasma is indicated in the result. But the name of a group of antibiotics is not a medicine yet! The doctor will prescribe the drug for ureaplasma, and he will also take into account other types of pathogens that are found together with ureaplasma.

Decoding the results of RNIF, RPIF

Direct and indirect immunofluorescence reactions are positive and negative. In the first case, the pathogen is present in the body, and in the second, it is absent. In doubtful cases, it is recommended to conduct several types of studies - this will give more accurate results.

Features of treatment of ureaplasmosis according to test results

Based on the test results, the doctor makes conclusions about prescribing medications. If ureaplasma is not detected or is present at an acceptable level, no treatment is required. If the permissible values ​​are exceeded, based on research, the doctor prescribes those antibiotics that are most suitable for a given type of ureaplasma and associated infections - there is rarely one ureaplasmosis. Along with ureaplasma, chlamydia, gonococci and trichomonas, mycoplasma, gardnerella, human papillomavirus (HPV) and genital herpes are detected.

Treatment for ureaplasmosis is carried out for both partners if they are infected. During this period, you should avoid sexual contact or use a condom. In addition to antibiotics, drugs that enhance immunity and physical therapy are used. To prevent relapses, you need to eat right, normalize body weight, follow a daily routine, harden yourself, and be physically active.

Where to get tested in St. Petersburg

We invite you to take tests for any infections in our laboratory in St. Petersburg at 10 Zanevsky Prospekt. An appointment based on the test results - a consultation with a urologist or gynecologist - will cost only 500 rubles.

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To determine the opportunistic microorganism Ureaplasma, a culture for ureaplasma is taken to determine sensitivity to antibiotics. This is a highly informative analysis, which allows you to select the appropriate antibiotic for treatment, but the result of this study must be assessed in conjunction with the results of a comprehensive examination.

In medicine, several varieties of this pathogen are distinguished, but Ureaplasma parvum and Ureaplasma urealiticum are considered the most dangerous to human health, since they affect the genitourinary system of the body, and in some cases are based in the lung tissues.

Infection can only be determined through laboratory testing; at the moment, modern research methods can detect the presence of infection, as well as its quantity. The amount of the pathogen subsequently determines the treatment method; if the norm is not exceeded, then therapy is carried out using immunomodulatory drugs.

(urealytivum, parvum) can be transmitted through sexual and household contact. Causes inflammatory processes that can lead to serious consequences, such as:

• termination of pregnancy (miscarriage);
• pyelonephritis.

Note that ureaplasma parvum is a type of urealiticum, therefore the same drugs are used in medicine to treat them.

A tank culture for ureaplasma is mainly carried out to diagnose the infection itself, and a clinical blood test is required to detect the body's antibodies to the pathogen. In addition to culture, antibiotic sensitivity testing is usually performed. An antibioticogram determines how antibacterial drugs affect certain microorganisms. This procedure is necessary because antibiotics are used very often and many bacteria have adapted to the drugs. Using this study, you can check the sensitivity of microbes to all antibiotics.

To ensure that the results of the analysis for ureaplasmosis are accurate, biological material is taken only under sterile conditions. The material to be tested in women can be a smear from the vagina and cervix, in men - a smear from the urethra, and urine is also cultured for ureaplasma.

For further treatment, the drug that most inhibits ureaplasma is determined.

Analysis results

When the number of colony-forming units is more than 104, the result is positive, and this indicates the development of an infectious process in the internal genital organs.

Note that sometimes the analysis results are not correct, since ureaplasma in the body may be in a state of persistence, that is, microorganisms do not multiply. This can happen if inadequate treatment with antibacterial drugs has been completed. In this regard, doctors do not recommend it until the test results are received. In addition, after antibiotic therapy, it is necessary to undergo control tests at least 3 times with intervals of 1 month. It is especially important to do this for women, since they are at risk.

The analysis is deciphered in a comprehensive manner. Before making a diagnosis, the attending physician also relies on what type of pathogen is found, what its quantity is, what the level of development of the inflammatory process in the urogenital tract. The data from the examination of a sick person and instrumental studies are important for the doctor. And for effective treatment, the antibiogram indicators are additionally taken into account.

Thus, if ureaplasma is detected in the body, it is imperative to begin treatment, otherwise there is a risk of getting a chronic form of ureaplasmosis, which in turn can seriously harm health. And for proper and effective treatment, it is better to get tested for the sensitivity of the microbe to antibiotics.

Ureaplasmosis can be transmitted sexually. Pathogenic organisms can only be identified by laboratory testing using polymerase chain reaction or PCR.

Bacteriological culture for mycoplasma and ureaplasma is a cultural study. Biological material is taken from the patient and placed in a special nutrient medium.

Usually, a culture test for ureaplasma and mycoplasma is prescribed when a certain disease is diagnosed; it is also recommended to take a urine test and a smear for ureaplasma for preventive purposes to prevent the development of the disease.

A repeat study is carried out two weeks after completion of treatment. Usually, a test for ureaplasma is taken once in men; in women, cultures are taken three times in a row after the end of menstruation.

Analysis for ureaplasma in men is carried out by taking a scraping from the mucous membranes of the genitourinary tract three hours after urination. Sperm is also taken for examination. Women undergo tests after completion of menstruation; cultures are taken on the urethra, cervical canal, and vaginal vault.

Most often, culture for ureaplasma parvum is examined when:

1. Determining the cause of chronic inflammation of the urinary and reproductive system;
2. Diagnosing diseases that are similar in symptoms to gonorrhea, chlamydia, mycoplasma infection and other diseases;
3. Selection and evaluation of the effectiveness of therapy using antibacterial drugs;
4. Preventive examination of a person.

A study of the microbiological environment is carried out two weeks after treatment has been completed.

Before being tested for ureaplasma, careful preparation is required.

• Since the biological material for the study is scraping of the mucous membranes of the genitourinary system, the analysis is carried out four hours after the process of urination.
• A day before the scraping is taken, it is necessary to exclude sexual intercourse.
• On the eve of the study, it is necessary to temporarily limit the use of antibiotics, as well as antifungal and antiseptic drugs.
• In women, the study is carried out no earlier than a week after the start of menstruation.

With complex culture for ureaplasma and mycoplasma, it is necessary to obtain a large amount of biological material for research. Therefore, in men, material for study is taken from the urethra and from sperm, in women - from the inner walls of the vagina. In this case, women should take the test between menstruation. In men, when detecting a urogenital infection, urine is also examined.

The pathological process is usually observed if a person’s immunity is weakened or any sexual disease develops. This leads to increased permeability of the mucous membrane, penetration and active development of pathogenic microorganisms.

Modern diagnostics establishes the exact indicators and type of DNA of ureaplasma, and also reveals the degree of sensitivity to medications.

Meanwhile, it is important to consider that the detected amount of ureaplasma is not an absolute indicator that indicates the presence or absence of an infectious disease. The disease can be diagnosed only after instrumental research and examination of the person.

Similarly, indicators of sensitivity to antibiotic drugs and data on the isolation of ureaplasma cultures cannot be absolutely accurate. This is due to the fact that in real life the reaction of antibiotics to the body may be different than in a laboratory study.

Culture analysis may give incorrect results. For example, ureaplasma is not always detected during the transition to a persistent state, when microorganisms are not able to reproduce in a nutrient medium.

A similar phenomenon can occur if taken or treated incorrectly with medications. At this moment, ureaplasma is located in the epithelial cells of the mucous membrane, which is why antibacterial agents cannot affect microorganisms.

Women are tested for ureaplasmosis three times, every 30 days.

If, upon examination and analysis, an inflammatory process is detected in a patient due to ureaplasmosis, and chlamydia is detected together with ureaplasma, drug treatment is necessary. When chlamydia is cured, ureaplasmosis automatically disappears.

Also, ureaplasma and mycoplasma may be the only causative agents of infectious disease and inflammatory process. In this case, treatment of the infection must be carried out with:

1. The risk of complications during pregnancy in women;
2. Infertility, unless other causes are identified;
3. An upcoming surgical intervention or an unsafe procedure in the genital area, which may introduce germs through wounds.
4. Clear signs of the inflammatory process, which are confirmed by an accurate diagnosis.

What to do if ureaplasma and mycoplasma are detected

If a patient has elevated levels of ureaplasma and mycoplasma, further actions depend on the person’s condition. Drug treatment will be prescribed if an inflammatory process is observed and the patient complains of certain symptoms.

The doctor will identify the true cause of the symptoms, establish an accurate diagnosis and prescribe medications. An analysis of the sensitivity of microorganisms to antibiotics will help you choose the right treatment for ureaplasmosis and mycoplasmosis.

In the absence of obvious complaints and symptoms of the disease, treatment with drugs is not carried out, since ureaplasmosis is not considered a sexually transmitted disease today. The video in this article will tell you about ureaplasmosis in more detail.

Ureaplasma is an opportunistic microorganism that causes genitourinary infections in women and men. The disease caused by this microorganism is called ureaplasmosis and can occur with a variety of clinical symptoms or without any manifestations. That is why timely diagnosis and treatment of ureaplasmosis is necessary. Modern diagnostic measures allow you to quickly and accurately determine the presence of a microbe in the body, making it possible to get rid of the disease in a short time. The main diagnostic method is culture for ureaplasma with determination of sensitivity to antibiotics. This highly informative analysis not only makes it possible to find out about the presence of infection in the body, but also at the same time to select the optimal treatment.

What is bacterial culture for ureaplasma?

In their medical practice, gynecologists and urologists often refer their patients to undergo a culture test for mycoplasma and ureaplasma to diagnose inflammatory diseases. Many people ask the question: “What is this and why do I need to do research?”

Bacteriological culture (bacteriological culture) refers to microbiological culture diagnostic methods. The purpose of the study with this method is to find bacteria of the large class Mollicutes, which includes Mycoplasma hominis and genitalium, Ureaplasma parvum and Ureaplasma urealyticum and to determine their sensitivity to antibiotics.

Mycoplasma infection is a collective concept that includes about 16 pathogens, the most common pathogens being: mycoplasma hominis and genitalium. They usually cause diseases of the urogenital tract, but under certain conditions they penetrate into other organs: lungs, trachea, bronchi.

The main problem of diagnosis and treatment for these microorganisms is their dynamic variability in the process of evolution. Every year, an increasing number of strains have lost sensitivity to the most commonly used antibiotics. This creates many problems when designing treatment regimens.

Advantages of the method

The diagnosis of ureaplasmosis and mycoplasmosis is established only after culture or PCR. A smear from the vagina, urethra, venous blood or 10 ml of morning urine can be used as biological material.

The diagnosis of ureaplasmosis and mycoplasmosis is established only after culture or PCR

What is sowing? In fact, although doctors use the term “seeding” to refer to the entire procedure, the process of seeding onto a medium is only one of its component parts. The entire diagnostic procedure is a dynamic chain consisting of collecting biological fluids, inoculating them, culturing them in a thermostat, studying them under a microscope and carrying out chemical reactions to identify pathogenic agents.

Culture to determine flora is the “gold standard” for diagnosing genitourinary diseases. It was first used several centuries ago, but is still not inferior to modern research methods. When choosing between PCR or tank culture, doctors first lean towards the second option. It is characterized by highly informative analysis, the ability to develop an individual antibacterial therapy regimen based on the obtained antibiogram, and allows strain typing. And the cost of culture for ureaplasma and mycoplasma is cheaper than the PCR method. The need to carry out the PCR method arises when the result of a bacteriological examination is negative, but in the presence of clinical symptoms. Polymerase chain reaction is also chosen in cases where it is necessary to obtain results within a few hours.

Indications for testing

Bakposev is carried out in the presence of complaints in the direction of a doctor - gynecologist or urologist. When it is discharged, the microbiological examination form always indicates the item “With determination of sensitivity to antibiotics” and the drugs commonly used for treatment are emphasized, usually in quantities of 7-10.

Inflammatory reactions from the genitourinary system cause a blurred clinical picture, difficult to diagnose without the help of laboratory services:

• dysuric phenomena: painful urination, pain, frequent visits to the toilet, small volume of urine;
• discomfort and pain during sexual intercourse;
• pain in the groin and suprapubic region, rarely in the inner thigh;
• enlargement of local lymph nodes, pain when touched, redness and swelling of the skin in this area;
• Women often experience menstrual irregularities, abnormal uterine bleeding, and pain in the lumbar region;
• discharge from the urethra or vagina with a strong or unpleasant odor;
• general symptoms: weakness, decreased performance, apathy, fever.

Unfortunately, in approximately 55-60% of cases there are no symptoms. A person is a carrier of infection without knowing it.

Rules for preparing for analysis

To accurately identify mycoplasma hominis and genitalium, ureaplasma urealyticum and parvum, or other mycoplasmosis, it is enough to take a bacterial culture once, but in compliance with all conditions.

The rules are the same for both men and women. Before taking the test, a number of conditions must be met:

Before taking the test, you must not take any antibacterial or antiviral medications for two months.

• do not take any antibacterial or antiviral medications for two months;
• two days before the test, abstain from sexual intercourse;
• It is advisable for women to visit a doctor in the second half of the menstrual cycle or no earlier than the third day after the cessation of menstruation;
• You should not take a hygienic shower in the morning before visiting a doctor; it is better to do it in the evening;
• do not urinate for four hours before the procedure;

How is it carried out?

The procedure is carried out quickly - on average in five minutes. In women, material for culture is taken from the urethra, cervical canal and posterior vaginal fornix. In men, it is taken from the urethra, having previously treated everything around with a sterile napkin, pressed on the urethra and taken drops for culture. If the discharge from the urethra is scanty, then it becomes necessary to obtain a scraping from the mucous membrane of the urethra using a Volkmann spoon or a special probe. All collected biological fluids are first placed in a transport medium for delivery to the laboratory. There, the material is transferred to a nutrient medium and cultured for ureaplasma and mycoplasma.

The study begins from the moment the material is transferred into a test tube or onto a Petri dish in a nutrient medium. It has optimal conditions for the growth and reproduction of bacteria, protects them from adverse environmental influences, and suppresses the colonization of other pathogens. Here, microorganisms go from an inactive state to an active one, divide and form small clusters - colonies, which are examined by laboratory diagnostic doctors. As the strains grow, the liquid changes from yellow to pink, and on the Petri dish tiny colonies of a round shape with jagged edges and a wrinkled surface are formed. A diagnostician examines strains under a microscope, studying growth patterns, morphology and chemical properties.

Decoding the results

The laboratory diagnostics doctor checks the presence of colonies on the nutrient medium daily. If the crop produces intensive growth, the test result will be positive. Next, an in-depth study of the morphological and chemical properties of the pathogen and determination of its sensitivity to drugs occurs. The absence of colony growth on the medium means that the pathogen is not in the body.

A laboratory diagnostics doctor checks the presence of colonies on the nutrient medium daily

How many days the analysis is done depends on the chosen environment. The results of sowing on a liquid nutrient medium can be assessed after just two days; on a solid nutrient medium, the bacteria growth process takes up to seven days. When compiling an antibiogram, the period is extended by another three days.

Once a pure bacterial culture is obtained, it is Gram stained, examined under a microscope, and a series of indicative chemical tests are performed. To determine sensitivity to antibiotics, automated systems are used - bacteriological analyzers. The laboratory assistant prepares a solution from the culture and places it on the test systems of the device. The culture is again incubated from four hours to two days, depending on the analyzer model. The result is given on paper in the form of a list of drugs marked sensitive, moderately sensitive and resistant (S, I, R).

Decoding the results is not difficult; the form with the results looks like this:

• name of the pathogen in Latin (Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium);
• microorganism concentration is the number of microorganisms capable of forming colonies in 1 ml of biological fluid (CFU/ml). The normal content of the pathogen is no more than 1 * 10 4, a result of 1 * 10 5 or more is considered positive, and high titers indicate an acute infectious process of the genitourinary system;
• list of medications indicating sensitivity.

Treatment methods

Therapy for the disease is carried out according to the results of the sensitivity of bacteria to drugs, taking into account the individual characteristics of the patient: age, presence of chronic diseases, allergies or contraindications to taking certain drugs.

The complex treatment includes:

• use of antibiotics for at least 7 days in doses optimal for each patient;
• correction of immune status;
• local therapy (suppositories, ointments, vaginal capsules);
• physiotherapeutic procedures.

Video

Culture for ureaplasma.

At least a tank. culture for ureaplasma and is considered a less sensitive diagnostic method compared to modern studies such as PCR or ELISA, the results of bacterial culture for ureaplasma are still listened to, but a urine test for ureaplasma is prescribed extremely rarely. Cultures are used to identify a diagnosis, determine the quantitative indicator of viruses in the material, and also when doctors prescribe the appropriate antibiotic for a particular patient.

Unfortunately, this method has several disadvantages compared to more modern diagnostics. Culture for ureaplasma and mycoplasma does not determine the specific type of pathogen (parvum or urealiticum). It is completely unsuitable for growing Mycoplasma genitalia in an artificial environment, because it is slower than other members of the family to be cultivated in an artificial environment. The tank culture for ureaplasma urealiticum also lags behind PCR in its sensitivity. It is only about 45%. The material is very unstable to transportation.

You should not think that bacterial culture for ureaplasma has become obsolete or has already been replaced by other methods. If carried out correctly and correctly interpreted the results, it can indicate the number of viruses in the body. Even more valuable is its value in determining the sensitivity of the pathogen to antibiotics. Based on these advantages, patients with infertility and cervical erosion, colitis and urethritis are increasingly learning how to take bacteriological cultures for ureaplasma.

How is the culture for ureaplasma carried out and how is it taken?

Doctors who have devoted most of their lives to treating infections consider a quantitative test for ureaplasma to be the most reliable result. And it doesn’t matter that someone calls it bacterial culture in the old fashioned way. It’s nice to know that in medicine it is considered a classic and its results are trusted. But still not everyone knows how to take a culture test for ureaplasma.

For ureaplasma parvum, quantitative analysis is carried out on the basis of material in which the presence of the pathogen is suspected. These are secretions formed on the mucous membranes. Samples in women are usually taken from the vagina, from the cervix, or directly from the uterus itself. In men, discharge from the urethral mucosa is taken for analysis. Urine culture for ureaplasma is usually not prescribed because this virus is not present in the urine. If the doctor recommends this urine test, it is only for the purpose of identifying other microbes in the body that may be involved in inflammatory processes.

In order for a doctor to prescribe a culture for ureaplasma parvum there must be good reasons:

• A woman is preparing for a planned pregnancy and undergoes all tests
• Infertility, which cannot be treated in any way and there are no apparent reasons for it
• A questionable PCR result has already been received, but confirmation is required
• Abundance of leukocytes in smears
• Presence of nonspecific flora in the genital area

After the material has been removed for bacterial culture, it must be immediately placed in a special medium. Bacteria will grow there. Agar or sugar broth can be chosen as a nutrient medium.

Results of bacteriological tests

Every patient who has had a culture test for ureaplasmosis thinks that perhaps the results will be comforting and the doctor will rule out the presence of the virus in the body. An analysis for ureaplasma inoculation in a laboratory is obtained no earlier than 48 hours from the moment the material is collected. Sometimes it takes up to 3 days until the results are known. When deciphering tests, the main indicator is the amount of virus. The numbers obtained in the results show whether the presence of the virus is dangerous for the body and whether its quantity causes the diseases that the patient already has.

If there are no viruses in the collected material, the result of such a study will be negative. In this case, no treatment will be required, but if you have symptoms of the above diseases, you will have to look for another source of infection. It could be chlamydia.

When there is a virus in the discharge, the patient receives a positive result, which necessarily indicates the concentration of microorganisms. The norm for inoculating a tank for ureaplasma is 10 4 CFU/mmol. Depending on the patient’s condition and the gender of the person contacting the laboratory, a result of up to 10 5 CFU/mmol can be accepted as the norm. If the culture for ureaplasma exceeds the norm, the patient will be sent for additional examination and further treatment with antibiotics will be prescribed.

When ureaplasma is detected, the culture results are taken into account when determining the method of treating diseases. Bacteriological culture is also used during treatment for intermediate testing. This is how doctors determine the correctness of the chosen treatment. The titers show a decrease in the virus, which means that the treatment is successful and the chosen course can be continued.