A culture tank is taken from the cervical canal. When and why is a smear for bacterial culture prescribed? Why is bacterial culture needed during pregnancy?

Today the tank is seeded from cervical canal is one of the most convenient tests aimed at studying the microflora of the female genital organs. It helps in diagnosing various inflammatory processes and diseases, allowing the doctor to prescribe the most effective treatment.

Unlike other tests of this kind, bacterial culture from the cervical canal allows you to study the reaction of bacteria and viruses to resistance to antibiotics. This sowing option is carried out using two methods: the standard disk method and the diffusion method. In the first case, special disks soaked in antibiotic concentrate are lowered into a container with microorganisms grown in a nutrient medium.

In the second case, the vaginal culture is tested for sensitivity to the antibiotic using paper strips on which the drug is applied. It is important to know that antibiotics taken by the patient within a month before the start of the study greatly distort the result. Such facts must be reported to the doctor before the culture is performed.

In addition, experts prescribe for patients with various forms vulvovaginitis, as well as when gram-negative diplococci are detected in a gynecological smear of a pregnant woman.

Decoding the culture tank from the cervical canal

How accurately and completely the deciphering of the culture tank from the cervical canal will be carried out directly depends on the experience and qualifications of both the laboratory technician who conducted the study and the doctor. Tank seeding allows you to determine the presence, degree of growth and quantity pathogenic microorganisms. Positive result analysis is marked in four different degrees:

• 1st – poor growth of bacteria, observed only on a liquid nutrient medium;
• 2nd – growth of bacteria of one species (numbering up to 10 colonies) on a solid nutrient medium;
• 3rd – from 10 to 100 colonies on a dense medium;
• 4th – more than 100 colonies.

The definition of the first and second degrees means increased contamination of the vaginal microflora, and the third and fourth clearly indicate that the inflammatory process was caused by this particular type of bacteria.

The reasons for the result of the 1st and 2nd degrees may be violations hormonal levels, metabolic problems, poor attitude to personal hygiene, weakened immunity, changes in the vaginal microflora after taking anti-inflammatory and antibacterial drugs, as well as the presence of inflammatory processes in other organs genitourinary system.

How to donate a tank culture from the cervical canal

Before donating a culture tank from the cervical canal, you must remember that the day before the analysis, douching and sexual intercourse are excluded, and the administration of any medications and hygiene products in the vagina. These include candles, ointments, creams, deodorants, etc.

Fence biological material is produced directly from the cervix, which is also called the cervical canal. To take the material, a thin probe is inserted and plunged into the canal approximately 0.5-1.5 cm. Despite the fears of patients, especially pregnant women, this is not painful and does not threaten the child in any way, because the cervical canal is quite long and its epithelium is quite elastic.

If you have come a long way towards the desired conception, you will understand how much happiness two lines on a test or hCG tests cause. But don’t forget that danger is still around you.

To avoid troubles and keep the child, you need to consult a gynecologist (and be sure to register with him) and tell him about everything that worries you. This is actually very important, especially after years of trying to get pregnant without success.

Culture from the cervical canal during pregnancy is one of the main tests on which the next 9 months depend. Most microorganisms accumulate in this place, which can harm the mother and child. Bacterial culture allows you to find harmful microorganisms. After receiving the results, you can begin treatment, which will increase the chance of a successful birth.

The cervical canal (os) is an organ that acts as a bridge between the vagina and the uterus. This is a kind of road for sperm that are sent to fertilize the egg. And also the place through which blood clots come out during menstruation. The width of the throat is approximately 7.5 mm. With age, the size may change, exactly the same as with infection or hormonal imbalance.

During pregnancy, the length of the cervical canal also changes. Usually for pregnant women the length is 3.5 mm, and the neck is at least 20 mm.

Both channels close together and open only before the birth of the child, so doctors determine the approximate date of birth. A plug forms near the pharynx; its function is to maximally protect the child from harmful environmental influences.

The plug removes itself two weeks before the baby is born.After this, you should be extremely careful and careful. The cervical canal widens by 9 cm during labor to allow the baby to come out.

Analysis from the cervical canal during pregnancy is alternative possibility learn about threats that can harm a child and a woman, and also assess the sensitivity of bacteria to antibiotics.

Preparation

In order to get the maximum accurate results Before collecting the material, you must follow the gynecologist’s recommendations for two days. If the analysis is false, incorrect treatment can cause significant harm healthy body.

• do not take any antibacterial medications;
• stop douching;
• do not use local contraceptive, for example, candles and creams;
• do not have sex for 1-2 days;
• It is not recommended to carry out an examination in mirrors before taking the test;
• Immediately before the analysis, it is forbidden to shower or visit the toilet.

Study

A smear from the cervical canal during pregnancy causes concern among patients. This is due to the fact that a probe is used to obtain the material. It is lowered to a depth of 1.4 cm. But does this method lead to spontaneous abortion? There is no need to worry, since doctors have verified that the method is completely safe. In addition, such an analysis is not prescribed just like that.

Collection of material occurs quickly, approximately 30 seconds, sometimes up to 1 minute. Injected before the probe gynecological speculum, and then a brush is lowered into the pharynx, no more than 1.9 cm. The biomaterial is packaged in sealed container with a special liquid and sent to the laboratory for testing.

The procedure must be carried out by a highly qualified specialist. The results are ready on the fifth day.

Decoding

Deciphering cultures from the cervical canal during pregnancy does not represent special labor, if the tests show normal. Since it contains only bifidobacteria and lactobacilli. In the cervical canal during pregnancy there may be coli no more than 10 to the second power. Other organisms should not be contained in the pharynx.

At bad tank sowing the following results are observed:

• increased concentration of E. coli;
• microscopic fungi;
• diplococcus of the genus Neisseria;
• Trichomonas vaginalis;
• Gardnerella vaginalis.

And also to negative result The smear includes staphylococcus of all types during pregnancy in the cervical canal. Unfortunately, the test cannot show the presence or absence of ureaplasma, chlamydia, and mycoplasma.

The diagnosis is made not only based on the results obtained, but also on the intensity of growth of these microorganisms. For example, if all the biomaterial germinates too slowly, this indicates that it is not sufficiently sterile. That is, when preparing the nutrient medium, mistakes were made or the rules were not followed.

About the need for urgent treatment may indicate >100 colonies of microorganisms. The reasons for such an active inflammatory process may include: non-compliance with hygiene rules, chronic diseases, insufficient immunological reaction of the body. It is important for the gynecologist to take correct solution about treatment. it is prescribed purely individually, depending on the case.

Interpretation and delivery of culture tanks from the cervical canal during pregnancy - important procedure, the purpose of which is to prevent serious illnesses caused by microorganisms. At the first stages of the appearance of deviations, it is easiest to carry out a special course conservative therapy than getting rid of significant inflammation. Therefore, it is recommended to take a throat culture test before pregnancy, so that the treatment does not affect the child in any way.

On this moment in gynecology, one of the most effective, convenient and useful methods for diagnosis is culture from the cervical canal. According to its results, it is possible to prescribe an effective treatment that is most suitable for the patient.

What is tank seeding? This is special laboratory analysis, thanks to which doctors have the opportunity to establish almost all types of microorganisms, if the material for bacterial culture is taken in the form of a scraping from the cervical canal. These microorganisms can cause inflammatory processes, and their identification will allow you to avoid many problems through timely treatment.

If you take a scraping from the cervical canal, you can identify not only the presence and number of microorganisms, but also identify their reaction to the antibiotics used. First, a culture is taken from the vagina. You can then use one of two methods. In the first case, standard disks are used. These are special board-shaped plates that are impregnated with concentrated antibiotics, and then dipped into the microflora and their behavior is observed. In the second case, determining the behavior of microflora consists of using strips of special paper, which are dipped into a concentrate of microorganisms, after which their growth is observed.

It is important to remember that the use of antibiotics is prohibited a month before you need to take a microflora culture. This can dramatically skew the results. Even in normal and relatively healthy body lactobacilli, E. coli and other types of microorganisms can be found in permissible norm, when data is decrypted.

Sowing tank allows you to identify microorganisms that lead to the onset of inflammatory processes: staphylococci, citrobacter, enterococci, yeast fungi, Protea and Escherichia coli.

This analysis is mandatory during pregnancy, in the presence of inflammatory processes in the reproductive system, in chronic vulvovaginitis and in case of relapses of these ailments after treatment. Held additional analysis if diplococci have been detected in a pregnant woman.

Preparing for analysis

In order for the scraping from the cervical canal to be complete and reliable result, it is necessary to properly prepare for the process of conducting such an analysis as bacteriological culture to the flora. To do this, you must avoid sexual intercourse and douching the day before the scheduled test. Tank culture from the cervical canal will have a more reliable result if no other medicinal preparations, which need to be inserted into the vagina and other genital organs. If you need to take a culture for microflora, then the use of deodorants and creams for intimate areas is strictly prohibited.

Carrying out microflora analysis

Most often, the analysis is carried out by an obstetrician antenatal clinic. It is forbidden to wash before taking tests. The woman should lie down on the gynecological chair. Next, the obstetrician, using special instruments, inserts a mirror surface and takes a smear. It must be taken from the cervical canal.

The woman should not feel any pain, she may just experience some discomfort, but the sterile probe used in the procedure is quite thin. The procedure does not take much time. Doctors recommend this procedure at least once a year, which will allow you to deal with problems in a timely manner.

Decoding analysis data

Accurate and correct decoding analysis indicators depends on the level of competence of doctors.

The indicator is considered positive if tests have shown the presence of microorganisms; their level of development and growth rate can be determined. The first degree refers to the case when microorganisms show meager growth. They are present in liquid media, but absent in solid media. In the second degree, microorganisms of the same type can show growth of up to 10 colonies on a hard surface. At the third level, their number can be up to 100 colonies on a solid medium. At the fourth level, the number of colonies exceeds one hundred. The first two levels inform that the nutrient medium is contaminated, and the third and fourth levels show the degree of the inflammatory process.

The reasons for this may be metabolic disorders, weakened immunity, failure to comply with hygiene standards, hormonal imbalances or hereditary phenomena.

Cervical culture is an important laboratory test that helps prevent any pregnancy complications due to any bacteria or infections. It is best to carry it out on early stages or during the planning period, which will protect the child from illness. The disease can be cured before labor begins, and the baby will be born healthy.

A smear on the flora is a basic and mandatory test when visiting a gynecologist. This method helps to identify the inflammatory process on early stages, differentiate the type of pathogen, determine the degree of vaginal cleanliness and the presence of dysbiosis.

The collection is carried out by a gynecologist from the vagina, cervix and external urethral opening. The resulting samples are placed on a glass slide, dried and transported to the laboratory for further microbiological study.

Information content is based on the fact that different cells and bacteria are stained various colors. This feature allows for high-quality and quantitative analysis composition of the flora and identify pathological deviations.

Using a smear, determine:

• content of erythrocytes and leukocytes in secretions;
• qualitative composition of microflora and degree of vaginal cleanliness;
• pathogens of sexually transmitted diseases (gonorrhea, trichomonas, ureaplasma);

A tank culture for flora and sensitivity to antibacterial agents is carried out if there is a suspicion of an inflammatory process in the pelvic organs and grade 3-4 violations of vaginal cleanliness.

Sowing is a cultural method and differs from a smear in that the material is placed in an environment favorable for potential pathogens, followed by a study of their reaction to the applied agents. antimicrobial agents.

A significant disadvantage of the study is its duration. Depending on the pathogen, culture for microflora and determination of sensitivity to antibiotics can take from 3-5 days to several weeks.

Related to this high frequency empirical prescription of antibacterial drugs, based on the choice of drugs with the maximum wide range action affecting all suspected pathogens.

For quick diagnostics specific pathogens (sexually transmitted diseases) using polymerase chain reaction (PCR) or linked immunosorbent assay(ELISA).

• sexual intercourse and use vaginal methods contraception;
• douching, administration of vaginal creams and suppositories.

It is advisable to carry out a smear at least two weeks after discontinuation of antibacterial drugs due to high risk false negative results during antimicrobial therapy.

The period of menstruation and two days after its end are considered contraindications for this study.

Features of collecting clinical material

Microbiological analysis is carried out to confirm or exclude inflammatory lesions infectious nature, determining the composition of microflora with the identification of transient (opportunistic) representatives, their quantitative relationship with healthy bacteria.

IN normal conditions the mucous membrane of the uterus and tubes is sterile due to the content of lysozyme in the secretion of the cervical canal, which has an antimicrobial effect.

The composition of the normal microbiota of the genital organs in women is relatively stable. Minor changes and differences that are not considered pathology may be caused by:

• age characteristics;
• pregnancy;
• hormonal changes.

Vaginal smears

Samples for microscopy are collected from the mucosa posterior arch or from inflammatory areas. After the speculum has been inserted, the discharge is collected onto a sterile cotton swab. To further study the stained smear, the discharge is transferred to a piece of glass by rolling the swab over the glass. Next, the smear is dried and fixed with ethanol.

If necessary, conduct a cultural study (culture for antibiotics from the vagina to determine the susceptibility of pathogenic microorganisms to various drugs) the swab must be immediately placed in a sterile container and sent to the laboratory.

Urethra

Sample collection is carried out in the tank. loop, after cleaning the external opening of the urethra with sterile gauze. The loop is inserted into the urethra, no deeper than two centimeters. Next, for microscopy and ELISA, the sample is distributed onto a glass slide. When performing culture analysis and polymerase chain reaction, the material is placed in a container containing a special medium and delivered to the laboratory.

Cervix

The sampling is carried out after opening the cervix in the speculum and carefully processing its vaginal part. solution. The tampon must be inserted into the cervical canal, being careful not to touch the vaginal walls.

If it is necessary to perform a culture test from the cervical canal for sensitivity to antibiotics, the swab is placed in a special medium for further transportation and sent to the laboratory.

When collecting material for microscopy, ELISA, PCR and virological research A special swab brush is used to obtain cell scrapings. The collection must be carried out extremely carefully so as not to injure the mucous membrane and prevent blood from getting on the tampon.

Contrary to popular belief, the procedure is not contraindicated for pregnant women and cannot cause miscarriage or harm the unborn child.

Uterus

A special probe is inserted into the uterus through the cervical canal, with further aspiration of the pathological contents. Strict adherence to asepsis rules is necessary. The procedure is not carried out if there is inflammatory diseases cervix and vagina, due to the risk of infection entering the uterine cavity.

Also, it is contraindicated during pregnancy.

Appendages

The collection of material is carried out during puncture of tumor-like formations or surgical intervention. As a rule, pus and exudate are used for culture.

External genitalia

The sample is taken from inflammatory areas. In case of damage to the Bartholin glands (large glands of the vestibule), a puncture is performed, followed by taking pus for culture.

Indicators of healthy microflora

The composition of the flora directly depends on:

• patient's age;
• hormonal levels;
• the presence of infectious and inflammatory diseases;
• background pathologies;
• taking medications that disrupt the healthy balance of microorganisms and bacteria (antibacterial drugs, long-term use of antifungal and non-steroidal anti-inflammatory drugs, cytostatics, hormones).

Vaginal microbiocenosis in a child begins to form after birth due to lactobacilli obtained during childbirth from the mother (anaerobic lactobacilli-bacillus Dederlein). This composition lasts up to several weeks, maintaining an acidic reaction. Further, the pH becomes neutral and remains so until puberty. At this stage, conditionally pathogenic bacteria (corynebacteria, strepto-, staphylo- and enterococci, anaerobes) are included in the flora.

After the onset of puberty and the increased influence of estrogens, the amount of glycogen (a substrate for the proliferation of lactobacilli) increases. As a result of the further predominance of lactobacilli and their production of acids from broken down carbohydrates, the pH decreases to 4.0-4.5.

Maintaining pH by lactobacilli vaginal discharge at this level, ensures a healthy balance of flora, suppresses the activity of opportunistic bacteria and supports natural resistance.

Purity levels

The division into degrees of purity is based on the qualitative indicators of the microflora and the quantitative ratio of healthy and opportunistic bacteria.

The predominance of yeast flora is characteristic of thrush.

This condition may indicate a violation of the vaginal microbiocenosis after a long course of antibiotics, cytostatics, NSAIDs or hormones.

Based on the nature of the microorganisms in the smear, the flora can be determined:

• mixed (typical for puberty, the beginning and end of menstruation, menopause, ovarian hyperfunction syndrome, some venereal diseases). To clarify the diagnosis, it is necessary to count leukocytes in the field of view and do ELISA or PCR;
• rod (gardnelosis or vaginal dysbacteriosis);
• lactobacillary (completely healthy indicators);
• coccobacillary (venous diseases, bacterial vaginosis).

Tank culture for flora with determination of sensitivity to antibiotics: interpretation, norms.

The easiest to carry out and the most common in clinical practice, is a method of diffusion of standard paper disks moistened antibacterial drugs, into a Petri dish filled with nutrient medium. The discs are laid on the surface of the agar, maintaining a distance of two centimeters from the edge of the plate and from each other.

After the bowl has stood at room temperature, it is moved to the thermostat.

The holding time in the thermostat is different for each representative of the flora. The standard incubation period is three to five days.

• the absence of growth retardation indicates complete resistance of the microbe to the agent used;
• a ring around a paper disk, up to 1.5 cm in diameter, indicates a weak reaction. This drug, will also not be effective in treatment;
• zone from 1.5 to 2.5 cm indicates standard sensitivity and moderate clinical effectiveness;
• hypersensitivity to the drug, characterized by an area of ​​more than 2.5 cm.

Example

The patient was diagnosed with chlamydia. For empirical therapy, in in this case, Azithromycin ® or Doxycycline ® are recommended. The choice was made on the first drug. Treatment has begun. Clinically, the patient's condition improved.

In the sowing results:

Interpretation of culture for microflora and sensitivity to antibiotics:

These results show that the treatment was chosen correctly.

• the pathogen has high sensitivity in relation to Azithromycin ® , Erythromycin ® and Josamycin ® could also be used for treatment;
• moderate sensitivity to Dokycycline ® is acceptable;
• resistance to Levofloxacin ®, Ofloxacin ®, Moxifloxacin ®, Amoxicillin/clavulanate ®;
• absolute resistance to Ceftriaxone ® .

Carrying out an E-test

Determining susceptibility to antimicrobial agents is similar to the disk diffusion method, however, instead of disks moistened with antibacterial agents, an E-test strip is placed in the agar. It marks different levels of antibiotic concentration, ranging from maximum to minimum.

The minimum inhibition concentration is determined at the intersection of the test strip and the growth inhibition zone.

This method is simple, but quite expensive; therefore, disk diffusion is used more often.

The female reproductive system is a complex complex of organs that not only ensures the birth of children, but also plays a vital role in female body. Whether all the organs of a woman’s genitourinary system cope with their functions ultimately determines her well-being, mood, and in some cases, her overall health.

The most common diseases affecting women reproductive organs, include, in particular, cervical ectopia, endometriosis and uterine fibroids.

Reasons for the development of cervical ectopia

Cervical ectopia (the term “ectopia” has long replaced the outdated term “erosion”) can have different origins. This ectopia of the cervical epithelium, cervical pseudo-erosion, cervical erosion, endocervicosis. In the practice of a gynecologist, there are ectopias that are traumatic in nature, but much more often specialists have to deal with ectopia infectious origin. The most common cause of the development of cervical ectopia is viral infections(mainly human papillomavirus, HPV), less often - bacteria.

Treatment of ectopia

The main difficulty in treating diseases of this group is timely diagnosis: Unfortunately, despite the abundance of information about the importance of regular visits to the gynecologist, many patients still skip annual preventive examinations, applying for medical care just on late stages diseases.

Prevalence of cervical ectopia

The problem of cervical ectopia is extremely common: one or another disease from this group is found in every second woman who turns to a gynecologist with complaints of discomfort, pain during sexual intercourse, bloody discharge during sexual intercourse (the so-called contact discharge). The latter already indicates that the process is neglected. If the cause of ectopia is infectious process, then the woman is worried about the discharge.

What tests need to be taken?

If cervical ectopia is suspected, a study is performed PCR method to detect human papillomavirus, as well as bacterial culture to detect staphylococcus, streptococcus, e. coli and other bacteria that can cause inflammation of the cervix - endocervicitis. Patients are also checked for the presence cytomegalovirus infection and herpes virus. All these tests can be performed in the Zdorovye network of clinics, as well as transvaginal ultrasonography. It is advisable for patients with ectopia to undergo extended colposcopy with various tests to exclude malignant changes in the cervix.

Consequences of HPV

When high HPV is detected oncogenic risk Patients must be prescribed treatment to prevent the development of cancer. However, cervical cancer is not the only problem associated with ectopia: patients often complain of decreased fertility, libido ( sexual desire) therefore, cervical diseases must be treated regardless of the presence or absence of a risk of developing cancer due to ectopia. If necessary, doctors at clinics in the Zdorovye network perform cauterization of ectopia using electrocoagulation and pharmaceuticals.

Endometriosis: symptoms

Another extremely common gynecological problem is endometriosis, a condition clinically manifested by chronic nagging pain in the lower abdomen. The pain may be constant. Endometriosis is also characterized by the presence of brown spotting discharge before and after menstruation. Sami menstrual bleeding against the background of endometriosis, they become abundant and painful.

Causes of endometriosis development

Endometriosis is a consequence varicose veins pelvic veins, circulatory disorders in the pelvis. That is why endometriosis is often detected in professional athletes, young and practically healthy women: intense physical exercise can provoke circulatory problems, which, in turn, lead to endometriosis.

Diagnosis of endometriosis at the Zdorovye clinic

To diagnose endometriosis, the Zdorovye network of clinics performs an ultrasound examination, in which the doctor usually detects an enlarged uterus with characteristic growths.

How to prevent endometriosis?

You can prevent the development of endometriosis by limiting physical activity and avoiding activities that require excessive effort. Such prevention is especially important for women whose relatives suffer from endometriosis: it has been proven that a predisposition to this disease is inherited.

To treat endometriosis, the Zdorovye clinic network uses drugs that relax the uterus. If endometriosis develops against the background of inflammation, we also treat the cause of the inflammation, and in the later stages of endometriosis we use hormonal drugs. However, it is better to organize treatment in such a way that the need for prescription hormonal drugs did not arise.

Consequences of untreated endometriosis

Untreated endometriosis can cause infertility or uterine fibroids. The latter is a fairly common complication of the nodular form of endometriosis, but it can also develop as independent disease.

Uterine fibroids: symptoms

In general, uterine fibroids are benign tumor, arising in the muscular layer of the uterus, myometrium. Characteristic manifestations fibroids are pain in the lower abdomen, intermenstrual bleeding, heavy and prolonged periods and pain during bowel movements.

When should you visit a doctor?

Uterine fibroids often develop in young girls, including those who have not given birth and are not sexually active, as well as in adult women aged 25 years or more. Since it is impossible to predict the appearance of fibroids, all women, starting from the moment their menstruation appears, should regularly visit a gynecologist and undergo all necessary examinations, including ultrasonic ones.

Treatment of uterine fibroids

If a fibroid is detected, we begin to monitor it. Signs active growth neoplasms are an indication for use medicines, including drugs that cause a reversible condition similar to menopause. Since the growth of fibroids depends on female sex hormones, it stops during artificial menopause.

Consequences of an advanced disease

In advanced cases, the myomatous node can become necrotic and cause septic conditions, which can be fatal. dangerous condition. But even in the absence of such serious complications fibroids can significantly worsen the quality of life, for example, causing infertility.

How to avoid female diseases?

Prevention, diagnosis and treatment gynecological diseases should become an integral part of life modern woman who takes care of herself and values ​​her health. That is why you should not put off visiting a gynecologist, even if there is no reason to worry.