Bad tank culture from the cervical canal. Culture from the cervical canal - smear analysis for flora. Decoding the culture tank from the cervical canal

Smear from cervical canal, what kind of research is this, how is it carried out, does it require pain relief, and is it always possible to get a reliable result? These questions are important, since it is taking a smear analysis from the cervical canal (Pap test) and from the cervix that allows for the most early stages diagnose cervical cancer or its underlying diseases, thus getting a chance to prevent the oncological process.

As a rule, when visiting a gynecologist, a woman is always examined in a chair and a vaginal smear is always taken, but it can be examined in different ways. The most common study is on the “degree of purity”, the composition of the microflora (seeding). But their results do not make it possible to judge the likelihood of oncological processes. But cervical cancer is asymptomatic and can be detected in the early stages by examining a smear from the cervical canal.

What you need to know

1. You need to undergo this examination in the middle menstrual cycle. Approximately 5-7 days after the end of menstruation.

2. 2-3 days before this event, you cannot have sex, use vaginal treatments, contraceptives, or douche. Also, during this time, you should not visit a gynecologist or do a colposcopy. Only then will the cytology of a smear from the cervical canal be reliable.

3. It is better to take the test when absolutely healthy microflora. if you have pathological discharge, unpleasant odor from the vagina, itching, rashes - you must first be cured and achieve, preferably, the first degree of vaginal cleanliness. Then there is Great chance the fact that there will be no inflammatory process on the cervix, because it makes the result uninformative. It is advisable to first take a smear for flora from the cervical canal; according to its results, there should be no more than 30 leukocytes in the field of view.

4. You need to get tested once a year. It is especially important to do this for those who have an active sex life, often change sexual partners, and have HPV (human papillomavirus) 16, 18 and other oncogenic types.

5. A doctor should take a smear using special brushes - spatulas. Pay attention to this. They are not always available in antenatal clinics, and doctors can take discharge for analysis directly from a gynecological speculum that touched the cervix. But such an analysis will not be reliable!

6. If there is ectopia, leukoplakia and other changes on the cervix, the material should be taken from them, since these are background diseases for cervical cancer.

7. It doesn’t hurt at all to pass it. This erroneous opinion arose due to the confusion of this study with aspiration of the endometrium - this is completely different, the instruments will not penetrate into the uterus. After taking a Pap test, there may be slight spotting (brown) - this is not dangerous and is normal.

8. When a cervical smear is taken, the norm during pregnancy is the same as outside of it. Another thing is that this examination is not mandatory during pregnancy, unlike microscopic examination smear, which is carried out twice.

Reading the result

Deciphering a smear from the cervical canal is the job of a gynecologist. But you should know that attention is removed by the presence of collected material atypical cells. IN in moderation they can occur during inflammatory processes. That is why we previously wrote that you need to take cytology only when the number of leukocytes does not exceed acceptable limits.

A smear from the cervical canal is normal - this is when atypical (with an altered nucleus) cells are absent. If there are altered cells, a diagnosis of dysplasia (neoplasia) of 1, 2, 3 degrees is made, or cancer - if detected typical type malignant cells.

If grade 1 dysplasia is detected, in the absence of underlying diseases on the cervix, the woman is recommended to be observed. In grades 2 and 3, colposcopy, biopsy, and often conization are required (when the affected area of ​​the cervix is ​​removed with a scalpel or radio knife). The fact is that grade 3 dysplasia often turns out to be cancer in situ. And then the treatment is carried out by a gynecological oncologist at an oncology clinic.

To identify the presence of bacteriologically viable microorganisms inhabiting the cervical section of the uterine body, specialists prescribe bacterial culture (culture of a bacteriological nature). As practice shows, this type of research is most often used in the gynecological and urological field. Tank. sowing in gynecological examination allows you to determine the number and type of bacteria inhabiting the cervix of the uterine organ. With the help of such an analysis, specialists can determine the level of development pathological processes. Almost anyone can be examined biological material, selected in the form of comparative samples, for example, blood, skin, semen, genital mucosa, urine, etc.

Bacterial culture ultimately allows for the creation of an antibiotic chart. Using special methodological technology, such a study of the cervix makes it possible to establish a range of pharmacological (antibiotic and antiseptic) drugs that can destroy unfavorable particles that are pathogens and carriers of infection. Tank. sowing is also carried out for the purpose of diagnosing a positive environment (flora). Using this analysis, it is possible to determine the number of lacto- and bifidobacteria contained in the cervical uterus or any other organ of the reproductive system. The described procedure is capable of identifying and determining the type and nature of fungal organisms. Often sowing bacteriologically selected for thrush.

Additional information about the disease thrush can be found in this video:

What are the features of submitting comparative samples for bacteriological culture?

Tank. seeding, as practice shows, is obtained not only from the cervix of the uterine body, but also from the cervical canal. Such a diagnosis may be planned in order to study the condition of the cervical canal. The following indications are available for taking comparative samples for bacteriological culture:

• In case of planning conception and subsequent pregnancy;
• When identifying inflammatory processes in the cervical part of the uterus;
• In case of detection of affected (abnormal) microflora as a result of a smear analysis (for example, identification of coccal pathogens);
• With an increased level of blood leukocytes;
• In the case of frequent inflammatory processes of the uterine organ and its neck, which are recurrent in nature.

Preparatory stage and carrying out the inoculation bacteriological procedure

Bacterial culture is prescribed exclusively by the treating specialist after conducting a number of other procedural tests. Carrying out the tank. seeding from the body of the uterus, doctors warn the patient who is scheduled to undergo this procedure in advance about observing certain restrictions. In order to properly prepare for a bacteriological examination, you should perform some actions:

• Do not do douching procedures in advance;
• Do not administer vaginal-type pharmacological agents (this includes cream-like preparations and suppositories);
• One day before the diagnosis, avoid sexual intercourse.

Before holding the tank. culture, at least two days should pass after the colposcopic examination. Experts do not recommend performing a bacteriological culture procedure if drug treatment(antibiotic substances in the form of tablets or intravenous infusion). In the next two weeks, the results of such a test will be distorted and will not provide necessary information, reflecting the real state of the genital organs, in particular their microflora.

Taking a bacteriological smear

Tank. sowing can be done on any day of the menstrual cycle. This procedural action is not carried out during menstrual flow, as well as during the next 2 days after its end. Bacterial seeding during gestation is prescribed individually and only by a leading specialist. The collection of comparative material is performed by a gynecologist. Bacteriological culture is done as follows:

• The patient gets rid of shoes and clothing worn below the waist;
• Located on the gynecological examination chair;
• An expansion device (speculum) is inserted into the vaginal area;
• The cervical opening must be treated (with a brush or probe at a depth of no more than 1.5 cm);
• Comparative material is selected;
• The biomaterial is placed in a sterile sealed tube containing a liquid or gel-like medium.

How are the results of bacteriological analysis interpreted?

The taken bacterial culture is processed for at least five days. Comparative samples are placed in an environment favorable for the development of microorganisms. After the specified time has passed for the development of microorganisms, specialists can determine which antibiotic or antiseptic pharmacological agents should be used in treatment. Tank. sowing makes it possible to identify those pharmaceuticals, which have the most detrimental effect on various pathogens.

Based on the results of the bacteriological analysis, a special conclusion is drawn up, drawn up on a form. It displays, first of all, information about the condition of the cervical canal: the microorganisms inhabiting this cavity are listed. If the result is positive (normal), there are no fungal organisms in the cervical canal, but lacto- and bifidobacteria are present in sufficient quantities. There must be at least 107 of them. When E. coli is detected, the norm is determined by the established standard indicator. Their presence is allowed in quantities not exceeding 102 units.

The presence of single (individual) enterococci in the cavity organ is also considered normal. Deviations (pathologies) are the presence of the following microorganisms of bacteriological type:

• Exceeding the normal amount of Escherichia coli and individual enterococci;
• The presence of yeast fungi (especially those containing mycelium);
• Staphylococcus (any type, including aureus and epidermal);
• Citrobacter;
• Protea;
• Gonococcus;
• Trichomonas;
• Gardnerellas;
• Leptothrix.

You can learn more about microorganisms such as staphylococcus from this video:

Tank. culture using conventional techniques may not show the presence of ureplasma, mycoplasma and chlamydia in the uterine cavity. These microorganisms develop at the intracellular level. To detect them, experts conduct research by chain reaction polymerase type (CPR). In addition to the listed data, the results of bacteriological analyzes display the presence of bacteria and their quantity. Based on the results of bacterial culture, leading experts determine the condition of the cervical part of the uterine body, as well as the cervical canal. Inflammatory processes can be caused for various reasons, for example, decreased immunity, failure hormonal levels and so on.

Bacterial culture (bacterial culture) is a study whose purpose is to find out what bacteria inhabit the cervical canal and how many of them live there. When an obviously or conditionally pathogenic microflora is detected, it is also determined which antibiotic or antiseptic drug can destroy this microflora (antibioticogram). The purpose of bacterial sowing is also to study beneficial flora - bifidobacteria and lactobacilli.

This analysis is capable of determining and yeast mushrooms, highlighting their types and determining sensitivity, therefore should be carried out for thrush - to select a rational antifungal therapy.

The essence of the method

With a special sterile brush, its contents are taken from the cervical canal: this is the secretion of local glands and desquamated cells, which will certainly contain microflora. Next, this material is placed in a test tube with a special nutrient medium for most microorganisms. Bacteria and fungi will absorb the substances they need for life and multiply. The main thing is not to create conditions for them during this period that lead to their death: if at least some of them die, the doctor will not be able to cure the woman.

There are nutrient media that do not require the creation of a special environment for them before the test tube with the material gets into the bacteriological laboratory. Such hermetically sealed test tubes can be delivered by the patient herself for testing. In the majority medical institutions after a smear is taken from the cervical canal, the tube is closed and placed in a thermostat, where there is a suitable temperature for the growth of microflora - 37 degrees. Such tubes are also transferred from the treatment room (or gynecologist’s office) under special conditions.

After the test tube enters the bacteriological laboratory, it is opened and the contents are applied to another nutrient medium located in a Petri dish. The cup is placed in a thermostat (a cabinet that maintains the set temperature) for 3-5 days, because the bacteria must grow in sufficiently. Only then can you separate each species, determine the number of units within the species, and conduct tests with antibiotics.

Who needs to get tested

Cultures from the cervical canal must be taken:

• annually – as a planned study;
• when planning pregnancy;
• with inflammation of the cervix;
• if coccal flora is detected in a smear for microflora;
• if present in the smear higher level leukocytes;
• with frequent recurrence of inflammatory diseases of the vagina and external genitalia.

Preparing for the study

To get a reliable result, you need to know how to prepare for the study:

1. do not douche, do not use any suppositories or vaginal creams the day before sowing;
2. exclude sexual activity for 24 hours before taking the test;
3. It is not recommended to undergo examination within two days after colposcopy;
4. If you took any antibiotics in the form of tablets, injections or droppers, the bacterial culture will be uninformative for two weeks after that.

The day of the cycle does not matter, you just don’t need to get tested during menstruation and 2 days after it ends. You can also undergo the study during pregnancy, then the material for culture should be collected only by a gynecologist.

How the procedure is performed

A woman comes into the office, takes off her shoes and clothes below the waist, and lies down on the gynecological chair. A special speculum is inserted into the vagina, and under visual inspection the cervical canal is treated to a depth of 0.5-1.5 cm with a sterile probe or brush. The procedure takes less than a minute. Then the resulting contents are added to a special hermetically sealed tube with a liquid or gel-like medium.

Decoding tank data. cervical culture

The results come no earlier than after 5 days - the period necessary for the bacteria to have time to grow. The analysis form must indicate the microorganisms inhabiting the cervical canal.

Normally, there are no fungi in it, but there are lactobacilli and bifidobacteria in an amount of at least 107. E. coli growth is allowed up to 10 2, single enterococci.

The following are considered pathogenic:

• large quantity Escherichia coli and enterococci;
• yeast fungi, especially if they are described as having mycelium;
• Staphylococcus: epidermal, aureus;
• citrobacter;
• Proteus;
• gonococcus;
• Trichomonas;
• gardnerella;
• leptothrix.

In addition to the type of microorganism and the definition of antibiotics to which it is sensitive, the number of microbes is also indicated. Depending on this, there are 4 degrees of channel purity:

1. bacteria grow only in liquid media;
2. there is already growth on solid media, in the amount of up to 10 colonies of one species;
3. 10-100 CFU on solid medium;
4. more than 100 colony-forming units on solid medium.

The causes of microflora disturbance in the cervical canal are infection through sexual contact or after medical interventions on the uterus or vagina.

Promote the development of the inflammatory process:

• hormonal disbalance;
• decreased immunity;
• inflammation in nearby organs;
• carried out antibacterial therapy;
• poor hygienic conditions.

healthy-lady.ru

Tank culture from the cervical canal: what is it and how is the analysis carried out?

Women's health requires a lot of attention, since the weaker sex is entrusted with such important reproductive function.

That is why regular examinations and consultations, general tests and your own increased attention to everything that happens in the body should be present in the life of every woman.

This category also includes bacterial culture from the cervical canal. Many, however, do not quite understand why this is needed. And what of what he can show is not accessible to a gynecological examination or ultrasound examination.

But as practice suggests, only bacterial culture can highlight the whole picture of the microflora of the cervix and help discover the cause of a particular ailment.

An undoubted advantage is also the availability of this study, its painlessness, ease of implementation and moderate cost. After all, you won’t even need to go to the laboratory: your gynecologist will perform the procedure, and at the next examination he will announce the results. Then a diagnosis will be made and a prescription will be prescribed. adequate treatment. Why is treatment necessary? Because this is not an ordinary procedure and it is prescribed only by observing ideal indicators brush strokes “for cleanliness”...

Tank culture from the cervical canal: what is it?

A cervical canal culture is the same as a smear, but it is taken from the canal that connects the cervix and vagina. Thus, its indicators are “clean” and provide reliable information about the state of the microflora of the cervical area.

Since this type of study is not included in the preventive group, indications are required for it. Namely, an increased number of leukocytes in an ordinary smear. If they are found in the cervical area, this indicates possible diseases from a number of endometritis/adnexitis/other inflammatory processes and the need for their immediate treatment.

And given the fact that the causative agents of such ailments are pathogenic microorganisms (fungi, E. coli, enterobacteria), which quickly adapt to medicines, then you won’t be able to do without antibiotics. But it is not so easy to select them without proper examination.

To "functions" bacterial culture from the cervix can also include the study of sensitivity to antibiotics and the selection of the most effective of them to eliminate the detected disease.

Is it worth saying that the microflora of the cervical canal cannot be sterile? That is, it is in any case inhabited by microorganisms. The only question is how pathogenic they are and at what speed they grow and multiply.

First of all, the presence of mushrooms should be excluded. Their presence, in any case, is not normal and requires immediate antibacterial intervention.

No less undesirable are enterococci and coli, which also indicate an inflammatory process in genitourinary system. But, unlike mushrooms, their single indicators (for E. coli the limit is 10²) are allowed and do not pose a threat to women’s health.

The same cannot be said about staphylococci, gonococci, trichomonas, leptothrix and other harmful microorganisms. Even their lonely representatives are capable of disrupting the healthy balance of microflora, which will certainly affect women's health. And, possibly, the health of the child, if the woman was pregnant at the time of the examination.

A completely different situation is observed with lacto- and bifidobacteria. Their presence is precisely a variant of the norm and, in the absence of an inflammatory process, should be at least 10 to the 7th degree.

If you don't have medical education, and especially not competent in analyses, leave their decoding to a familiar specialist. After all, this is not the case when outside information sources will come to your aid. And if they come, then nothing but broken peace of mind they won't bring it.

First of all, because the results obtained are not just numbers that can be compared with “generally accepted norms.” These are your personal individual microflora indicators. And even a slight “deviation” may be absolutely normal for you, taking into account many factors.

But what then is not included in the norm?

And those results are not included in which bacterial culture detected pathogenic bacteria that are in the growth stage and are actively developing. Moreover, the most important stage of their development is considered to be:

• The first stage demonstrates the slow growth of microorganisms that has been observed in their liquid habitat.
• The second stage indicates the proliferation of bacteria already on a hard surface, but only up to 10 colonies.
• The third stage means an increase in the number of colonies from 10 to 100 and indicates the presence of an inflammatory process.
• The fourth stage exceeds the 100 mark on solid media.

The reasons for such disorders are very diverse and relate to both hormonal levels and condition immune system, personal hygiene and related ailments.

Tank seeding during pregnancy

Often this test is prescribed during the patient’s pregnancy, which justifiably raises her doubts about the safety of this procedure.

But in order not to panic, it will be enough to have basic knowledge of the structure of the small pelvis and possible changes caused by an interesting position. It's about about the color of the cervical canal on early stages: it takes on a bluish tint, which helps determine the presence of a fertilized embryo. Do not forget also about the mucous plug, which forms in this very cervical canal and reliably protects the entrance to the uterus in which your baby grows and develops. She protects from pathogenic microorganisms, which can be detected during bacterial culture.

But, since the plug comes off on the eve of childbirth, it is still worth treating the failure of the microflora during pregnancy. What can we say about isthmic-cervical insufficiency, in which the cervix cannot withstand pressure and begins to open already in the middle of the second trimester.

Against this background, cervicitis (an inflammatory process in the cervical canal) may develop, and, in the absence of adequate therapy, this is a direct threat to pregnancy.

How to prepare for analysis?

First of all, you should figure out whether you need this:

• Are you planning a pregnancy?
• Have you been diagnosed with an inflammatory process in the cervix?
• A normal smear revealed coccal flora and an increased number of leukocytes?
• Do you often worry about gynecological diseases?

If you answered yes to at least one question, you should take a smear for bacterial culture from the cervical canal.

This procedure is painless and only requires you to undress and lie down on the gynecological chair. And the doctor, using a sterile probe mirror, will quickly take a smear, after placing it in a test tube with a special medium.

All that remains is to wait for the results, which will be ready in at least a few days.

Is it worth preparing to collect material? It’s difficult to call this preparation, but you still need to take into account a few rules:

• Before the procedure itself, you cannot perform genital hygiene, douche, or use any vaginal medications.
• You should abstain from sexual activity for a day.
• Antibiotics are excluded when taking tests of this kind. IN extreme cases, you should warn your doctor about this.

Do not forget also about menstruation: during it and for several days after, no smears are taken.

Price for research

Unlike a regular vaginal smear, culture from the cervical canal involves a detailed study of the microflora. And, most often, this procedure is paid.

Unfortunately, it is impossible to give the exact cost of the analysis, since it depends only on the price list of the laboratories available to you. On average, the price range ranges from 400 to 1500 thousand rubles. At the same time, you can choose where your biomaterial is processed. Although, often doctors long time cooperate with the same laboratory, and your analysis will be sent there. Therefore, the announced amount will not be discussed.

However, if you are not satisfied with the cost of collecting the prescribed bacterial culture, you will probably still be given the opportunity to choose another test processing network. But, on the other hand, this may make it difficult to decipher the results obtained, since they will need to be compared with existing ones. And, preferably, they should be from the same laboratory.

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Interpretation of flora culture with determination of sensitivity to antibiotics

Thrush after antibiotics: how to treat and how to treat it. 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 painted in different colors. This feature makes it possible to conduct a qualitative and quantitative analysis of the 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).

Preparation for analysis

• 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 to this study.

Features of collecting clinical material

Microbiological analysis carried out for the purpose of confirmation or exclusion inflammatory lesions infectious nature, determining the composition of microflora with the identification of transient (opportunistic) representatives, their quantitative relationship with healthy bacteria.

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

The composition of the normal microbiota of the female genital organs 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 a 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 performed in the presence of inflammatory diseases of the cervix and vagina, due to the risk of introducing infection into the uterine cavity.

Also 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-, staphyloid 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.

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 chlamydial cervicitis. 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 can be used;
• 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.

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lifetab.ru

Tank culture from the cervical canal

Currently there are many laboratory research, allowing us to determine what caused the development of women's diseases reproductive system. One of the most informative methods used in gynecology, a tank is considered to be inoculated from the cervical canal. It is this analysis that makes it possible to correctly prescribe treatment.

Bacteriological culture is essentially a smear, which is taken directly from the cervix. Taking material from the cervical canal makes it possible to accurately determine the state of the microflora, identify the presence of pathogenic bacteria, and also establish their sensitivity to various groups of antibiotics.

This type of research is indicated in the following situations:

• annual scheduled examination;
• pregnancy planning;
• relapses of gynecological inflammation;
• suspicion of cervicitis (damage to the cervix);
• high level of leukocytes in material taken from the vagina;
• the presence of coccal microflora in the smear to determine purity.

Modern medicine has successfully mastered many techniques for diagnosing diseases. However, such a simple and long-known method as taking a smear during a gynecological examination does not lose its relevance to this day.

Analysis of a gynecological smear will determine the presence of sexually transmitted diseases, inflammatory processes, and the onset of menopause. However, it is impossible to determine pregnancy or AIDS using this method.

The undoubted advantage of this procedure is its accessibility, low cost and ease of implementation. Microflora smear results can be obtained within two days (usually the next day).

A preventive medical examination by a gynecologist involves taking a smear from the vagina, urethra and cervical canal. Any initial appeal regarding complaints of discharge, when registering for pregnancy or during the initial appeal regarding the establishment of the fact of pregnancy, during the treatment period gynecological diseases, before carrying out procedures (installation of an intrauterine device, etc.) are indications for taking a smear.

Direct indications for taking a smear are the following situations:

• The patient complains of itching, burning, discharge with an unpleasant odor and/or color.
• Copious mucous or purulent discharge.

The presence of the above symptoms indicates the development of an inflammatory process caused by a decrease in immunity, the ingress of pathogenic microorganisms (Escherichia coli, cocci, trichomonas, candida, etc.), and the development of thrush.

In women who have no complaints (conditionally healthy), the following are considered indications for taking a smear:

• Conducting an annual medical examination (smear for microflora, degree of purity).
• Control during the course of treatment (antibiotic therapy, hormonal treatment).
• Before performing gynecological manipulations (installation intrauterine device, abortion, etc.).
• Initial contact with a gynecologist.
• It is recommended to take a smear test when changing sexual partners.
• Registration due to pregnancy.

Monitoring the state of the vaginal microflora allows you to start treatment in a timely manner and identify sexually transmitted diseases.

Separate mention should be made of taking smears during pregnancy. The first smear is taken from a woman during pregnancy registration. If the test result is good, then repeat smears will be taken at 30 and 36 weeks.

This frequency of examination allows you to avoid the development of complications during childbirth and after. birth period(the chance of intrauterine infection of the child and penetration of infection into the uterine cavity is excluded).

Preparation

No special preparation is required before taking a smear. Manipulation is not carried out during menstruation (except emergency cases). Most the right time this is the middle of the menstrual cycle, from approximately 9-21 days from the start of menstrual flow.

• The day before the smear test, refrain from sexual contact.
• Stop taking antibiotics or other antimicrobials two weeks before the analysis. If this is not possible, notify the gynecologist before the procedure.
• Do not use candles or lubricants. If possible, do not use scented hygiene products for washing.
• The last urination should be 2 hours before the procedure. This will allow you to collect the most reliable smear from the urethra (since urine will wash away pathogenic microflora).
• Do not use douching on the eve of a visit to the gynecological office!
• Before visiting the gynecological office, you can wash yourself with warm water.

Following these recommendations will allow you to get the most reliable results analysis. Sometimes women try to improve the result of a smear by douching. During the douching procedure, a larger amount of microflora (including pathogenic ones) is washed out of the vagina.

As a result, it is possible to obtain an ideal analysis result. But is it worth doing this? Of course, a categorical no! The gynecologist does not need a perfect analysis of your smear. Your health is important to him. A disease detected in time is much easier to treat than advanced cases. Treat the procedure conscientiously, this will help you maintain your health.

In some cases, with a high level of leukocytes, but no pathogen identified, they are prescribed rerun smear with provocation. Eating salty foods (herring, salted cucumbers etc.) and/or smoked foods, beer, the evening before the smear test is called a provocation.

Methodology

The procedure for taking a smear does not require special conditions. The analysis is taken in the gynecologist’s office, on a gynecological chair. Taking a smear is quick (within 3-5 minutes) and painless. Sterile instruments and gloves are used.

A special gynecological speculum is inserted into the woman's vagina; it allows you to see the cervix as closely as possible. Using a medical spatula, sterile cotton swab or brushes take material from the cervical canal, vagina and urethra (opening of the urethra).

Each analysis is taken with a separate sterile instrument! The resulting analyzes are applied to glass slides with special marks: V – a smear taken from the vagina, C – a smear from the cervical canal of the cervix, U – a smear from the urethra. After the preparation has dried, the material is sent for testing to the laboratory.

The result of the analysis will be ready within 24 hours from the date of submission. The test result is considered valid for 10 days; after this period, a second smear is taken. If you are undergoing gynecological manipulation (for example, installation intrauterine contraceptives), then do not put off visiting a gynecologist. IN otherwise, the procedure will have to be rescheduled.

If the smear is sent for bacterial culture, the test result will appear no earlier than in 5 days. It is impossible to speed up the process because bacteria take time to grow.

A cervical smear (Pap test) is often prescribed to women when examined by a gynecologist. In this article we will try to answer the questions: what kind of study is this, how is it performed, does it require pain relief, is it always possible to obtain accurate data? These questions are important, because the Pap test is uterine cervix makes it possible to detect oncology at the earliest stages and get a chance to prevent the development of cancer.

What is it: a cervical smear

Usually, when visiting a gynecologist, the patient is always looked at in a gynecological chair and a smear is taken from the vaginal area, but she can be examined in various ways. Most in demand medical procedure- this is the “degree of purity”, sowing. However, their results cannot show the likelihood of developing cancer. But a cancerous tumor of the uterine cervix passes without symptoms and initial stage Its development will be revealed by examining a smear from the cervical canal.

What you need to know:

1. The test should be taken during the middle period of the menstrual cycle. About a week after your period stops.
2. A few days before the test, you should not have sexual intercourse, use vaginal devices, contraceptives, or douching. It is also prohibited to go to the gynecological chair or do colposcopy. Only then is it like this cytological examination as a smear from the vaginal area is reliable.
3. It is necessary to take the test if your microflora is completely healthy. If a woman experiences pathological discharge, a foul odor from the vaginal area, itching, or a rash, she must first be treated, it is better if she can achieve the first degree of cleanliness of the vaginal area. Then there is a high probability that there will be no inflammation on the uterine cervix, since it affects the result, making it inaccurate. It is better to take a smear for flora before cytology; there should be no more than 30 leukocytes.
4. A Pap test is allowed once every 12 months. It is especially important to do this for those who often change sexual partners, have HPV 16, 18 and other oncotypes.
5. A specialist should take the analysis using a special medical mini-spatula. Attention! In antenatal clinics, devices are not always available, and the gynecologist can take a smear directly from a special examination mirror that touched the cervix. This analysis It won't be accurate!
6. If there is ectopia, leukoplakia and others on the cervix pathological changes– the material must be taken from them, since this background diseases at cancerous tumor.
7. The collection is not painful. This misconception arose due to the fact that the study is confused with endometrial aspiration - this is completely different, inside female organ instruments do not penetrate. If you bleed after taking a smear, this is normal.

When the test is taken, the norm during pregnancy is the same as outside of it. Another thing is that this study is not necessary for pregnant women, unlike a microsmear examination, which is performed 2 times.

Analysis from the cervical canal: what is it and explanation

The analysis is deciphered by a gynecologist. However, the woman should know that the doctor is looking to see if atypical cells are present in the material that was collected. They may be present in small quantities when there is inflammation in the organ.

That is why it was said above that you should take a smear only when the number of leukocytes does not exceed normal values.

A smear is considered normal when there are no atypical cells. If they are detected, the doctor diagnoses dysplasia of 1, 2, 3 degrees, or oncology - if a typical type is detected cancer cells. If grade 1 dysplasia is detected, if there are no underlying pathologies on the cervix, the patient is recommended to be observed by a doctor.

For grades 2 and 3 pathology, it is necessary to do:

• Colposcopy;
• Biopsy;
• Often also conization.

The fact is that grade 3 pathology usually turns out to be a cancerous tumor in situ. And then the therapy is performed by a gynecological oncologist at an oncology clinic.

Indicators of a smear from the cervical canal during pregnancy

During the period of pregnancy acceptable standards the content of microscopic organisms in the cervical canal is the same. There cannot be leukocytes during pregnancy. However, the number of leukocytes may increase slightly due to hormonal changes in the body of a pregnant woman. Pap test is not mandatory medical research when carrying a baby, but the doctor may prescribe this procedure as a supplement, if you suspect that there is an exacerbation of inflammation or the awakening of hidden genitourinary infection. Inflammation in the reproductive system of a pregnant woman poses a serious threat to the expectant mother and child.

Infections can disrupt pregnancy and provoke:

• Miscarriage;
• Premature birth;
• Weak labor.

Infections can also enter the child’s body during delivery. That is why, when planning conception, doctors advise the woman and her sexual partner to be thoroughly examined and, if there are infections, to treat them completely. Attention! During pregnancy, take more medicines it is forbidden.

Taking a smear from the cervical canal: does it hurt?

In no case, taking the test does not hurt at all. Some women, while carrying a baby, do not even think about the fact that this is the cervical canal and why it is needed in the body at all. Others, on the contrary, carefully study this information, since they have been diagnosed with isthmic-cervical insufficiency.

This means the incompetence of the uterine cervix, which opens already in the first stages of bearing a child and cannot hold the developing fertilized egg.

Usually, this happens at 16-18 weeks, when the child is rapidly gaining body weight, and is also actively moving. With isthmic-cervical insufficiency, there is a risk of threatened miscarriage. The reason for the development of this situation may be a large number of male sex hormones, which make the uterine cervix softer and looser. Another reason for the deficiency may be multiple pregnancy, which puts strong pressure on the cervix. Other causes of pathology include injury to the uterine cervix and abnormalities of its development.

A timely visit to the doctor makes it possible:

• Quickly diagnose pathology;
• Carry out treatment;
• Save pregnancy.

Sometimes the doctor may prescribe surgery, and stitches will be placed, they will prevent the canal from opening. When the time comes to deliver the baby, these stitches will be removed. In some cases, especially after the 24th week, the gynecologist may use some medical devices - gynecological rings, pessaries.

What is a cervical smear (video)

Attention! A woman must undergo preventive gynecological examination, at least once a year, preferably more often. This will help prevent the development of terrible pathologies, for example, a cancerous tumor, which in the first stages of development can be asymptomatic.