Gardnerella: The Norm In Analyzes In Women

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Gardnerella: The Norm In Analyzes In Women
Gardnerella: The Norm In Analyzes In Women

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The microflora of the vagina of healthy women is mainly composed of neutral microorganisms - lactobacilli, which play a protective role. A decrease in their concentration leads to the active growth of opportunistic bacteria colonies, which are normally found in a minimum amount. These microorganisms include gardnerella vaginalis, which contributes to the development of bacterial vaginal dysbiosis, nonspecific vaginosis in women.

Photo of gardnerella under a microscope
Photo of gardnerella under a microscope

Gardnerella vaginalis (Gardnerella vaginalis) is a gram-variable, predominantly gram-negative, capsule-free small bacterium localized in the vagina, urinary tract. Shows activity, can normally exist both in aerobic and anaerobic environments, but the preferred conditions for growth and vital activity of colonies is the absence of oxygen.

The number of gardnerella is limited by lactobacilli and other neutral microorganisms. Various factors, functional failures, systemic, chronic pathologies lead to an increase in their concentration in the vaginal environment, active reproduction. Note that gardnerellas are able to create optimal conditions for the development of other pathogenic microorganisms, infectious agents in the vagina.

Content

  1. Causes of bacterial vaginosis, gardnerellosis
  2. Symptoms
  3. Diagnostics
  4. Tests for gardnerellosis
  5. Quantitative PCR (gardnerella vaginalis DNA)
  6. Florocentosis, femoflor
  7. Decoding, test results
  8. Treatment
  9. Metronidazole
  10. Antibiotics
  11. Candles
  12. Folk remedies
  13. Prevention
  14. Output

Causes of bacterial vaginosis, gardnerellosis

About 19 species of various microorganisms live on the vaginal mucosa. Approximately 93-95% of the total vaginal biocenosis is occupied by lactobacilli. By producing lactic acid in the process of metabolism, inhibiting the activity of pathogenic flora in tissues, they provide resistance (stability) of the vaginal environment, performing a protective function.

Normal pH of vaginal contents is 3.7-4.5. The acidic environment inhibits the growth of pathogenic, opportunistic flora, which include gardnerella and other anaerobes. An increase in their concentration leads to the development of vaginal dysbiosis, other diseases, pathologies in the organs of the genitourinary tract.

Causes of gardnerellosis:

  • acute, chronic diseases of the organs of the genitourinary system of inflammatory etiology;
  • lack of hygiene;
  • stagnant processes, diseases in the pelvic organs (urethritis, endometritis);
  • frequent douching with chlorine-containing agents;
  • the use of vaginal antiseptics that have a detrimental effect on the beneficial microflora;
  • immunodeficiency states, autoimmune diseases;
  • intestinal dysbiosis;
  • fungal infections;
  • decrease in general resistance, local, general immunity;
  • endocrine disruptions, diseases (diabetes mellitus);
  • the use of contraceptives with 9-nonoxynol (vaginal suppositories, tablets).

Despite the fact that gardnerella is not a sexually transmitted disease, the main route of transmission of vaginal gardnerella is sexual, oral-genital, anal contact.

An increase in gardnerella is facilitated by a sharp change in the imbalance of the vaginal microflora, the growth of colonies of facultative anaerobic bacteria due to hormonal imbalance, and prolonged use of certain medications (complex antibiotics).

Systematic wearing of tight synthetic underwear, unbalanced diet, bad habits, also provoke the growth of opportunistic flora.

It is not necessary to exclude the vertical route of transmission of bacteria - from mother to child, as well as the contact-household route of infection, since according to studies of Gardnerella vaginalis, they were identified in adolescents, virgins who are not sexually active.

Symptoms

Gardnerellosis in women in the initial stages of development is often asymptomatic. The incubation period ranges from several days to several months.

In terms of symptoms, the disease is similar to fungal infections. In the case of an increase in concentration more than the permissible norm, opportunistic bacteria release specific substances, which leads to the appearance of a sharp unpleasant odor, reminiscent of rotten fish, which intensifies after unprotected intercourse.

Gardnerella symptoms in women, yellow discharge
Gardnerella symptoms in women, yellow discharge

The main symptoms of vaginal dysbiosis:

  • abundant vaginal discharge of a grayish, yellow-gray, greenish color;
  • itching, burning in the genital area;
  • redness of the vaginal mucosa;
  • pain, discomfort when urinating;
  • painful intercourse;
  • periodic aching pain in the lower abdomen.

Gardnerellosis increases the risk of developing inflammatory diseases, leads to complications during pregnancy, miscarriages, ectopic pregnancy, and menstrual irregularities. The chronic course of the infection can become one of the causes of infertility.

In men, vaginal gardnerella causes urethritis, balanitis, prostatitis, burning sensation when urinating. Symptoms appear periodically and subside over time, even if no treatment has been carried out.

Diagnostics

An accurate diagnosis of vaginal bacteriosis cannot be made based solely on symptoms, gynecological examination data due to the similarity of clinical manifestations with other diseases, and also due to the fact that bacteria are found in healthy women.

Indications for diagnostics:

  • suspected bacterial vaginosis;
  • planning pregnancy;
  • frequent miscarriages, problems with conception;
  • complications during gestation;
  • inflammatory processes in the organs of the genitourinary system;
  • cervical, vaginal discharge;
  • painful periods;
  • preparation for IVF;
  • problems with conception.

If you suspect a vaginal infection, we recommend that you undergo a comprehensive examination at the clinic.

Tests for gardnerellosis

To determine the concentration of gardnerella, a number of laboratory tests, analyzes, differential diagnostics are prescribed:

  • Quantitative PCR;
  • Bimanual research;
  • Florocentosis and NCMT;
  • Florocentosis and NCMT and microscopy;
  • Microscopy of a vaginal smear. Sowing for research is carried out on solid nutrient media.

Additionally, serological tests (blood tests), pH-metry (determination of the acid-base balance of the vaginal environment), amine tests to identify chemical compounds produced by anaerobic bacteria are used. Also, tests are prescribed for the presence of sexually transmitted infections.

Quantitative PCR (gardnerella vaginalis DNA)

PCR for gardnerella (polymerase chain reaction) is one of the most reliable tests for the qualitative determination of the DNA of pathogenic bacteria in biomaterial taken from the urogenital tract. For analysis, a smear is taken from the vagina (in men from the urethra), urine.

Analysis benefits:

  • high accuracy of the result (98%);
  • maximum information content;
  • quick results (up to 6-8 hours after the analysis);
  • ease of sampling biomaterial;
  • the possibility of carrying out at any stage of pregnancy;
  • the effectiveness of the technique in the presence of concomitant diseases, inflammatory pathological processes.

A DNA test for gardnerella vaginalis should be taken for women 2-3 days before the onset of estrus or three days after menstruation. On the day of the examination, you cannot use intimate hygiene products, do not douche, refrain from sexual intercourse. Stop taking antibiotics a month before taking tests, and stop taking hormones and other medicines a day.

The detection of gardnerella in a smear is a reason for further research, such as florocentosis, femoflor-8, NCMT florocenosis. These methods make it possible to determine the ratio of lactobacilli and opportunistic microorganisms (mycoplasma, fungi, anaerobes) in the urogenital tract of women of childbearing age in real time.

Florocentosis, femoflor

Florocentosis is a complex of PCR tests, which are used in gynecology to diagnose infectious and inflammatory diseases in women, to identify and differentiate sexually transmitted pathogens. The test is indicated for carrying out in the presence of pronounced manifestations of genital infections.

Florocenosis NCMT is the most informative complex diagnostic method with real-time detection by Real-time PCR by the method of clinically significant pathogenic microorganisms such as infections such as trichomoniasis, mycoplasmosis, gonorrhea, chlamydia. For research, scrapings of epithelial cells of the urogenital tract are taken.

The Femoflor-8 complex is performed to analyze the biocenosis of the vagina. It is prescribed in the presence of symptoms of bacterial vaginosis, nonspecific vaginitis, and other inflammatory infections, as well as to monitor the effectiveness of the therapy used one month after treatment.

Decoding, test results

The norm in the analyzes - gardnerella vaginalis was detected in minimal amounts or fragments of bacterial DNA in the test material are absent at all.

Microorganism test results
Microorganism test results

If the number of gardnerella is 10 6-10 7 and their number is constantly growing, a diagnosis of gardnerella, bacterial vaginosis is made. If the number does not exceed 10 5, there is no cause for concern. In this case, there is no need to treat gardnerella.

If the DNA of bacteria in the biomaterial is present in a small amount, there are no signs of genital infections, inflammatory processes, diseases of the genitourinary system, a woman is a carrier.

Treatment

Therapy is prescribed by the attending gynecologist, taking into account the diagnostic data. Antibiotics of general, local action in the form of tablets, vaginal suppositories, hormonal drugs, immunomodulators, prebiotics, antimicrobial agents are used.

Complex therapy is aimed at reducing the number of pathogenic pathogenic agents, normalizing the vaginal microflora with drugs. If vaginal bacteriosis causes inflammation, anti-inflammatory drugs are prescribed.

During treatment, doctors recommend sticking to a diet, limiting the use of fatty, spicy foods, marinades, smoked meats, avoiding stress, hypothermia. Until the end of treatment, do not have an intimate relationship without a condom. After treatment, it is imperative to undergo a second examination, to be tested.

Metronidazole

Patients are prescribed Metronidazole (500 mg orally twice a day) for five to seven days. The drug can be prescribed in the form of a gel (metronidazole 0.75%), applicators. Metronidazole gel is injected intravaginally 5 g once a day for a week.

Lactobacterin, Acylact, Kanamycin (cream, gel), Clindamycin, Ornidazole, Secnidazole are also used in treatment. Before prescribing drugs, the sensitivity of bacteria to the active components of drugs is pre-checked.

Antibiotics

Antibiotic therapy is aimed at destroying gardnerella, other pathogenic microorganisms localized in the urogenital tract. Prescribe complex antibiotics of general, local action in the form of tablets, vaginal suppositories. Apply Tetracycline, Erythromycin, Lincomycin, Clindamycin, Neomycin.

For many strains of gardnerella, drugs of penicillin, cephalosporins, aminoglycosides are destructive.

Candles

Efficiency is noted in the treatment of gardnerellosis with intravaginal suppositories of Pimafucin. The drug has a pronounced antibacterial activity, is rapidly absorbed by the vaginal mucosa. Apply for 7-11 days once a day at night. Pimafucin is used in treatment during pregnancy.

Also in the treatment of gynecological diseases, intravaginal tablets or Terzhinan suppositories are used. Effective against gardnerella and other types of anaerobic bacteria. Has antimicrobial, antifungal, anti-inflammatory effect, normalizes the pH of the vaginal environment. It is permissible to use during pregnancy, lactation.

Folk remedies

Alternative medicine can be prescribed as an adjunct to primary therapy. It is prescribed to normalize the vaginal microflora, increase immunity, and eliminate unpleasant symptoms.

Decoctions of medicinal plants (oak bark, chamomile, St. John's wort, yarrow, birch leaves, plantain), which have an antimicrobial, anti-inflammatory effect, are used for douching, baths.

Prevention

Observing preventive measures, you can avoid infection with gardnerellosis, the appearance of possible relapses.

Preventive measures include:

  • compliance with the rules of intimate hygiene;
  • refusal to use drugs for douching, contraceptives containing 9-nonoxynol (Oval, Nonoxynol);
  • competent use of antibacterial agents;
  • consultation with a gynecologist before using hormonal agents;
  • refuse to systematically wear tight synthetic underwear;
  • balanced diet;
  • use contraceptive methods with casual sex partners;
  • undergoing gynecological examinations 2-3 times a year.

Output

Gardnerellosis is one of the most common forms of vaginal bacteriosis. An infection, if treatment is started immediately, in rare cases gives complications, but if the disease is started, it will negatively affect the health and quality of life of women. After the end of treatment therapy, observing preventive recommendations, you can forever forget about such a problem as gardnerellosis.

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