Analysis of femoflor screen in women and men: what is it, what infections are included?

Analysis of the femotofrain screen - a technique for studying the urogenital tract of a woman. The basis is a polymerase chain reaction (PCR), with which you can fully study the composition of the microflora of any biotope. It is possible to obtain a complete qualitative and quantitative description of the microflora, to assess the leading type of biocenosis and the nature of the interrelationships between microorganisms.

There are many varieties of analysis. They differ mainly in a set of microorganisms that enter the test panel, as well as the leading method for determining microflora. The advantage of the method is that it is highly sensitive, specific, which allows to study all groups of microorganisms, including those that are difficult to detect by conventional methods. Also a big plus is that microorganisms are not cultivated for research, therefore, the speed of the test is increased. Results now do not need to wait a long time.

It is also possible to identify those cultures that are difficult to cultivate. The method is highly specific and selective, which means that the probability of obtaining false-positive or false-negative results is significantly reduced. Reliability and reliability increase dramatically. It allows to reveal dysbacteriosis, to study not only obligate and optional microflora, but also transient microflora.

What is it and what is included in this analysis?

It is an analysis by means of which it is possible not only to study the normal microflora of the urogenital tract, but also to reveal microorganisms. Gives qualitative and quantitative characteristics, determines the ratio between different groups of microorganisms. With the help of this method it is possible to identify a wide range of microorganisms: bacteria, viruses, mycoplasmas, fungi. Depending on the species, it can reveal a different number of microorganisms and show their number.

With the help of a screening study, it is possible to identify and evaluate 14 indicators that give a complete picture of the microflora of the urogenital tract. These are the main representatives of normal microflora (obligate and optional forms).

Also this method can reveal 7 absolute pathogens, which, when ingested, cause the development of an infectious process. It can be viruses, bacteria, protozoa. A result of the investigation of normal microflora is necessarily given, together with the total bacterial contamination and the number of each representative. This makes it possible to identify dysbacteriosis, or to determine the etiology of the inflammatory process, and also to select the optimal method of therapy.

Femoflora in women

The study of the microflora of a woman is important. Recently, more attention has been paid to the microbial ecology of the female urogenital tract. The growing interest in this issue is largely due to the steady increase in the number of patients with gynecological diseases, which is one of the most urgent problems of medicine. Studies can be carried out in various ways, but today most specialists choose the method of femoflore.

With the help of this method, it is possible to diagnose the presence, severity and nature of imbalance in the microflora. The analysis has certain indications, in particular, it is necessary to carry out when planning pregnancy, when it is impossible to conceive, multiple miscarriages, miscarriage, before planned surgical interventions of the gynecological profile. The study is also conducted for prevention with the purpose of timely detection and correction of violations of normal microbiocenosis.

The material of the study is a scraping of epithelial cells from the vagina, urethra, cervical canal. In order to obtain an objective result, it is necessary to conduct preliminary colposcopy, or ultrasound, after which 24-28 hours are taken scraping. During this period, sexual intercourse and medication are excluded. On the day of sampling of biological material, it is necessary to refrain from urinating for 1.5-2 hours. The optimal option for women is femoflore 8, 16, as well as a femoflor screen. Many experts choose the femoflor screen, since this method is universal, and it allows to identify simultaneously existing microbiocenosis disorders, and also to determine STIs (if any).

Femoflora in pregnancy

Analysis of microflora during pregnancy is very important, because it depends on the woman, what will be the future baby's microflora. Microorganisms contained in the vagina and birth canal, seed the skin of the baby at the time of birth, and are its primary microflora, on the basis of which further microbiocenosis is formed. Violations can be dangerous for both women and children, affect the nature of delivery, and the course of further recovery processes in the postpartum period. It should be borne in mind that the vaginal microflora forms a stable microbial environment that protects the body from the effects of adverse factors, prevents colonization by pathogens. Thanks to the "estrogen explosion", pregnancy is the optimal period for the formation of the flora of the vagina - lactobacillus, bifido- and propionbacteria. According to available data, the third trimester of pregnancy is most favorable.

Femoflor for men

This analysis is designed to study the genitourinary system of a woman. This is reflected in the very name of the method "femo" - a woman, "flora" - flora, environment, that is, with a literal translation we get a "study of female flora." The method includes ready-made panels of investigated microorganisms, and is calculated on revealing of the basic representatives of a normal microflora of the woman.

Nevertheless, it is necessary to take into account that the method is based on PCR - a relatively universal method for detecting the genome, particles of microorganisms in the analyzed samples. It is able to confirm the presence or absence of the investigated microorganisms in the analyzed sample, regardless of the source of its origin. This may be a sample taken not only from the urogenital tract, but also from another biotope, for example, the airways, the oral cavity. Also, a sample can be obtained not only from a woman, but also from a man, and even from an animal. The PCR method is widely used in various fields: medicine, veterinary medicine, plant growing, biotechnology.

The only reason why this method can be restricted to women only is that it contains a limited set of reagents and nutrient media. The composition includes only those materials that are necessary for the detection of representatives of the vaginal microflora of a woman. On other microorganisms, the kit simply does not respond. Thus, with the help of this test, only those microorganisms that are common to both men and women can be detected in the smear of a man. It is also possible to diagnose sexually transmitted infections. The best option will be femoflor 16.

Indications for the procedure of the femoflor Screen

The procedure is carried out in preparation for pregnancy and IVF, when planning operations on the organs of the reproductive system. Also, the indications are painful sensations, dysbiotic conditions, chronic and acute pathological conditions. A study is also being conducted to control the effectiveness of disease therapy, to monitor the results in dynamics, with ineffectiveness of the study by other methods. It allows differentiating different diseases with similar symptoms. It is recommended that women with infertility, miscarriage, miscarriages and premature birth in the anamnesis.

Femoflor with STI

In the presence of infection, the study is aimed at identifying the main representatives of pathogenic microflora. This includes 14 major microorganisms that can provoke the development of infectious diseases and are transmitted sexually. Bacteria, viruses, fungi and protozoa can be detected. Also this method is used to check the effectiveness of treatment, or to monitor the disease in dynamics. The material of the study is a scraping from the urethra and the cervical canal.

The study is not conducted if a person is receiving antibiotic therapy, and also 14 days after taking medications, since this can substantially distort the existing clinical picture. On the day of the test, no manipulation of the genitals can be carried out, including washing. It uses femoflor 16, which allows you to identify anaerobic pathogens of the disease. The test is carried out for pregnant women, in preparation for gynecological operations and IVF, or for pregnancy planning.

Interpreting the results is not difficult, but here you need to understand a certain specificity. The total number of bacteria should not exceed 10 ⁶ -10 ⁸  cfu / ml. If this indicator increases, we speak about an excess of microorganisms. Then the primary diagnostic value is given to the relationship between different forms of microorganisms. It is important that representatives of obligate microflora prevail. Representatives of conditionally pathogenic flora should not exceed 3-4%. The decrease in the number of microorganisms indicates the development of dystrophic processes, or complete atrophy of the vaginal microflora.

[1], [2]

Femoflor with ureaplasma

When ureplazm it is recommended to use femoflor 16 or 17. Using these methods, you can identify urogenital infections caused by ureaplasma. Most often, this form of the disease proceeds secretly, does not manifest itself in any way, or is characterized by a hidden, erased course with mild symptoms that practically do not bother the person. Also, for this infection is characterized by a low focal infection, so it almost does not cause discomfort. Nevertheless, it is dangerous for its complications, propensity to chronization. It is one of the main causes of infertility.

[3], [4]

Femoflor with thrush

The main causative agent of thrush is yeast-like fungus Candida. He is a representative of the normal microflora of the vagina and refers to opportunistic forms. With a decrease in immunity and a decrease in the activity of the obligate (basic) bacterial flora, the colonization resistance of the mucous membranes is substantially reduced, as a result of which opportunistic microorganisms begin to actively grow, causing an infectious and inflammatory process. To identify dysbiosis, assess its degree, severity, stage of development, as well as detect Candida and determine their quantitative index, usually an analysis of "femoflor 8" is sufficient.

[5], [6], [7]

Femoflor screen infertility

When infertility is often necessary to resort to the evaluation of microbiocenoses, because often it is the violation of normal eubiosis, or the presence of pathogenic microorganisms, and is the cause of inflammatory, infectious processes that lead to infertility. For diagnostics in this case it is recommended to apply the analysis of the femoflor screen.

[8]

Preparation

Biological material for the purpose is scraping from the posterior-lateral vault of the vagina, cervical canal or urethra. He takes in the conditions of the laboratory (gynecological office). For this, a woman needs to be prepared beforehand. For 14 days you can not take eubiotics, probiotics. Approximately 2 days before the study, exclude sex, do not apply tampons for a day. After colposcopy or ultrasound should be at least 48 hours.

How do they take Femoflor?

Take a scraping from the vagina, the cervical canal directly during the inspection, so the woman alone does not have to do anything. The only thing that is required is to observe several simple rules of preliminary preparation. Before the procedure, you can not do any hygienic procedures, and you can not use certain medicines, candles, in particular, treat with antiseptics.

Most often, scraping is taken from the posterolateral vault of the vagina. In this case, the fence should be made immediately, before the examination. If necessary, excess plaque is removed with a special tampon. It is also necessary to observe the sterility of all the material being examined. Taking the material is an important stage in the diagnosis, since in violation it is possible to get an incorrect picture of pathology at the root.

To take the scraping, a probe is used, which is then placed in a test tube. The tube must be marked and tightly closed with a lid.

Smear on the determination of the biocenosis of the urogenital tract of femoflora

For the study, you need to take biological material. Before proceeding to the fence, it is necessary to refrain from urinating at least 2 hours before the procedure. The probe is inserted in one movement about 1-1.5 cm, and then it is removed. Once the biological material is collected, the test tube should be labeled. Then the received biological material is transported to the laboratory, accompanied by a laboratory technician specializing in the transport of samples. A sample can be frozen for no more than 1 month.

Technique of the femoflor Screen

After the collection of biological material, it is delivered to the laboratory, where it is further investigated. The aim of the study is to estimate the total bacterial mass, and a quantitative and qualitative assessment of the normal and optional flora is also carried out. Then the percentage ratio of different forms of microorganisms and their ratio to the total amount of microflora is estimated.

The principle of the method is based on PCR (polymerase chain reaction) - a molecular genetic method aimed at detecting the DNA strands of the present microflora. This means that it is possible to unambiguously identify the bacterium, and the result will be 100% reliable.

The advantage of the method is that even a minimal amount of material can be taken for the study and this will be enough. This is explained by the fact that the PCR method repeatedly copies the detected DNA and further identifies and analyzes the main properties of the biological material.

The sequence of the procedure can be represented in 4 main stages. First, weave the strands of DNA. After this, an annealing takes place, during which special primers are joined, to which nucleic acids are subsequently layered. Further complementary strands of DNA are completed. Thus, no matter how much biological material has been taken for the study, it will be multiplied by PCR, resulting in the possibility of its full analysis.

Femoflora from the cervical canal

The collection of biological material from the cervical canal is carried out with suspicion of the development of pathological processes in the cervical region, in inflammatory processes. If the pathology site is clearly visible in the mirrors, material is taken from it for investigation. After removing all impurities, the neck is treated with a sterile physiological solution. The fence is made using a special probe, which delineates circular movements throughout the channel.

How much is the femoflor?

Due to the fact that the need for full cultivation, cultivation and further identification of microorganisms by biochemical and immunological methods is not available, the speed of the study is significantly increased, and the time spent on carrying out the full complex of bacteriological studies is reduced. On average, the study is conducted from 1 to 3 working days (in contrast to standard bacteriological methods, in which the study lasts from 7 to 10 days).

Normal performance

Representatives of the Doderlein group should prevail. Of these, the main are lactobacilli, whose concentration reaches 108-109 cfu / ml. The second place in the number of occupy bifidobacteria, the concentration of which ranges from 105 to 107 cfu / ml. Propionibacteria are present in a concentration of 104 to 106 cfu / ml.

Eubacteria, clostridia, peptococci, and vellonella are representatives of obligate flora, as well as representatives of microorganisms of the genus Peptosreptococcus (10 ⁴  cfu / ml).

Indigenous flora is represented by aerobic and facultative-anaerobic microorganisms, the concentration of which varies between 10 ³ -10 ⁴  cfu / ml. This group includes staphylococci, streptococci, E. Coli, enterococci, the number of which varies from  10 ³ to 10 ⁴  cfu / ml. The number of Corinebacteria and Klebsiella should not exceed 10 ³  cfu / ml.

The device for analysis

For carrying out the set "Femoflor" is required. To carry out the amplification of the detected DNA, a certain set of reagents is required: a DNA matrix, that is, a region to be amplified, 2 complementary parimeters, by which the completion will take place. The enzyme is thermostable DNA polymerase, which catalyzes the polymerization reaction. Deoxyribonucleophosphate is used as a building material. For the DNA polymerization, magnesium salts and a buffer solution are necessary.

The set of reagents "Femoflor" contains a complex that allows to calculate the total number of bacteria; a special complex for detecting the composition and quantity of bacteria that make up the normal microflora. In addition, the kits contain complexes for determining the composition of the facultative microflora. The composition depends on the type of kit (Femochlor 4, 8, 16, 24, etc.).

Raising and lowering of values

In order to decipher the analysis, it is necessary to decipher individually each block of tests, as well as to evaluate the nature of the relationship and the percentage ratio between different groups.

First, the quality of sampling of biological material is evaluated. In the sample obtained, the number of epithelial cells should not exceed 10 ⁴. The total bacterial mass implies the determination of the volume of all microorganisms in the biocenosis. This has an important diagnostic significance for further estimation of the population ratio. This number should not exceed 10 ⁶. The maximum should be the amount of lactobacilli - about 10 ⁹  cfu / ml. The conditionally pathogenic forms should not exceed 3-4% of the total bacterial mass. Pathogens can be present in a single form, but this always implies the presence of an infectious process, or a high risk of its development.

Absolute normocenosis

The vaginal microflora is mostly determined by the hormonal background of the woman's organism, the nature of which varies and largely depends on the state of the organism. This provides selective advantages in the biotope of various forms of microorganisms, which are currently more adapted. Basically, the biotope is inhabited by vaginal bioavariants of saccharolytic microorganisms, united under the term "Doderlein". With the development of these microorganisms, a large amount of lactic acid is formed, which prevents the colonization of the biotope by acid-sensitive microorganisms, therefore the species composition of the biocenosis is rather monotonous: lactobacillus lactobacilli occupy the leading positions, which constitute up to 97%. The second place among the physiological bacteria of the vagina is occupied by a representative of the genus Bifidobacterium. They have strict anaerobism, their concentration in the vagina is much lower. And finally, the third place is given to representatives of the genus Propionibacteria. Among them, there are strains that have antiviral properties.

Conditional normocoenosis

There is also an optional microflora, which is represented by conditionally pathogenic forms. Their level should not reach 3-4%. In the vagina there are up to 20 kinds of conditioned pathogens, activated with a decrease in immunity.

[9], [10]

Types of Femoflora

The analysis has several varieties. This or that form is chosen depending on the purpose of the study. So, some of them are ideally suited for the study of the urogenital tract in the planning of pregnancy, operations, which allows to identify potential risks and predict the further course of the process. Others are used to diagnose venereal infections and control the quality of treatment, its effectiveness. Can be used for both men and women.

Others are used to identify a narrow range of infections. For example, femoflor 4 allows to determine the total concentration of bacteria and identify gardnerellas, candida, lactobacilli. The variety of tests varies from femoflore 4 to femoflor 24. The number indicates the number of microorganisms that can be detected using these tests. Thus, femoflora 4 allows us to evaluate 4 parameters, whereas by resorting to femoflore 24, 24 microorganisms can be detected.

• Femoflor 4

High-precision diagnostic method using the PCR method. Allows you to evaluate 4 main indicators, determine the total biomass, identify representatives of the genus Gardnerella, Candida, Lactobacillus. According to the results obtained, the laboratory assistant makes conclusions about the presence or absence of pathogenic forms of microorganisms. The amount of normal microflora is estimated by the ratio of lactobacilli with the MHF - the total microbial number.

• Femoflor 8

A method that allows you to examine the microbiocenosis of a woman and identify 8 basic indicators. It allows to reveal the dysbacteriosis rather effectively, to assess the degree of its severity. Usually this method is sufficient for diagnosis of dysbacteriosis and detection of inflammatory processes, evaluation of the quality of treatment.

• Femoflor 9

It is a technique for studying microflora. Very similar to the technique of femoflore 8, has the same indications for conduction. The only difference is that it can detect cytomegalovirus and herpesvirus of the second type.

• Femoflor 10

The examination is mandatory taking into account the menstrual cycle (in the first half, but not in the first 5 days). It is performed with severe symptoms of dysbacteriosis, inflammatory and infectious process. Indication can be both subjective sensations of the patient, and objective, well visible during the examination. Can be conducted with a preventive purpose. It is an extended study of microflora. The results are presented in genome-equivalents, the amount of which is directly proportional to the cellular biomass of microorganisms.

• Femoflor 12

This screening study of vaginal microbiocenosis, which is carried out using the PCR method. Allows you to quantify the composition of microflora. Both obligate and conditionally pathogenic microflora are assessed. It is possible to identify some unconditionally pathogenic microorganisms, including candidias, mycoplasmas cytomegalovirus and herpesvirus, as well as Trichomonas, Neisseria, Chlamydia.

Femoflor 13

This is also a screening study that allows you to assess the nature of microflora and to detect pathogenic forms of microorganisms. It is also used for the diagnosis of many latent infections, for example: ureplasma, microplasma, chlamydia and others. The disadvantage of this method is that it conducts only a qualitative assessment of the microbiota, with the exception of the total number of bacteria.

Femoflor 16

This study, which is most often used to assess the condition of the urogenital tract. The technique can be applied to men. With its help you can not only assess the state of microflora, but also determine the majority of sexually transmitted infections.

Femoflor 17

It can detect 17 different types of microorganisms. It differs from all previous methods in that it allows to estimate as much as possible the quantitative and qualitative composition of microflora. Used to evaluate ureplasma and mycoplasmal infection.

Femoflor 18

This screening study of urogenital microflora, a modified version of femoflore 17, which is additionally capable of detecting viral infections.

Femoflor 24

This is the maximally expanded variant of a screening study of the urogenital tract, which allows diagnosing 24 types of microorganism.

Differences of PCR and femoflor

Femoflor is a comprehensive study that a doctor can appoint a patient to identify if necessary. It is used for prophylactic purposes, for diagnosing and selecting appropriate treatment. If there is a need to assess how effective treatment is, they also resort to this method. Depending on the type of study, when the analysis is assigned to the flamencof, the lab technician knows what it is necessary to perform and what elements to look for in the sample obtained. Includes the whole range of necessary activities, from the preparation and collection of biological material, and ending with the issuance and interpretation of the results. One of the most important stages is laboratory diagnostics, during which the PCR method is used to detect the DNA of a microorganism and its further identification.

That is, PCR is one of the methods of laboratory diagnostics that enables a lab technician to detect the DNA of a microorganism, and carry out its qualitative and quantitative characteristics. With the help of PCR, you can examine any microorganisms, proteins, strands of DNA. It has a wide range of possibilities. In the analysis of "femoflora", theoretically any method could be used, for example, genomic sequencing, RIF, ELISA, and other methods. The result of this will not change.

Another difference is that a doctor can prescribe an analysis such as a haemophilus. But there is no such thing as "prescribe a PCR study", because this is not an analysis, but a method of carrying out a laboratory study to which a sample is exposed in the laboratory. Depending on the conditions, another method can be chosen, which the laboratory assistant deems more rational in this particular situation.

It does not matter for the doctor and the patient what method the study will be performed. The main thing is to get an accurate and correct result. Today, most laboratories use this method, because it has proved to be reliable, specific, highly sensitive. The probability of errors is minimal, reliability and accuracy are high.

Florocenosis and femoflor: Which is better?

It is better to use femoflor, as this is an accurate and verified study that allows you to get a complete picture of the urogenital microbiocenosis, to reveal pathology, to determine its cause. Thus, the doctor will have almost all the necessary data to develop tactics and strategies for further treatment. In addition, there is always the opportunity to re-conduct the analysis and evaluate the effectiveness of treatment.