Microbiological and bacterioscopic research is used to diagnose inflammatory processes and allows to establish the condition of the vaginal biocenosis, as well as some causative agents of sexually transmitted diseases. This research is carried out at the primary reference of the woman to the gynecologist, and also before gynecological operations and diagnostic manipulations.
For the diagnosis of trichomoniasis, in addition to bacterioscopy of stained smears, washings of vaginal discharge with physiological saline are investigated.
Conducting bacterioscopy of smears is the leading method in determining the biocenosis of the vagina. In healthy women, the condition of the biocenosis is characterized by the predominance of gram-positive lactobacilli (Dederlein sticks) producing hydrogen peroxide, which creates an acidic environment in the vagina. Acid reaction of the vaginal fluid prevents colonization of the vagina by conditionally pathogenic and pathogenic microorganisms. In smears stained by Gram, a small number of epithelial cells and leukocytes, as well as Gram-positive rods, are observed.
As a result of changes in the microbial landscape for various diseases, the normocenosis passes into pathological forms: dysbiosis ( bacterial vaginosis ) and vaginitis (colpitis) of various etiologies.
In some cases, when it is necessary to identify microorganisms, the excretions from different parts of the reproductive system are sown to appropriate nutrient media. This study is used for suspected specific nature of the inflammatory process and for determining the sensitivity of microflora to antibacterial drugs.
After the introduction of vaginal mirrors with a metal spoon Folkman make a scraping of the mucous membrane of the cervical canal and the contents are applied to the slide by a thin layer in the form of an oblong smear. Then the mirror is removed, the finger inserted into the vagina, lightly massaged the urethra and scraped its mucous membrane with the other end of the spoon. Scraping is applied to the same slide in the form of a round thin smear.
In inflammatory processes in the vagina, swabs are taken from the posterior fork with a wooden spatula simultaneously with taking smears on the flora and applying a thin wide layer on the slide.
To properly assess the condition of the vagina, there are four degrees of purity of the vaginal contents.
- At the first degree of purity in the smear from the vagina, only Doderlein sticks and squamous epithelium cells are found. The reaction of the contents is acidic.
- The second degree of purity - in the smear vaginal sticks, leukocytes (no more than 5 in the field of vision), cocci, epithelium. The reaction is acidic.
- The third degree of purity is characterized by the presence in the smear of single Doderlein sticks, a large number of various microbes and leukocytes up to 15 in the field of vision. The reaction is neutral.
- Fourth degree - in the smear there are no Doderlein sticks completely, the whole field of vision is covered by leukocytes, flocculation of cocca flora, flat epithelial cells are found. The reaction of the contents is alkaline.
For bacteriological examination, the detachable is taken with a sterile cotton swab. To take material from the urethra, the patient should not urinate for 2 hours.
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