What does mixed microflora mean? Flora smear in women. A smear from the vaginal mucosa for cleanliness - deciphering the results, how to prepare, why is it done? Normal indicators of vaginal microflora. Normal vaginal microflora

Agree that the appearance of even minor problems in the genital area causes quite significant discomfort and makes you want to quickly deal with the problem. The reasons are trivial: a violation of the vaginal microflora or minor inflammation. When contacting a gynecologist and making complaints, it is first necessary to conduct a vaginal examination and smear tests for flora. Microflora smear analysis is the most frequently performed and most informative method for diagnosing vaginal diseases. Deciphering the result can help answer questions about the patient’s health status.

The microflora of a woman’s vagina is very “densely populated.” When conducting a smear analysis, the analysis transcript may indicate:

Leukocytes (L)- white blood cells, normally up to 10 fields of vision. In pregnant women, as a rule, leukocytosis increases to 20-30 in the field of view. The more acute the process, the higher the level of leukocytes; such changes are most often characteristic of colpitis and vaginitis.

Flat epithelium- these are the cells that line the surface of the mucosa. The female genital tract is also covered with mucous. The epithelium is normally always present here, since, when it dies, the squamous epithelium sloughs off and enters the vaginal cavity. When an infection occurs in the vaginal area, the amount of epithelium can increase significantly. If desquamated epithelial cells are not detected in the analysis transcript, this indicates atrophic processes vaginal mucosa, or a lack of female estrogens and an excess of androgens.

Yeast - yeast-like mushrooms from the genus Candida. The presence of yeast fungi in women is a pathology, the permissible threshold is up to 104 CFU/ml. More high performance indicate the presence of vaginal candidiasis (thrush). In case of pain, discomfort, discharge from unpleasant smell, itching, burning, and also after long-term treatment antibiotics, it is necessary to conduct a microflora study to exclude candidiasis. If the test results show fungal spores, but the woman does not complain, this means that thrush (candidiasis) is hidden (asymptomatic).

Slime– how a product of the vital activity of microorganisms and cells can indirectly indicate the manifestation of dysbacteriosis or be a symptom of an infectious inflammatory process. Identifying mucus is extremely important. In the smear results, the presence of a small amount of mucus is not a pathology and this confirms normal pH values.

Doderlein stick- lactobacilli, a permanent inhabitant of the vaginal environment, which makes up 90% of the entire vaginal microflora. The abundant presence of rods helps to normalize the acidic environment of the vagina; their decrease also occurs with bacterial vaginosis.

"Key Cells"- this is the name given to epithelial cells covered on all sides with gardnerella; they are also called atypical cells.

Small bacteria– gardnerella are microorganisms and are found in a healthy vaginal environment. But when their number is sharply increased, and gardnerella colonies settle on large epithelial cells, forming into “key cells,” this indicates bacterial vaginosis or gardnerellosis. If there is an abundance of atypical cells in the smear, one can think of vaginal dysbiosis.

Escherichia coli. This bacterium is an inhabitant of the intestines, but sometimes, when it enters the genital tract, it lives in the vagina in small quantities. A pathological increase in quantity can cause inflammation and often leads to cystitis in women.

Staphylococcus aureus– occurs as a variant of normal microflora in the interpretation of the results. With an increase in the content and a simultaneous increase in leukocytes in gynecological analysis, are a symptom of inflammation of the vaginal mucosa and even endometritis (inflammation of the uterine lining).

Leptothrix– pathological anaerobic bacterium (Gram-negative), often leads to bacterial infections, to candidiasis, vaginosis, worsens the course of chlamydia and trichomoniasis.

Mobiluncus– an anaerobic bacterium, found in women with dysbacteriosis and bacterial vaginosis.

Trichomoniasis (Trich)- is a microorganism of the genus protozoa that lives in liquid medium vagina. Often leads to infectious complications.

Cocci- these are also spherical bacterial organisms, and if they are present in a gynecological smear, inflammation can be confidently diagnosed. Sometimes among the cocci there are double rods called diplococci. They are also called gonococci (Gn). These organisms are a symptom of gonorrhea. If there is an abundance of cocci in the smear, one can think about a decrease in the woman’s immunity or the beginning of an inflammatory process of the mucous membranes of the genitals.

To prescribe to a gynecologist correct treatment, you need to know whether the “coccal flora” belongs to the category of bacteria: gram-positive (gr.+) or gram-negative (gr.-).

The gynecological smear should indicate this affiliation, since these cocci, having different structures and effects on the mucous membrane, also have different ways treatment. To help the gynecologist and the right choice drugs for effective treatment, it is necessary, in some cases, to conduct a bacterial culture of a smear to clarify the diagnosis. Gram-positive cocci are most often streptococci, enterococci and staphylococci. Gram-negative most often gonococci and Proteus. In the smear they are designated GN.

State of bacterial flora

The results of bacterial culture studies on flora may differ in the same woman throughout her life. From 14 to 55 years, when hormonal levels change critically, the normal result of microflora analysis also changes.

The feminine essence lies in its uniqueness and individuality. Its microflora is also individual. Good performance should not have pathogenic fungi or pathogenic bacteria, the most common of which are yeast fungi of the genus Candida, gonococci, chlamydia. Healthy flora consists of 90% lactic acid bacteria, which produce lactic acid to maintain a constant pH in a slightly acidic environment.

This means that as long as the acidic environment is maintained in the vagina, harmful flora does not multiply, that is, it does not cause much discomfort to the woman’s body. Changes in the vaginal microflora often occur with low immunity, with various metabolic disorders, diabetes mellitus, viral and colds, taking antibiotics. One of important factors is a stable hormonal background, namely the regular production of estrogen.

Changes in microflora during pregnancy

In pregnant women, the production of estrogen is temporarily suspended, but progesterone is produced abundantly. As a rule, a woman’s body, protecting itself from possible infection and diseases of the fetus, regulates the condition of the mucous membranes. For example, in the vaginal microflora the number of Doderlein bacillus increases 10 times in order to reduce the activation of pathological flora. Therefore, it is advisable to obtain the result of a smear on the microflora before pregnancy to determine the degree of purity. Pathogenic bacteria and fungi, especially gonorrhea, trichomoniasis, candidiasis, vaginosis and others, pose a danger because the vaginal walls become loose, which is fraught with complications during childbirth.

Monitoring the condition of the genital tract is required not only during gestation, but also throughout life. In deciphering bacterial culture, gynecologists name four degrees of purity of the mucous membrane:

• I- without pathology. When deciphering the smear - 95% lactobacilli. Single presence of leukocytes, epithelial cells.

• II - This is also a variant of healthy microflora, but conditionally pathogenic microorganisms may appear in small quantities.

• III– the number of conditionally pathogenic bacteria in the bacterial culture exceeds the number of Doderlein bacilli.

• IV– against the background of a large amount of bacterial flora, the abundant presence of leukocytes and epithelium, a sharp decrease in Doderlein rods.

When the vaginal microflora changes at different degrees of purity, a change in the pH reaction is observed. From acidic, at the first-second stage, at the third stage - slightly alkaline and at the fourth stage - alkaline pH. It is imperative for a gynecologist to analyze the results of a smear to establish a diagnosis and choice correct method treatment, since a smear shows not only the presence of chronic infections or dysbiosis in a woman’s body, but also the quality of her immune system. To clarify, the doctor can then do additional studies of the woman’s discharge (cytomorphology and bacterial culture).

How to analyze a smear for microflora?

Rules for obtaining reliable and informative analysis results:

1. Do not take a smear test during menstrual bleeding.
2. Don't take a bath.
3. Do not use a syringe.
4. Do not use medicinal intravaginal products (suppositories, cream, tablets for the vagina).
5. On the eve of the analysis, do not have sex.

Before visiting a gynecologist for bacterial culture, it is recommended to use plain soap to wash the genitals. It is advisable not to urinate before taking the bacterial culture. Using a sterile spatula, the gynecologist will take a smear for bacterial culture from the urethra, the mucous membrane of the vagina, and the cervix. During the medical procedure, the gynecologist makes a note where the smear was taken from:

• from the vagina – marked “V-vagina”;
• from the cervix – marked “C-cervix”
• from the urethra – marked “U-uretra”.

Timely, regular testing by a gynecologist is the key to women’s health. A smear for microflora should be taken once every 6 months, which will completely eliminate the occurrence of any disorders in the female genital area.

During a laboratory examination of a smear from the genital organs, the results sometimes reveal a mixed flora.

Then the fact of existence is confirmed inflammatory focus, pathogenic microorganisms that provoke its development are identified. The pathology is detected immediately, so the doctor can immediately prescribe treatment.

Mixed flora in a smear - what does it mean?

Laboratory testing allows not only to confirm the presence of microbes or fungi, but also indicates what percentage of healthy flora and what percentage of pathogenic flora is contained in the smear. When an infectious disease develops, a disorder of the acid-base balance is observed - an acidic environment replaced by alkaline.

When visiting a gynecologist or urologist, a smear is always taken in order to see the full picture of the development of pathology based on the test results obtained. If materials were collected from the vagina or urethra, then there is a suspicion of inflammatory processes in the genitals. Before this, they usually appear characteristic features the presence of pathogenic microorganisms in excess. First, pain appears in the lower abdomen, the color of the discharge changes, and an unpleasant odor appears. Sometimes illness accompanied by itching and burning in the genital area.

In women, the risk of developing pathology increases during the climatic period, during pregnancy. Taking hormonal medications also affects the acid-base balance.

Only a doctor should make a diagnosis based on laboratory test results, taking into account all the patient’s symptoms and complaints.

What it is?

When mixed flora is found in a smear, this indicates imbalance of pathogenic and beneficial microorganisms. Normally, biological material contains particles squamous epithelium, lactobacilli, white blood cells and many other beneficial bacteria.

If the body is completely healthy, 90-95% of the biological material will be beneficial flora, and the remaining 5% will be pathogenic microorganisms, represented by cocci and rods.

They do not harm a healthy person, but as soon as the number of pathogenic bacteria increases, there is a risk of getting sick. When mixed flora is detected in a smear, this indicates an increase in the number of pathogenic microorganisms that provoke the development of infection. In a normal state, they are practically impossible to detect. If test results confirm that an inflammatory process has begun in the body, it is necessary urgent treatment. Only a specialist can prescribe it.

If it is detected in a cytology smear

This analysis allows us to identify the state of the microflora of the genital organs of a man or woman. If a smear is taken from the urethra or vagina, this allows you to see the volume of cells, identify their affiliation to pathogenic or beneficial flora.

A laboratory cytology test has more possibilities than conventional tests. When processing biological material, attention is paid to epithelial cells and their condition.

If a mixed flora is detected, this occurs due to the comparison and detection of the inflammatory process and substandard formations. This means that the acid-base balance is already disturbed in the body, it is progressing growth of pathogens. The difference between the tests is that, based on the results, a specialist can determine not only the changes themselves, but also their causes, and determine what nature of the infection is spreading in the body.

Mixed flora in men

With the help of a bacteriological smear, which is taken from the urethra, hidden forms of infection can be detected. It is for this purpose that the analysis is done. If mixed flora is detected, this indicates that pathogenic bacteria are actively multiplying, provoking inflammatory processes in the body.

Mixed flora often indicates the likelihood of developing prostatitis or urethritis, sexually transmitted diseases. If a laboratory test reveals that the white blood cell count has increased, this is considered a clear sign of inflammation. Then there is a possibility that gonorrhea, chlamydia, ureaplasmosis, and trichomoniasis are progressing in the body. The final diagnosis can only be made by a specialist based on analyzes and symptoms of the disease.

If it is found in women

When test results reveal a mixed flora in females, this indicates:

• the beginning of puberty in girls;
• development of sexually transmitted diseases;
• entry of the organism into the climatic period;
• increased functioning of the female reproductive glands;
• the initial stage or end of the menstrual cycle.

To determine the exact reason for the presence of mixed flora in biological material, you need to know the volume of leukocytes present there and take into account auxiliary factors.

The only thing that remains undeniable is the fact of imbalance between pathogenic bacteria and beneficial. Only a gynecologist can decipher a smear; based on his experience, he knows better what the true cause of the pathology is.

Pathogenic flora during pregnancy

The discovery of mixed flora in pregnant women is explained primarily by the fact that each organism is individual - it has its own microflora characteristics. Pregnancy often provokes an increase in the number of pathogenic microorganisms, especially fungal, which leads to the development of candidiasis (thrush), bacterial vaginosis. This occurs due to an imbalance in the acid-base balance.

Drastic changes also occur due to infection, exacerbation of chronic diseases, and changes at the hormonal level. Pregnancy planning should certainly include preliminary consultation gynecologist with certain tests. If this is not done, the opportunistic vaginal flora will be transformed into pathogenic, and an inflammatory process will begin to develop. It is always better to prevent a disease than to treat it.

Mixed flora in a smear - what is it? What diseases can the analysis tell about? How to properly prepare for research? A mandatory procedure when visiting a gynecologist is a smear. It clearly shows where the inflammatory process is located and what bacteria cause it. An important advantage of this method is the ability to quickly identify pathology. Without a smear, it is simply impossible to determine many diseases. The analysis shows not only the presence of pathogenic microorganisms and fungi, but also their percentage to non-pathogenic. The imbalance causes the pH to change from acidic to alkaline. And this is an indicator of the development of infection. A smear is taken by the gynecologist immediately after the examination at each visit. This is important not only for diagnosis, but also for disease prevention. The doctor collects anamnesis: takes into account complaints, assesses the condition of the genital organs, the presence of nonspecific discharge. Then, using a disposable spatula, a fence is made from the urethra, vagina, and cervix. Collected material spread onto a glass slide and sent to the laboratory.

Even healthy women should visit a gynecologist once a year and have a smear done. Patients with gynecological diseases and pregnant women undergo smears more often. How to prepare:

• do not use vaginal medications first;
• do not douche;
• do not have sexual intercourse for 2 days;
• Do not urinate 2 hours before your doctor’s appointment;
• wash with water without soap;
• do not take a bath the day before;
• Do not come for testing at the beginning or end of menstruation.

How to read test results?

- this is the task of the gynecologist. Sometimes the doctor questions the accuracy of the analysis. In this case, the smear is taken again. It is advisable to see one doctor and take tests to one laboratory. The mixed flora in a vaginal smear consists of epithelial cells, leukocytes, Dederlein rods and other microorganisms. The norm is 95% lactobacilli. They protect against harmful microorganisms and infections. The norm is 5% of opportunistic bacilli and cocci. A small number of such bacteria (staphylococci) are not harmful and do not cause unpleasant symptoms. The percentage shift indicates the degree of purity of the vaginal composition. First degree. The smear contains mucus, normal leukocytes, moderate amount epithelial cells and most lactobacilli. This means the microflora is normal, healthy immunity, no inflammation.

You shouldn’t do the decoding yourself, but women should know some facts.

Second degree. There is moderate mucus in the smear. Leukocytes are normal. Lactobacilli are present along with cocci and yeast fungi. This is also considered normal, but there is a possible risk of inflammatory diseases. The first two degrees show the woman's health. Medical procedures are allowed: biopsy, curettage, surgery. Third degree. Increased amount of epithelium and mucus. White blood cells exceed normal levels. Fourth degree.

A large amount of mucus and epithelium. The leukocyte level is several times higher than normal. There are no lactobacilli; the entire microflora is represented by pathogenic bacteria. This indicates an advanced disease. On last degrees All gynecological procedures are contraindicated. The doctor prescribes treatment for inflammation and then makes a second smear. Most of the microflora consists of pathogenic cocci and yeast fungi. The number of lactobacilli is at minimum values. The inflammatory process has begun. Based on the results of the analysis, the doctor determines the microorganism that caused the inflammatory process, and then treatment is prescribed. At vaginal candidiasis antifungal drugs are used. If the causative agent is gonococcus, antibiotic therapy will be required.

Inflammation

Itching, burning, and unusual discharge often accompany two diagnoses. The first of them is colpitis (vaginitis) - a gynecological disease of the vagina caused by Klebsiella, Enterobacteriaceae, Escherichia coli, gonococci, and hemolytic streptococcus group. The discharge is profuse, the vagina is inflamed. The smear contains high levels of leukocytes and macrophages. Pathogenic microflora far exceeds the norm.

This is the next possible diagnosis. Peptococci and peptostreptococci attack here. The symptoms are as follows: mild itching is a concern, the burning sensation is not very acute, the discharge is small. But characteristic special symptom. It's an unpleasant smell. It intensifies when sperm enters the vagina. This is due to the fact that a reaction occurs and volatile amines are released, which smell similar to rotten fish. Decoding of microflora shows complete absence lactobacilli, cocci and a large number of epithelial cells. Leukocytes are either normal or slightly elevated.

Coccobacillary flora is determined by high content leukocytes. Dederlein's rods are completely absent. The discharge resembles thick mucus with an unpleasant odor. This is bacterial vaginosis or a sexually transmitted disease. If there is no flora in the smear, this indicates that the body has suffered after antibiotic therapy in large dosages. Lactobacilli have died, and treatment will be aimed at restoring the microflora. Flora mixed in a smear is:

• in sexually mature women who are sexually active;
• at the beginning and end of menstruation;
• during menopause;
• for sexually transmitted diseases;
• at the beginning of puberty;
• with ovarian hyperfunction.

What bacteria should not be present?

A smear from a healthy woman should not contain gonococcus. The pathogen is insidious in that in the latent form of the disease it may not manifest itself in symptoms. It can only be detected in a laboratory. There should be no Staphylococcus aureus - the cause of many purulent inflammatory diseases. Streptococcus is also dangerous for the mucous membranes. It lives in the large intestine. But when it enters the vagina, it becomes aggressive and can cause miscarriage, premature birth and fetal death. The presence of enterococcus indicates an inflammatory process of the entire genitourinary system. This bacterium lives in the intestines, and this is normal. But when it gets into the ureter, bladder or vagina, inflammation begins. If the analysis is normal, but the woman has signs of any pathology, preventive medications are prescribed to normalize the balance of beneficial and opportunistic bacteria.

Every visit by a woman to a gynecologist necessarily includes certain tests, and the detected mixed flora in the smear shows certain imbalances between beneficial and harmful microorganisms.

The normal flora is 95% lactobacilli, and cocci and bacilli, which pose a potential health threat, account for the remaining 5%.

If such proportions are violated, the risk of various diseases increases significantly.

Mixed microflora is especially dangerous for pregnant women, so if it is detected during such periods, it is recommended to undergo complex treatment.

Studies of smear analysis for flora are correlated with quantitative changes in blood composition.

Microscopic examination identifies lactobacilli, pathogenic coccal bacteria, bacilli that provoke the development of diseases, and shows the risks of oncological changes.

These studies determine the composition of the microflora of the mucous membranes of the woman’s genital organs.

At the same time, mixed flora is characteristic of menopause, menstruation, sexually transmitted diseases, the onset of puberty, and ovarian hyperfunction.

The predominance of lactobacilli characterizes a healthy microflora. If the smear contains most of the lactobacilli, epithelial cells, mucus, and normal leukocytes, then this indicates the absence of inflammatory processes and healthy immunity.

With moderate mucus and normal leukocytes, an increase in the number of cocci and fungi may be observed. This situation increases the risk of inflammatory processes.

With a significant increase in leukocytes, mucus and epithelial inclusions, we can talk about pathologies.

In the worst case, lactobacilli are detected in small quantities, and leukocytes are significantly higher than normal.

At the same time, pathogenic bacteria and fungi make up the majority of the microflora. This situation indicates inflammation and requires immediate treatment.

Based on the results of the analysis, the attending physician identifies the causative agent of the disease and prescribes appropriate treatment.

For example, for candidiasis, antifungal drugs are used, and in cases of diseases caused by gonococci, they need to be treated with antibacterial agents.

Treatment is prescribed not only based on the results of a smear test for flora, but after a comprehensive study of urine and blood.

In any case, the mixed microflora identified during the analysis of the smear results requires careful attention and consultation with a specialist.

Symptoms of diseases and causes of mixed flora

In mature women living an active sexual life, and sometimes in girls even before the onset of puberty, a mixed flora is observed.

Such diagnostic picture may indicate sexually transmitted diseases, inflammation of the genitourinary system.

Pathological conditions are accompanied by certain symptoms. Itching, mucous discharge with an unpleasant odor and a burning sensation may indicate colpitis (inflammation of the vagina) or bacterial vaginosis.

These diseases are caused by pathogenic bacteria.

Moreover, despite the common origin, one disease resolves with an increase in the number of leukocytes, while the other does not.

However, in both cases, the disease provokes an increase in the number of pathogenic microorganisms.

Predominance in the female body pathogenic flora may be caused by several reasons:

• the use of antibiotics for a long time significantly weakens the immune system and destroys beneficial bacteria;
• excessive douching, washing away normal microflora, provokes the development of harmful microorganisms;
• hormonal contraceptives disrupt the microflora, significantly changing the concentration of leukocytes and lactobacilli;
• intrauterine devices negatively affect the balance of vaginal microflora.

To determine a more precise cause, comprehensive additional research, the totality of which allows us to put correct diagnosis, prescribe the optimal treatment.

Rules for taking a smear and deciphering the results

A smear in women may reveal scanty or abundant mixed flora. Deviations in indicators are often directly related to violations of the rules for preparing for a smear test.

On the eve of visiting a doctor, you need to prepare in a certain way:

• visit the toilet two hours before, since urination is contraindicated during this period;
• Before the procedure you just need to wash your face warm water no soap;
• You cannot take a smear test during menstruation;
• abstain from sex for two days;
• do not use tampons, vaginal suppositories, or douche.

Although deciphering smear results is the responsibility of the doctor, understanding what certain indicators may mean is important for any woman.

Healthy genital organs are characterized by a predominance of lactobacilli, and if their number decreases, the risk of damage by pathogenic microorganisms increases.

A large number of leukocytes is an indicator of the inflammatory process. However, the norms for the vagina, urethra and cervix are different.

A significant excess of the indicators will be the basis for additional research.

The number of red blood cells increases during menstruation, damage to the mucous membrane and inflammatory processes.

Normally, upon microscopic examination, their number does not exceed several units. A small amount of mucus is also common in the vagina and cervix.

The results of a smear for mixed flora are presented in encrypted form. It will be useful for any woman to know what each Latin designation means.

The letter “V” represents the vagina, and the numbers next to this letter clarify the smear readings.

In a similar way, the numerical values ​​clarify the readings of the letters “U” - “urethra” and “C” - “cervix”.

The Latin letter “L” stands for leukocytes, “Ep” stands for squamous epithelium. The letters “gn” and “trich” indicate the presence of gonococci and trichomoniasis bacteria.

The abbreviation "abs" refers to the absence of bacteria and infections in the smear examination.

Thus, the analysis of a smear for mixed flora has certain standards, which are presented in the following form.

Leukocytes: (U) 0-5 in the field of view under a microscope, (V) 0-10, (C) 0-30. Mucus: (V) and (C) - “moderate”, and in the case of (U) - “moderate” or “absent”.

Epithelium. (V, C, U) – “moderate”. In all cases, an increase in these indicators indicates inflammatory processes.

Gram-positive rods (gr.+). (V) – “large amount”, (C) – “absent”, (U) – “absent”.

This picture indicates a healthy body, good immunity and about the normal state of microflora.

Gram-negative rods (gr.-). (V), (C), (U) – should be absent everywhere, and opposite values ​​indicate inflammatory processes within these organs and dysbiosis.

Correct interpretation of a smear requires a certain qualification of a doctor, and in some cases repeated examination.

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In any situation, it is better to be observed and treated by one doctor. This will ensure the accuracy of the diagnosis and a positive therapeutic result.

Mixed flora in a smear in women is sometimes diagnosed during a laboratory test. This is one type of analysis that allows you to identify pathogenic microorganisms in the vagina, their numbers, the possible development of inflammation, as well as the percentage of healthy and pathogenic flora. Flora smear analysis reveals the presence of a fungus, pathogenic microbes(cocci, staphylococci), in the genitals.

Among the varieties of microflora there are:

• rod type, when the number of rods in single leukocytes does not exceed 10 x1 cm2. This is the norm. If it is exceeded, dysbacteriosis or gardnerellosis in the vagina develops. In this form, the microflora is populated by lactobacilli. When deciphering the analysis, doctors take into account the ratio of the number of lactobacilli, leukocytes and erythrocytes;
• coccobacillary when detected high content leukocytes and the absence of Dederlein's bacillus completely. When thick mucus with an unpleasant odor is released from the vagina. Such flora is diagnosed with the development of bacterial vaginosis. Treatment with antibiotics is required.

What is mixed microflora?

Mixed Flora is an imbalance between beneficial and pathogenic bacteria. When studying biological material, one can see the presence of squamous epithelium, a large number of lactobacilli, leukocytes, other microorganisms and potentially dangerous bacteria in the vagina. If their number does not exceed the norm, then this is not harmful to the body. If their number increases, then the development of female diseases is possible.

In particular, during pregnancy the concentration of microorganisms in women is often increased. If such a mixed flora is observed, it will be suggested to undergo treatment to avoid the uncontrolled proliferation of pathogenic agents, in particular staphylococci, gonococci, and coccobacilli.

With mixed flora, there is an imbalance between pathogenic and beneficial microorganisms. A healthy body has more beneficial flora (at least 90%), while pathogenic flora is no more than 5%. It is not harmful to women's health and does not pose a risk for developing diseases.

A mixed flora appears in the background:

• taking antibiotics when the functions of the immune system decrease, thereby creating favorable conditions for the development of pathogenic bacteria;
• the use of contraceptives that can lead to an imbalance between the number of leukocytes and lactobacilli in the vaginal environment;
• using intrauterine devices to protect against unwanted pregnancy, which can create an imbalance in the vaginal environment and lead to the development of coccobacilli.

When the flora is colonized by harmful bacteria, dysbacteriosis in the vagina is observed, the development of an inflammatory process, sexually transmitted diseases, discomfort in the genitals (itching, burning), which makes women nervous and worried. You need to contact a gynecologist to clarify the diagnosis and take a smear. If a smear reveals an increase in the number of pathogenic microorganisms that can provoke the development of an inflammatory process, treatment is required to avoid serious negative consequences.

Decoding the smear

The interpretation of the smear is carried out exclusively by a gynecologist to confirm the accuracy of the analysis if doubts arise. unpleasant symptoms among women. It is not recommended to decipher the smear yourself, although you still need to know some details.

A smear is taken from the vagina to identify mixed flora and submitted to the laboratory for examination.

Normally, there should be at least 95% lactobacilli that can protect the body from harmful microorganisms. There should be no more than 5% of pathogenic bacilli that are not capable of harming the female body. This percentage ratio can indicate the degree of cleanliness in the vagina.

When deciphering a smear, several degrees are distinguished:

Upon confirmation pathogenic microflora, cocci, and yeast fungi, treatment can no longer be avoided. This indicates the development of an inflammatory process, while women experience burning, itching, unusual vaginal discharge, and increased temperature. This happens with appendicitis, enterobacteriosis, and the appearance of E. coli in the stool. The number of leukocytes in the smear is exceeded, pathogenic microflora is higher than normal. The same situation occurs with bacterial vaginosis caused by streptococci, when itching, burning, and an unpleasant odor are evident. Especially when sperm enters against the background of the release of volatile compounds, indicating the complete absence of lactobacilli, while epithelial cells and leukocytes do not exceed the norm.

What should you pay attention to?

Girls and women should pay attention to the symptoms.

1. When severe itching, burning and discharge of unpleasant mucus with an unpleasant odor, the development of a venereal disease is possible, which happens in girls at the beginning of puberty or in women with the onset of menopause.
2. It is important to pay attention to the rules for taking a smear for flora. Before the procedure, you should not take baths, use candles, tampons or tablets. You should avoid going to the toilet 2 hours before your smear test.
3. You can douche the day before, but only with warm water without using soap or other hygiene products.
4. You cannot take a smear during your period, at the beginning or at the end of the cycle.
5. When taking a swab from the nasopharynx, you must refrain from eating and drinking water.
6. Women pay attention to symptoms. Maybe it hurts Bottom part abdomen, there is redness, itching, nonspecific discharge from the genitals, which happens after long-term use of antibiotics and candidiasis is diagnosed.

It is important for women to know what should and should not be in a smear. In order to check your flora, whether there is any development of the inflammatory process and whether the microorganisms in the smear are normal in order to avoid the development of infectious pathogens: Candida fungus, streptococcus, staphylococcus, gonococcus, gram-negative bacteria. For example, the presence of streptococci in the flora in large quantities can lead to miscarriage, fetal death in pregnant women, the development of inflammatory processes in the genitourinary system, damage to the ureter, bladder and genital organs.

A low level of estrogen in the body indicates the proliferation of the Dederlein bacillus or dysbacteriosis with an increased content of leukocytes and the absence of the Dederlein bacillus, while the ratio between red blood cells and lactobacilli is disturbed. Eh maybe after long-term use antibiotics. Leads to cervical erosion and the development of inflammatory processes in the genitourinary system. The growth of pathogenic flora in the vagina inevitably leads to inflammation in the vaginal mucosa, the development of nonspecific inflammation, such as mixed flora.

What does a smear mean during pregnancy?

Each woman’s body is individual and the microflora may have its own characteristics. During pregnancy, the number of pathogenic microorganisms increases and the development of candidiasis, thrush and bacterial vaginosis is possible due to an imbalance in the acid-base balance.

Similar changes in the vaginal flora are observed during infection of the genital organs, exacerbation of chronic diseases, and hormonal changes.

Even at the stage of pregnancy planning, it is important for women to be tested for microflora in the vagina in order to avoid the development of an inflammatory process, which may well occur with unstable immunity and hormonal levels during pregnancy. Pathogenic flora should not be more than 5%. A change in pH, its increase, occurs for a number of reasons: not only with reduced immunity and long-term use of antibiotics, but also with the occurrence of inflammatory diseases, imbalance in the vagina, which, of course, can negatively affect the development of the fetus.

The main thing is to prevent development serious illnesses, dispersal of candidiasis and coccobacillary flora. Timely smear testing and interpretation of the results allows you to prevent the disease, quickly stop the development of microorganisms, thereby normalizing the pH level in the vaginal environment, and suppressing the activity of microorganisms.

If dysbacteriosis, severe discomfort, an imbalance between pathogenic and opportunistic microorganisms, also coccus bacillus, gonococcus, which are harmful to the body, are detected, their constant growth is noted, then the doctor will prescribe antibiotic treatment. If a mixed flora is detected in a smear during pregnancy, treatment is prescribed in combination to suppress pathogenic agents: staphylococci, gonococci, coccobacilli. Self-medication is unacceptable. If unpleasant symptoms appear, women urgently need to visit a gynecologist.

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Mixed Flora is an imbalance between beneficial and pathogenic bacteria. When studying biological material, you can see the presence of flat epithelium, a large number of lactobacilli, leukocytes, other microorganisms and potentially dangerous bacteria in the vagina. If their number does not exceed the norm, then this is not harmful to the body. If their number increases, then the development of female diseases is possible.

In particular, during pregnancy the concentration of microorganisms in women is often increased. If such a mixed flora is observed, it will be suggested to undergo treatment to avoid the uncontrolled proliferation of pathogenic agents, in particular staphylococci, gonococci, and coccobacilli.

With mixed flora, there is an imbalance between pathogenic and beneficial microorganisms. A healthy body has more beneficial flora (at least 90%), while pathogenic flora is no more than 5%. It is not harmful to women's health and does not pose a risk for developing diseases.

A mixed flora appears in the background:

• taking antibiotics when the functions of the immune system are reduced, thereby creating favorable conditions for the development of pathogenic bacteria;
• the use of contraceptives that can lead to an imbalance between the number of leukocytes and lactobacilli in the vaginal environment;
• use of intrauterine devices for protection against unwanted pregnancy , which can create an imbalance in the vaginal environment and lead to the development of coccobacilli.

When the flora is colonized by harmful bacteria, dysbacteriosis in the vagina is observed, the development of an inflammatory process, sexually transmitted diseases, discomfort in the genitals (itching, burning), which makes women nervous and worried. You need to contact a gynecologist to clarify the diagnosis and take a smear. If a smear reveals an increase in the number of pathogenic microorganisms that can provoke the development of an inflammatory process, treatment is required to avoid serious negative consequences.

is a laboratory test in which the contents of the vagina are placed in a nutrient medium and optimal conditions are created for the growth of bacteria.

Research objectives:

• identify the causative agent of genital infection;
• establish the degree of contamination - the number of bacteria in the vagina;
• monitor the state of microflora after long-term treatment with antibiotics and cytostatic drugs. It is carried out 7-10 days after discontinuation of the drug.

• to all pregnant women upon registration;
• with inflammatory processes in the genital organs;
• Gram-negative diplococci were found in the smear - to confirm gonococcal infection (gonorrhea);
• with vulvovaginitis, recurrent or chronic.

Vaginal discharge is placed in nutrient media - solutions or jelly-like masses that contain nutrients for bacteria. Test tubes and Petri dishes are placed in a thermostat for 3-5 days, where the temperature is constantly maintained at about 37 degrees, optimal for the proliferation of microorganisms.

After cultivation, the laboratory assistant evaluates the results. From each microorganism, during the process of division, a whole colony of bacteria grows. Based on its appearance, the laboratory technician determines the type of pathogen. And by the number of colonies one can judge the concentration of these microorganisms in the vagina. Next, the concentration is compared with normal values.

The conclusion issued by the laboratory states:

• the type of microorganism that predominates in the smear;
• pathogenicity of a microorganism – the ability to cause disease:

• Pathogenic – the presence of which can only be caused by disease.
• Opportunistic - bacteria that cause disease only when immunity is reduced, with a significant increase in their number.

• concentration of the microorganism in the vagina. In numerical terms and in the form of verbal characteristics: “meager”, “moderate growth”, “abundant growth”.

I degree is the norm. In degree II, they speak of a violation of the vaginal microflora. III-IV degrees indicate a disease caused by this type of bacteria.

Mixed Flora is an imbalance between beneficial and pathogenic bacteria. When studying biological material, you can see the presence of flat epithelium, a large number of lactobacilli, leukocytes, other microorganisms and potentially dangerous bacteria in the vagina. If their number does not exceed the norm, then this is not harmful to the body. If their number increases, then the development of female diseases is possible.

All bacteria are divided into three shapes large groups: spherical, rod-shaped and convoluted. All of them can normally be found in the vaginal microflora. But spherical bacteria, that is, cocci, include causative agents of inflammatory diseases. These are diplococci, streptococci and staphylococci. To determine their quantitative content, a smear is taken on the flora.

Symptoms of diseases and causes of mixed flora

In mature women with an active sexual life, and sometimes in girls even before the onset of puberty, a mixed flora is observed.

Such a diagnostic picture may indicate sexually transmitted diseases and inflammation of the genitourinary system.

Pathological conditions are accompanied by certain symptoms. Itching, mucous discharge with an unpleasant odor and a burning sensation may indicate colpitis (inflammation of the vagina) or bacterial vaginosis.

These diseases are caused by pathogenic bacteria.

However, in both cases, the disease provokes an increase in the number of pathogenic microorganisms.

The predominance of pathogenic flora in the female body can be caused by several reasons:

• the use of antibiotics for a long time significantly weakens the immune system and destroys beneficial bacteria;
• excessive douching, flushing normal microflora, provokes the development of harmful microorganisms;
• hormonal contraceptives disrupt the microflora, significantly changing the concentration of leukocytes and lactobacilli;
• intrauterine devices negatively affect the balance of vaginal microflora.

To determine a more precise cause, comprehensive additional studies are carried out, the totality of which makes it possible to make the correct diagnosis and prescribe optimal treatment.

Varieties of microflora

Among the varieties of microflora there are:

• rod type, when the number of rods in single leukocytes does not exceed 10 x1 cm2. This is the norm. If it is exceeded, dysbacteriosis or gardnerellosis in the vagina develops. In this form, the microflora is populated by lactobacilli. When deciphering the analysis, doctors take into account the ratio of the number of lactobacilli, leukocytes and erythrocytes;
• coccobacillary when detecting an increased content of leukocytes and the complete absence of Dederlein's bacillus. When thick mucus with an unpleasant odor is released from the vagina. Such flora is diagnosed with the development of bacterial vaginosis. Treatment with antibiotics is required.

Based on the results of a smear examination in women, the type of vaginal microflora is determined, which influences the performance of a certain analysis or the statement of the absence of any pathologies. Divided:

• meager. When examining a vaginal smear, only large quantities of beneficial microorganisms are found - Dederlein bacilli, which is completely normal;
• meager. This type of vaginal microflora is found in many women of childbearing age. It is characterized by the presence of large colonies of Dederlein's shelves and a small number of leukocytes in the field of view (up to 7-10);
• mixed. This type of vaginal microflora indicates the presence of certain inflammatory processes, which are accompanied by a rapid increase in the number of leukocytes (up to 30). Cocci, which have the appearance of spherical bacteria, are also often found. At the same time, the number of lactobacilli rapidly decreases, which leads to a decrease in the protective functions of the woman’s body;
• abundant. This microflora is characterized by the presence of a large number of leukocytes on the surface of a woman’s vagina in the complete absence of Dederlein’s rods. In this case, a huge number of cocci are also found. They provoke the development of many unpleasant symptoms in a woman.

The degree of cleanliness of a woman’s vagina

Based on the results obtained after examining a smear for microflora, several degrees of vaginal cleanliness in women are distinguished:

• 1st degree (acidic environment). It is characterized by a small number of leukocytes (up to 10), epithelial cells (no more than 5-10). During the study, a large number of Dederlein rods are found. At the same time, there are almost no other bacteria present in the smear. Mucus is also detected in small quantities. Such test results are ideal and are extremely rare among women of childbearing age who have an active sex life.
• 2nd degree (slightly acidic environment). It has the same characteristics as in the previous paragraph. The only difference is the presence of gram-positive cocci in a small amount. This normal condition, which occurs in most healthy women of childbearing age.

• 3rd degree (neutral environment). IN in this case leukocytes and epithelial cells are found in quantities that exceed 10 pieces. Gram-positive cocci are also present in the vagina. Dederlein rods are found in small quantities, which is not normal. In this case, vaginal inflammation or colpitis is diagnosed, which is also accompanied by the release of a moderate amount of mucus. For some women, this condition may not cause significant discomfort. But most people experience characteristic symptoms– copious creamy discharge, itching and burning in the vagina, discomfort and painful sensations during sexual intercourse.
• 4 degree (alkaline environment). In this case, a huge number of leukocytes, epithelial cells and other microorganisms are found in the woman’s vagina. In this condition, the microflora of Dederlein's bacillus may be completely absent. Detection of an alkaline environment indicates the presence of an inflammatory process in the vagina, which is accompanied by intense discharge. They may have a characteristic color (white, greenish, gray) and an unpleasant odor. This condition always accompanied by itching, burning, pain, which intensifies during sexual intercourse.

Mixed flora in a smear: provoking factors and their elimination

What it is

A study of the vaginal microflora shows the number of pathogenic and non-pathogenic bacteria.

Depending on the resulting ratio, the smear is given a specific name.

Normally, the smear should include about 95% lactobacilli. The number of cocci and rods should be insignificant - no more than 5%.

With mixed flora, an imbalance in the number of bacteria is observed in the smear. The number of pathogenic microbes that can cause a variety of diseases is growing.

At the same time, there is an increase in the number of leukocytes. Their presence indicates the possibility of an inflammatory process.

Mixed flora does not pose a strong danger. But complete lack of treatment can lead to unpleasant consequences.

The inflammatory process in the pelvic area is fraught with the formation of adhesions and deformation of organs.

The patency of the tubes is disrupted, ovulation disappears and the structure of the endometrium changes. This leads to problems at the pregnancy planning stage.

To the main characteristic features mixed flora include the following:

• the presence of mucus in the smear;
• the presence of stratified squamous epithelium;
• traces of phagocytosis;
• increase in the number of leukocytes.

Flora smear in women- a laboratory test that determines the types of bacteria that are present in the vagina. This is the most common and simplest method for detecting inflammation and STDs (sexually transmitted diseases).

The examination is absolutely painless. It is performed during a routine gynecological examination. The doctor takes the material with a disposable spatula from the walls of the vagina and cervix. The contents of the vagina (vaginal secretions) are applied to the glass. In the laboratory, the material is stained so that the bacteria become clearly visible.

Purpose of the study

• determine the state of the vaginal microflora;
• identify sexually transmitted infections and their causative agent;
• determine the degree of the inflammatory process;
• assess the degree of vaginal cleanliness, which is mandatory before further diagnostic studies and gynecological operations - cauterization of erosions, removal of polyps, curettage;
• assess the health status of pregnant women.

When does a gynecologist take a smear for flora?

• complaints of itching or vaginal discharge, other symptoms of inflammation;
• preventive examinations;
• control of the treatment;
• reception hormonal drugs and immunosuppressants;
• control of microflora during long-term use of antibiotics;
• pregnancy. It is carried out 3 times during pregnancy (at registration, at the 30th and 36th week).

Normal vaginal microflora

The most numerous are lactobacilli and bifidobacteria, which attach to the vaginal epithelium. They produce alcohols, peroxide, lactic and other acids, which provide an acidic reaction in the vaginal secretion. As well as lysozyme and other enzymes that inhibit the proliferation of other types of bacteria.

Microorganisms that make up the microflora of a healthy woman

The number of bacteria is expressed in decimal logarithms, in order not to write numbers with a lot of zeros.

In description vaginal microflora you can often find names gram-positive or gram-negative bacteria. These terms mean that the first bacteria are stained according to the method developed by the microbiologist Gram, while the others do not change their color.

Gram-positive rods in a smear, which include lactobacilli, are a good sign. Normally they predominate in women reproductive age. During menopause (menopause) and postmenopause, gram-negative bacteria come first.

Depending on their oxygen demand, bacteria are divided into

• aerobic- those that develop in the presence of oxygen;
• anaerobic- which do not require oxygen to function.

CFU/ml.

How to make a smear on the vaginal microflora?

The procedure includes several stages.

1. The woman is placed in a gynecological chair.
2. Introduction of sterile gynecological speculum to gain access to the vaginal walls and cervix.
3. Collection of material from the posterior wall of the vagina. This procedure is absolutely painless. Unpleasant sensations may occur only when the spatula touches inflamed area.
4. Applying material to a glass slide. The vaginal secretion is distributed with streaking movements over the skim glass in the thinnest possible layer so that the cells are arranged in one row and do not cover each other.
5. Fixation of the smear is necessary if it is delivered to the laboratory after more than 3 hours. The treatment avoids cell deformation during drying and makes it possible to preserve the drug.
6. Smear staining using the Gram method. Methylene blue is used as a dye. After staining, it is easier to establish the type of bacteria and determine the composition of the microflora.
7. Evaluation of the result, which consists of 3 parts: counting leukocytes, species composition of microflora, assessment of vaginal cleanliness.

• openings of the urethra and paraurethral passages (narrow canals located parallel to the urethra);
• vaginal walls;
• cervical canal.

How to prepare for this smear?

• stop taking antibiotics 14 days before and antifungal drugs;
• 2 days in advance, stop administering any vaginal forms of drugs - solutions, suppositories, tablets, tampons, ointments, creams;
• abstain from sexual intercourse for 2-3 days;
• Before the procedure, you should not douche or wash the inside of the vagina.

What does a smear show on the vaginal microflora?

• Sexually transmitted infections (sexually transmitted infections). They are evidenced by the presence in the smear of a significant number of ureaplasmas, mycoplasmas, gardenella, gonococci, trichomonas and other pathogenic bacteria.
• Inflammation vagina(vaginitis, colpitis) or cervical canal(cervicitis and endocervicitis). Evidence of the inflammatory process is a large number of leukocytes in the smear.
• Vaginal dysbiosis. Violation of the composition of microflora contributes to the development of diseases of the genital area. Dysbacteriosis is diagnosed when the number of lactobacilli decreases and other types of microorganisms begin to predominate.
• Candidiasis or thrush. Normally, single fungi of the genus Candida are acceptable. At fungal infection their number increases sharply, pseudomycelium is found in the smear - threads of elongated cells and bud cells sitting on them.

4 degrees of vaginal cleanliness

What is the norm for a smear on the vaginal microflora?

• flat cells of the vaginal epithelium - up to 10 in the field of view;
• single leukocytes- up to 10 in the field of view;
• cells of the intermediate layer are single;
• “false key” cells - rare;
• the total number of microorganisms is “moderate”, sometimes “large”;
• mucus - in small quantities;
• Lactobacilli predominate among bacteria; other types of microorganisms are rare and rare.

• Large numbers of destroyed epithelial cells. This indicates cell lysis, which occurs with abnormal growth of lactobacilli.
• Key cells. These are epithelial cells covered with various bacteria.
• Parabasal cells. Cells of the lower layers of the mucosa. Their appearance indicates significant inflammation or atrophy of the mucosa.
• "Massive" amount of bacteria, except lactobacilli.
• Yeast cells with pseudomycelium and blastopores (bud cells). Their presence indicates thrush.
• Strict anaerobes - most of them are pathogens.
• Gonococcus - pathogens of gonorrhea.
• Trichomonas - causative agents of trichomoniasis.
• Atypical cells which are a sign of precancerous or oncological changes .

What do leukocytes indicate in a smear on vaginal flora?

Why is sensitivity to antibiotics performed when examining a smear?

Antibiotic sensitivity

There are a large number of antibiotics, but not all of them are equally effective against different groups bacteria (antibiotics do not affect viruses). It happens that after a course of antibiotics the patient does not recover or the disease returns after a few days/weeks. This happened because antibiotics that had little effect on the causative agent of the disease were prescribed for treatment.
In order for treatment to be as effective as possible, it is necessary to determine which antibiotics:

• completely destroy the bacteria that causes the disease;
• stop the growth of the pathogen;
• do not affect the life activity of this bacterium.

How is antibiotic sensitivity testing performed?

After cultivation (about 7 days), the growth of bacteria in test tubes is analyzed. Where bacteria are sensitive to the antibiotic, colonies do not form. This drug is optimal for treating the patient. In a test tube where drugs to which antibiotics are insensitive are added, the growth of bacteria is the most intense. Such medicines cannot be used to treat this disease.

What is smear culture?

Objectives of the study:

• identify the causative agent of genital infection;
• establish the degree of contamination - the number of bacteria in the vagina;
• monitor the state of microflora after long-term treatment with antibiotics and cytostatic drugs. It is carried out 7-10 days after discontinuation of the drug.

• to all pregnant women upon registration;
• with inflammatory processes in the genital organs;
• Gram-negative diplococci were found in the smear - to confirm gonococcal infection (gonorrhea);
• with vulvovaginitis, recurrent or chronic.

How is microbiological testing performed?

Vaginal discharge is placed in nutrient media - solutions or jelly-like masses that contain nutrients for bacteria. Test tubes and Petri dishes are placed in a thermostat for 3-5 days, where the temperature is constantly maintained at about 37 degrees, optimal for the proliferation of microorganisms.

After cultivation, the laboratory assistant evaluates the results. From each microorganism, during the process of division, a whole colony of bacteria grows. Based on its appearance, the laboratory technician determines the type of pathogen. And by the number of colonies one can judge the concentration of these microorganisms in the vagina. Next, the concentration is compared with normal values.
Those bacteria whose concentration exceeds 10 4 CFU/ml are considered significant. At this concentration, microorganisms can cause disease. If such a quantity of bacteria is detected, the result of the analysis is considered positive.

The conclusion issued by the laboratory states:

• view microorganism that predominates in the smear;
• pathogenicity microorganism - ability to cause disease:

• Pathogenic - the presence of which can only be caused by disease.
• Opportunistic - bacteria that cause disease only when immunity decreases, with a significant increase in their number.

• concentration microorganism in the vagina. In numerical terms and in the form of verbal characteristics: “meager”, “moderate growth”, “abundant growth”.

During a laboratory examination of a smear from the genital organs, the results sometimes reveal a mixed flora.

Then the fact of existence is confirmed inflammatory focus, pathogenic microorganisms that provoke its development are identified. The pathology is detected immediately, so the doctor can immediately prescribe treatment.

Laboratory testing allows not only to confirm the presence of microbes or fungi, but also indicates what percentage of healthy flora and what percentage of pathogenic flora is contained in the smear. When an infectious disease develops, a disorder of the acid-base balance is observed - an acidic environment replaced by alkaline.

When visiting a gynecologist or urologist, a smear is always taken in order to see the full picture of the development of pathology based on the test results obtained. If materials were collected from the vagina or urethra, then there is a suspicion of inflammatory processes in the genitals. Before this, characteristic signs of the presence of pathogenic microorganisms in excess usually appear. First, pain appears in the lower abdomen, the color of the discharge changes, and an unpleasant odor appears. Sometimes illness accompanied by itching and burning in the genital area.

In women, the risk of developing pathology increases during the climatic period, during pregnancy. Taking hormonal medications also affects the acid-base balance.

Only a doctor should make a diagnosis based on laboratory test results, taking into account all the patient’s symptoms and complaints.

What it is?

When mixed flora is found in a smear, this indicates imbalance of pathogenic and beneficial microorganisms. Normally, biological material contains particles of squamous epithelium, lactobacilli, white blood cells and many other beneficial bacteria.

If the body is completely healthy, 90-95% of the biological material will be beneficial flora, and the remaining 5% will be pathogenic microorganisms, represented by cocci and rods.

They do not harm a healthy person, but as soon as the number of pathogenic bacteria increases, there is a risk of getting sick. When mixed flora is detected in a smear, this indicates an increase in the number of pathogenic microorganisms that provoke the development of infection. In a normal state, they are practically impossible to detect. If test results confirm that an inflammatory process has begun in the body, urgent treatment is necessary. Only a specialist can prescribe it.

If it is detected in a cytology smear

This analysis allows us to identify the state of the microflora of the genital organs of a man or woman. If a smear is taken from the urethra or vagina, this allows you to see the volume of cells, identify their affiliation to pathogenic or beneficial flora.

A laboratory cytology test has more possibilities than conventional tests. When processing biological material, attention is paid to epithelial cells and their condition.

If a mixed flora is detected, this occurs due to the comparison and detection of the inflammatory process and substandard formations. This means that the acid-base balance is already disturbed in the body, it is progressing growth of pathogens. The difference between the tests is that, based on the results, a specialist can determine not only the changes themselves, but also their causes, and determine what nature of the infection is spreading in the body.

Mixed flora in men

With the help of a bacteriological smear, which is taken from the urethra, hidden forms of infection can be detected. It is for this purpose that the analysis is done. If mixed flora is detected, this indicates that pathogenic bacteria are actively multiplying, provoking inflammatory processes in the body.

Mixed flora often indicates the likelihood of developing prostatitis or urethritis, sexually transmitted diseases. If a laboratory test reveals that the white blood cell count has increased, this is considered a clear sign of inflammation. Then there is a possibility that gonorrhea, chlamydia, ureaplasmosis, and trichomoniasis are progressing in the body. The final diagnosis can only be made by a specialist based on analyzes and symptoms of the disease.

If it is found in women

When test results reveal a mixed flora in females, this indicates:

• the beginning of puberty in girls;
• development of sexually transmitted diseases;
• entry of the organism into the climatic period;
• increased functioning of the female reproductive glands;
• the initial stage or end of the menstrual cycle.

To determine the exact reason for the presence of mixed flora in biological material, you need to know the volume of leukocytes present there and take into account auxiliary factors.

The only thing that remains undeniable is the fact of imbalance between pathogenic bacteria and beneficial. Only a gynecologist can decipher a smear; based on his experience, he knows better what the true cause of the pathology is.

Pathogenic flora during pregnancy

The discovery of mixed flora in pregnant women is explained primarily by the fact that each organism is individual - it has its own microflora characteristics. Pregnancy often provokes an increase in the number of pathogenic microorganisms, especially fungal, which leads to the development of candidiasis (thrush), bacterial vaginosis. This occurs due to an imbalance in the acid-base balance.

Drastic changes also occur due to infection, exacerbation of chronic diseases, and changes at the hormonal level. Pregnancy planning should certainly include preliminary consultation gynecologist with certain tests. If this is not done, the opportunistic vaginal flora will be transformed into pathogenic, and an inflammatory process will begin to develop. It is always better to prevent a disease than to treat it.

Analysis of vaginal secretions is carried out from time to time to monitor the state of reproductive health, if there are complaints of itching and burning in the genital tract, during pregnancy or menopause. The results allow us to objectively assess the number and percentage of pathogenic and opportunistic microorganisms.

Microflora in the vagina

A smear on the flora in women is an analysis that allows you to assess the likelihood of pathological processes in the reproductive system. The analysis can detect squamous epithelial cells, cocci, Dederlein's lactobacilli, leukocytes and other microorganisms. Microflora can be scanty, medium, mixed or abundant. If the microflora in the vagina is poor, then only Dederlein's rods are detected, these are beneficial lactobacilli.

With an average number, large colonies of rods and 7-10 leukocytes will fall into the field of view of the laboratory technician. If we are talking about mixed microflora, 15-30 leukocytes are found in a smear in women, a small amount of cocci - spherical pathological bacteria. The result “abundant microflora” means that the inner walls of the vagina are covered with leukocytes in the absence of lactobacilli. This causes an unpleasant odor and discharge significant amount mucus.

Why do they take a smear test for flora?

A gynecologist takes biological material from the vagina (smear for flora) from women to identify the presence of pathogenic microflora and determine the presence of pathology. In the absence of complaints, doctors previously recommended taking the test annually, but now the American Congress of Obstetricians and Gynecologists has introduced new rules. People between the ages of 21 and 65 need to have smear tests every three years.

More often, diagnostic manipulation is performed in the presence of complaints: burning or itching in the vagina, pain in the lower abdomen, changes in the consistency, color or smell of discharge. The analysis should be done during pregnancy, suspected development gynecological pathologies, menopause. Experts recommend doing a smear after finishing taking hormonal medications that can affect acidity levels, and regularly visiting a gynecologist.

Preparing for analysis

A week before taking biological material from the vagina, it is recommended to stop taking antibiotics and other medications that can have a significant impact on the result of the smear. If you cannot stop taking medications, you should inform your doctor. The day before the analysis, you need to stop douching and treatment with suppositories or vaginal tablets.

What can be found in a smear

To diagnose pathological conditions, the doctor will most likely take a smear not only from the vagina, but also from cervical canal and urethra. Technically, these are completely different procedures, but the material is usually collected only once. During microscopic diagnostics, a laboratory technician can detect flat epithelium, mucus, Doderlein bacilli, and leukocytes in a smear.

The inner surface of the vagina and cervical canal consists of squamous epithelium. The presence of a large number of cells of this type indicates the possible development of urethritis or vaginitis. A lack of squamous cells indicates insufficient secretion of progesterone, a hormone necessary for successful conception and pregnancy.

Leukocytes are necessary for the body to cope with. Normally, the number of cells in the vagina does not exceed 10, in the cervix - 30. High concentration leukocytes most often indicates the presence of an inflammatory process reproductive system(vaginitis, cervicitis), accompanied by phagocytosis.

Mucus is produced by the vaginal glands and cervix. The amount of mucus in the smear should be moderate. Heavy discharge (the doctor will also assess this visually during the examination) may indicate vaginal dysbiosis. Doderlein rods constitute normal microflora; these are gram-positive cells. A lack of rods in most cases indicates the development of bacterial vaginosis.

Mixed type

If a mixed flora is detected in the analysis, what does this mean? The question is relevant for most women, and therefore should be given attention Special attention. The presence of a mixed type of flora in a smear indicates a balance between normal and pathogenic microorganisms. With this result, squamous epithelium, leukocytes, Doderlein's lactobacilli and other types of microorganisms are found in the biological material.

In the absence of an inflammatory process, the number of lactobacilli predominates (approximately 90-95%). The remaining 5% comes from opportunistic bacteria, which include rods and cocci. Potentially dangerous microorganisms do not harm the body, but as their numbers increase, the threat of developing pathology increases.

The risk of developing diseases with mixed abundant flora in a smear during pregnancy is very high. Bearing a child in general is a special condition of the female body, in which existing chronic diseases or new problems will appear. It may be necessary to undergo complex treatment to prevent the uncontrolled proliferation of pathogenic agents.

During the analysis process, biological material taken from the vagina is assigned a degree of purity. This indicator indicates the presence of pathogens and the level of acidity of the microflora. The first degree is a normal condition in which opportunistic microorganisms and lactobacilli are in a state of balance, the permissible limits are not violated. The second degree is a relative norm. At the same time, the percentage of pathogenic bacteria is slightly increased, but does not pose a health hazard.

The third degree of purity involves a large amount of mixed flora in the smear. At the same time, the number of opportunistic microorganisms prevails over Doderlein bacilli, which are normally contained in large quantities in the secretions. We are definitely talking about pathology if the results indicate a quarter degree of vaginal cleanliness. This condition is characterized by a predominance of squamous epithelium, pathogenic bacteria and leukocytes.

Abundant microflora

Mixed flora in large quantities usually indicates the presence of pathological processes in the uterus. At the same time, microscopic examination of the biological material reveals a large amount of mucus and squamous epithelium, layers of MPE cells, shaped elements blood, there are traces of phagocytosis. The pathological condition is treated with vaginal suppositories, which inhibit the functioning of pathogenic microorganisms and restore normal level pH.

Coccobacillary microflora

Mixed flora in small quantities is pathological condition. If the smear is dominated by coccobacilli (something between ordinary cocci and bacilli), then in most cases the gynecologist diagnoses the presence of Gardnerella vaginalis, Haemophilus influenzae or chlamydia. An increase in the number of pathogenic agents will lead to the development of fungal infections, vaginitis and bacterial vaginosis.

Causes of flora disturbance

A sparse mixed flora in a smear can be detected after taking antibacterial drugs, which strongly affect the immune system, creating conditions for the development of pathogenic bacteria. Disturbances in the balance of microflora can result from taking hormonal drugs contraception. At the same time, the number of lactobacilli and leukocytes in the environment usually increases.

Women themselves provoke an imbalance by protecting themselves from unwanted pregnancy. Bad results flora smears are usually obtained by those patients who have established intrauterine device. This contraceptive creates an imbalance suitable for the active development of coccobacilli.

Frequent douching provokes the proliferation of pathogenic microflora and washing out the normal contents of the vagina. Therefore, intimate hygiene should be moderate. Daily washing with plain water is enough (at least once a day, maximum after each visit to the toilet or changing a hygiene product during menstruation). The vagina is a self-cleaning system, so it does not require excessive hygiene procedures. It is not advisable to use aggressive agents for intimate hygiene. It is better to choose gels with a neutral pH, without dyes or flavors.

Is treatment required?

Mixed flora in a smear requires clarification of the diagnosis, because therapy is not required in all cases. If erosion is present, cauterization is prescribed, but some forms of the disease do not require medical intervention(regular observation only). Gonorrhea, mycoplasmosis, chlamydia, trichomoniasis and similar diseases are treated by special means, containing components aimed at combating certain bacteria.

If there is a slight change in the microflora, a course is enough vaginal suppositories or ointments. After finishing treatment, you need to take the test again. If the results again reveal pathological microorganisms in large quantities and mixed flora in the smear (in women, this may be a consequence of taking certain medications), you may need to undergo a course of therapy with stronger drugs.

The gynecologist may recommend additional examinations to the patient that will eliminate the possibility of an incorrect diagnosis (repeated analysis after certain preparation, for example, completing a course of antibiotics or refusing hormonal contraceptives, ultrasound of the pelvic organs, analyzes of biological fluids, etc.). It is better to immediately listen to the doctor’s advice in order to immediately clarify the diagnosis.

Features during pregnancy

Mixed microflora is often detected in Pregnant women undergo this test at least three times: when issuing an exchange card and registering, up to thirty weeks and in the third trimester, shortly before giving birth, that is, at thirty-six to thirty-seven weeks. Sometimes it may be necessary to additional examination: if there are complaints of itching, changes in the amount, smell or consistency of discharge, burning.

A successful sign of conception before the onset of delayed menstruation is a change in character vaginal discharge. During implantation, immunity decreases slightly because the fertilized egg is often perceived by the body as a foreign object. Pregnant women often encounter thrush. It is important to get rid of the symptoms of this disease before delivery, because the child can become infected when passing through the mother’s genital tract.

If mixed flora is associated with serious illnesses, the doctor may recommend terminating the pregnancy. The fact is that many drugs are prohibited during pregnancy, and the lack of therapy can lead to intrauterine infection and death of the embryo. Therefore, experts recommend getting tested and undergoing treatment at the stage of pregnancy planning.

It is much easier to prevent any pathology than to eliminate it (especially if you have to be treated during pregnancy). Mixed flora in a smear in women is no exception. Do not forget about the prevention of diseases of the reproductive system and regularly visit a gynecologist. Following simple rules will not only prevent gynecological diseases, but also to bear a healthy child.