How long does it take for Gardnerella to appear? How the infection is transmitted. General description of gardnerellosis

Gardnerellosis- what kind of disease is this and how dangerous is it? First of all, it should be noted that gardnerellosis is a gynecological disease that is sexually transmitted and can be found even more often than, for example, or.

As a rule, people most often fall ill who lead disorderly sex life and having casual connections. And the consequences can be very unpleasant. In women, the disease can even lead to infertility. In men, the disease is not so pronounced and passes in most cases without symptoms, but it is also fraught with complications - up to inflammation of the urethra and the same infertility.

Thus, gardnerellosis is a disease that needs to be taken seriously. And at the first signs, immediately consult a doctor. We hope the answer to the question “gardnerellosis - what is it?” You received. Now let's look at the causes of the disease, symptoms and treatment methods.

Causes

Gardnerellosis is caused by the bacterium Gardnerella vaginalis. Once the bacterium enters a woman’s body and begins to actively develop in it, it leads to vaginal dysbacteriosis.

There may be several reasons for gardnerellosis: as we have already said, these include disordered sexual intercourse, a weakened immune system, and non-compliance with personal hygiene rules. Vaginal dysbiosis is also facilitated by changes in hormonal levels, occurring after abortion, pregnancy, childbirth, climate change and even poor quality food.

In men, there is only one reason for the appearance of gardnerellosis - sexual infection from a partner. Once in a man's body, Gardnerella vaginalis can lead to inflammatory processes urethra and subsequent complications. Up to prostatitis.

Signs and symptoms of gardnerellosis

In women, the symptoms of gardnerellosis are expressed, first of all, by abundant, which have a smell reminiscent of rotten fish. Also, discharge from gardnerellosis is characterized by uniformity, wateriness and color: it can be yellow or white-gray.

Approximately half of women with gardnerellosis experience an inflammatory process of the vagina, or, as it is called, vaginitis. It is characterized by itching and burning. or just getting stronger.

In men, signs of gardnerellosis can also include burning, itching and pain when urinating.

Treatment and prevention

Treatment of gardnerellosis can be quick and quite effective, provided that the disease is not advanced and has not taken over. chronic form. How to treat gardnerellosis? Before answering this question, it is necessary to understand that the treatment of the disease is divided into two stages, and each of them is inseparable from the other. First you need to stop the proliferation of harmful bacteria, this is achieved through the use of antibacterial drugs. The course of treatment lasts 7-10 days.

The next stage is recovery normal microflora vagina due to its colonization with lactobacilli.
In any case, how to treat gardnerellosis should be determined by an experienced specialist and prescribed a course of treatment. Therefore, we will not dwell on the drugs used to eliminate the symptoms of gardnerellosis - self-medication is fraught with various complications. We only note that both partners must undergo treatment to avoid reinfection. Treatment for gardnerellosis should only be prescribed by a doctor based on each specific case.

And a little more about such a concept as the prevention of gardnerellosis. The recommendations here are quite simple: avoid promiscuity, have normal nutrition, maintain personal hygiene.

Microorganisms are constantly present and developing in the vagina of a healthy woman, 95% of which are beneficial microflora: lacto- and bifidobacteria. In addition to them, the mucous secretion also contains opportunistic species: bacteria, mycoplasmas, fungi, gardnerella and others. If not favorable conditions, a decrease in the body's immune defense, pathogenic microorganisms begin to actively grow and develop, which causes the appearance of gardnerellosis in women.

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Etiology

Gardnerellosis is caused by an anaerobic bacterium that does not form capsules and spores - gardnerella vaginalis. These microorganisms are found in small quantities in the normal vaginal microflora of a healthy woman. Under favorable conditions, colonies of microbes begin to grow rapidly, destroying lactic acid bacteria, as a result of which gardnerellosis develops. In destruction beneficial microflora Other opportunistic microorganisms are also involved: fusobacteria, peptostreptococci, etc. Therefore, we can conclude that Gardnerella vaginalis is not the only pathogenic microorganism that causes this disease: the pathology is mixed.

Gynecologists call this pathology bacterial vaginosis. However, in International classification diseases, it is impossible to meet such a diagnosis: this term came into use after the creation of the official list.

When beneficial microflora is destroyed, an optimal environment for the proliferation of pathogenic microorganisms is created, the pH of the vagina increases to 7 and higher. Together with gardnerellosis, chlamydia, nonspecific vaginitis and other diseases develop, which causes vaginal dysplasia.

Gynecologists highlight following reasons emergence bacterial vaginosis among women:

• The use of antibacterial agents and antiseptics for douching without a doctor’s recommendation.
• Uncontrolled use of spermicides and contraceptives.
• Intrauterine contraception without indications.
• Hormonal imbalance, accompanied by a decrease in blood volume during the menstrual cycle.
• Lengthening the period monthly cycle during puberty and menopause.
• Inflammatory pathologies of the genitourinary system.
• Promiscuous sexual intercourse.
• Immunodeficiency pathologies.
• Developmental defects.
• The presence of a foreign body in the vagina and uterus.

Gardnerellosis - dangerous pathology, because due to weakening local immunity and the development of bacterial flora, there is a high risk of HIV infection.

Symptoms and complications

At the initial stage of development, gardnerellosis occurs without obvious clinical signs, but with the development of the pathological process, pronounced symptoms appear:

1. 1. Uncharacteristic discharge with an unpleasant odor.
2. 2. Itching and burning in the vagina.
3. 3. Swelling of the labia.
4. 4. Pain during sexual intercourse.
5. 5. Difficulty urinating: it can be difficult, accompanied by pain and itching.

Actively multiplying, the microorganism produces amino acids, which, when broken down, release amines - substances that give vaginal discharge a fetid fishy smell.

Gardnerella vaginalis is sexually transmitted. In women during pregnancy, the disease is rarely diagnosed. Due to hormonal changes in the vagina, the number of lactobacilli increases, which create an acidic environment and protect the cervix from the penetration of pathogenic microorganisms.

However, the treatment of bacterial vaginosis during pregnancy requires special attention, since the disease can cause serious complications, such as:

• Miscarriage.
• Premature birth.
• Postpartum endometritis and sepsis.
• Uterine bleeding with infection of the child.
• Insufficient baby weight at birth.
• Pneumonia of newborns.
• Chronic diseases of the genitourinary system.
• Complications in the mother after surgery.

Untreated gardnerellosis during pregnancy is dangerous for women and children. Therapy is difficult because antibacterial agents Do not use during pregnancy.



Diagnostics

To confirm or exclude the diagnosis, the doctor examines and interviews the patient. Additionally, the woman is sent for tests:

1. 1. pH-metry, or examination of vaginal mucus - to determine the alkaline reaction. The normal vaginal environment is created by lactic acid bacteria. In case of deviations, the doctor diagnoses an imbalance between pathogenic and beneficial microorganisms.
2. 2. A smear for ureaplasma, which is mixed with a solution of potassium hydroxide. This produces a characteristic foul fishy odor.

Examining the biomaterial, a laboratory technician may notice symptoms of gardnerellosis:

1. 1. Desquamated cells lining the mucous membrane.
2. 2. Epithelial cells with gardnerella and other pathogenic microorganisms.
3. 3. Lack of lactic acid bacteria.
4. 4. Increased content of leukocytes that occurs during inflammatory reactions.

In addition to taking smears, the doctor may refer the patient to additional methods diagnostics such as:

1. 1. Immunofluorescence.
2. 2. PCR diagnostics, or polymerase chain reaction.
3. 3. DNA hybridization.
4. 4. Cultivation of microorganisms.

The above methods are quite expensive and labor-intensive, so diagnostic measures they resort to in rare cases.

The norm for Gardnerella in women is 10 to 5 CFU. If the values ​​in the analyzes exceed these indicators, the diagnosis is considered confirmed.



Treatment

After making a diagnosis in order to exclude the cause of the pathology, the doctor prescribes a treatment regimen for the patient, which includes the following medications:

1. 1. Antibiotics wide range actions: Doxycycline, Azithromycin. The selection of the product is made individually based on the general condition of the woman and the degree of invasion.
2. 2. Antimicrobial tablets: Metronidazole, Trichopolum, Tiberal, Ornidazole (affects anaerobic pathogenic microorganisms), Imidazole, Macmiror, Clindamycin, Vilprafen and others.
3. 3. Local treatment - vaginal suppositories, gels and creams for gardnerellosis: Clindamycin, Flagyl, Hexicon, Metronidazole (an antiprotozoal agent with antibacterial activity).
4. 4. If gardnerellosis is combined with thrush, they are prescribed combined agents antimicrobial and antifungal action: Terzhinan, Polygynax, Neo-penotran.

During pregnancy, a woman can use it as a treatment vaginal suppositories Klion.




In rare cases, the doctor resorts only to local treatment, but the effectiveness of therapy will be low.

During treatment, the patient is recommended to adhere to the rules dietary nutrition. To replenish the necessary vitamins and microelements in the body, it is necessary to include fish, poultry, dairy products. The basis daily menu should consist of vegetables and fruits.

After antibiotic therapy, the doctor prescribes probiotics, which help restore the beneficial microflora of the vagina. Effective drugs:

1. 1. Vagilak.
2. 2. Lactobacterin.

Alternative medicine

As an auxiliary method, you can use treatment with herbs and plants at home after consultation with your doctor.

Effective folk remedies:

1. 1. 250 g chopped oak bark pour 750 ml of water, leave for 5 hours. Boil the liquid for 20 minutes, then strain. Pour into a basin and use for sitz baths before bed. The course of treatment is 14 days.
2. 2. Mix juniper berries, chamomile, oatmeal, leaves in equal proportions walnut and oak bark. For 1 liter of boiling water, take 200 g of the mixture and leave it covered for an hour. Then the broth must be strained and used to add to sitz baths.
3. 3. Soak a cotton swab in 10 ml of aloe juice. Insert into the vagina for 9-10 hours, you can leave it overnight. The course of treatment is one week.

Baths and douches cannot be used during pregnancy. Women are advised to wash their vagina with herbal antiseptics. After giving birth, the patient undergoes a course of drug therapy.

Gardnerellosis – infectious inflammatory disease, based on dysbiosis of the natural microflora in the vagina associated with the proliferation of the bacteria Gardnerella vaginalis. The minimum amount of the microorganism is found on the mucous membranes genitourinary tract even healthy women.

But only under certain unfavorable conditions does the microorganism begin to multiply and thereby cause bacterial vaginosis. If a woman is diagnosed with gardnerella, and the first symptoms of the disease have already appeared, then treatment must be started immediately to avoid complications.

Women are sensitive to their health in the field of gynecology. The appearance of pain, discharge, unpleasant odors, itching and others pathological abnormalities leads to discomfort and panic. In fact, most diseases belong to a harmless group that can be treated with simple medications and prevention. Gardnerellosis is one such disease.

To prevent the development of the disease, it is important to keep the vaginal microflora in proper condition, but it is impossible to constantly monitor this. A decrease in beneficial microorganisms (lactic acid bacteria) for microflora means a decrease in local immunity, and this becomes main reason development of sexual diseases in women.

It is important to know that thrush or gardnerellosis bacteria are always present in the vagina, but only when the balance is imbalanced do they acquire aggressive qualities and begin to actively multiply.

Gardnerellosis is considered a relatively harmless disease that is easy to treat, but it creates a favorable environment for others dangerous diseases(chlamydia, vaginitis, colpitis), which without timely treatment lead to complications and loss of reproductive functions.

It all starts with the growth of pathogenic microbes, which, in the absence of immune protection, fill and infect the genitals, increasing the acidity (pH) to a value of 7 or more. This indicator is considered one of the indicators of development.

After exposure to certain factors and weakening of the immune system, the infection begins to multiply in the vaginal environment. During this, it begins to produce amino acids, which break down into volatile amines. These compounds cause an unpleasant fishy odor, which is characteristic of gardnerellosis.

The pathology is characterized by a significant decrease in the amount beneficial bacteria(lactobacillus), which produce lactic acid. As it decreases, the acidity in the vagina increases and the pH level changes to neutral.

A similar situation can occur in men, but this happens extremely rarely, because most of the bacteria are excreted in the urine, or the male body successfully suppresses their reproduction.

Reasons for development

Most cases of gardnerella infection are through sexual intercourse, but there are other ways to become infected. Doctors list the main causes of the disease as:

• decrease in local immune system due to stress, colds and infectious diseases;
• reception strong antibiotics, which disrupt the vaginal microflora and kill lactobacilli in the intestines and genitals;
• douching (women often douche various decoctions, without doctor’s recommendations, thereby simply “washing out” beneficial microorganisms;
• usage contraception(particularly dangerous are drugs containing 9-nonoxyl, which also reduces the number of lactobacilli);
• promiscuity with frequent changes of partners;
• pregnancy, menopause and any other hormonal changes (including the use of hormonal drugs);
• unprotected sexual intercourse.

There are risk factors that can provoke gardnerellosis:

• pathologies associated with endocrine system (diabetes, thyroid etc.);
• improper and irregular personal hygiene;
• hormonal imbalances (menopause, pregnancy, menstrual irregularities);
• Availability chronic diseases in the body, diseases of the genitourinary tract;
• frequent stress and overexertion;
• wearing synthetic, tight-fitting underwear.

Most often, gardnerellosis is combined with intestinal dysbiosis. The bacterium is usually activated during other sexually transmitted diseases: chlamydia, gonorrhea, mycoplasmosis.

How is the infection transmitted?

The main route of transmission of gardnerellosis is sexually, during classical and oral sexual contact. The source of infection is a sick woman. The man acts as a carrier of the disease. It is believed that Gardnerella vaginalis cannot live in the male body.

However, the latest medical research show that in males who have unprotected sexual intercourse with a sick woman, Gardnerella bacteria are also found in the urethra. In any case, pathological gardenerellosis bacteria rarely take root in men.

Gardenerellosis is classified as a venereological type only if the bacterium goes through an incubation period, which lasts 4-10 days. Thus, during sexual intercourse a man transmits the disease to a healthy woman, where the microbes take root or stop developing depending on the level of the immune system.

It is possible to transmit gardnerellosis from mother to child during childbirth. But the bacteria cannot multiply in the baby’s body, since the baby does not have enough glycogen, which is necessary for the reproduction and active functioning of the pathogenic microorganism.

Rarely possible contact-household method transmission of infection, for example, through bed dress, towels and underwear. You can become infected by using another person’s hygiene products or from someone else’s bedding. Even a carrier of the disease, an infected person who has no clinical manifestations, is dangerous to other people.

First signs

Can help determine the onset of development primary signs. There are not many of them, but they can cause significant discomfort to a woman. Incubation period bacteria last from 4 to 10 days and at this time signs appear such as:

1. Unpleasant smell Looks like " rotten fish"from the genital area. A woman has to wash herself several times in order to get rid of discomfort, but soap does not help, but only worsens the situation. The reason for this smell lies in the breakdown of amines, which are found in the waste products of gardnerella.
2. Itching external genitalia.
3. Change in consistency and color of discharge(thicker, with a yellowish tint, can be white, gray or yellow).

The onset of gardnerellosis is similar to some others venereal diseases, therefore, if symptoms appear, you should consult a gynecologist so as not to confuse the pathology with another disease.

Classification: types of disease

Anaerobic microorganisms - Gardnerella vaginalis have oval shape and reach a size of 1-1.5 microns. At low concentrations they do not cause symptoms or complications, but when their quantity increases, inflammatory processes appear that can lead to endometritis in a woman, and urolithiasis in a man.

Officially adopted classifications V medical practice no, but there are lists that gynecologists use when making a diagnosis. The following types are distinguished:

• gardnerellosis in the genital tract in men and women;
• damage to the upper genital tract;
• bacterial vaginosis;
• development of the disease during pregnancy.

Each type requires special approach in treatment, so it is important to establish a true diagnosis and find the cause of development.

Clinical forms of the disease

Medical classification includes the following forms of the disease:

• Bacterial vaginosis. Is the most common clinical form. It is characterized by the detection in the vagina, in addition to gardnerella, of other microorganisms - mycoplasma, etc. With bacterial vaginosis, there are no signs of inflammation (swelling, redness, etc.). But there are signs of disruption of the vaginal microflora. The pathogenesis of this form of gardnerellosis is a decrease in general and local immunity.
• Gardnerellosis of the upper genital tract. Infection in this form is transmitted lymphogenously (through lymph) and hematogenously (through blood). There were cases when this disease was complicated by the development of endometritis and inflammation of the ovaries and fallopian tubes. When bacteria enter the bloodstream, shock and septicemia may develop.
• Gardnerellosis of the urinary tract. This form develops due to the location of the vagina and urethra. Sometimes even a healthy woman can have gardnerella in her urine. Confirmation of this form of the disease will be when more than 1000 CFU of microorganisms are detected in 1 ml of urine.
• Gardnerellosis in pregnant women. Occurs in 17% of cases. Often the infection is ectopic, since at this time the defense mechanisms body. With the intrauterine form in women, the risk of premature birth increases several times.

Main symptoms

Gardnerellosis can be asymptomatic or manifest clinical symptoms. In the first case, the disease will not manifest itself externally in any way, but lab tests confirm the presence of infection.

In the second case, the woman will be bothered by symptoms such as:

• the appearance of atypical discharge (cheesy consistency, grayish-yellow color with a characteristic fishy odor);
• itching in the external genital area;
• swelling and hyperemia of the labia;
• painful sensations during sexual intercourse (occurs due to mechanical irritation);
• painful and frequent urination.

If the disease is not treated, the unpleasant odor does not go away even after washing. Using soap even increases its spread. During sexual intercourse, the smell also becomes pronounced.

Features of manifestation during pregnancy

Gardnerella in pregnant women has the same symptoms as those who are not pregnant:

• pronounced fishy smell;
• swelling of the external genitalia;
• urinary disorders.

In expectant mothers, the disease is most often accompanied by candidiasis (thrush). In this case discomfort are doubly intensified. There is a risk of candidiasis affecting the mucous membranes, skin and internal organs fetus

What are the dangers of infection during pregnancy?

Gardnerella has no direct effect on the fetus, since it does not penetrate the blood-placental barrier. But indirectly, the disease can cause complications during childbirth and gestation.

These will include:

Since the pH of the vaginal environment and the acidity of sperm will become almost identical in gardnerellosis, it will be easier for sperm to reach the egg and fertilize it. To exclude the presence of the disease during pregnancy, a few months before planning pregnancy, you should take smears for the presence of various microorganisms.

If no pathogenic bacteria are identified, then conception can safely begin.

The difficulty of treating gardnerella in pregnant women is that some antibiotics and others medicines cannot be used by pregnant women, as it may harm the fetus. Therefore the probability successful treatment infections are sharply reduced.

Symptoms of Gardnerella in pregnant women indicate the stage of the disease, the further course of the disease and the possibility of complications.

Diagnostics

To diagnose the disease, the following tests are done:

A doctor can assume the presence of gardnerellosis based on an examination of a woman in a gynecological chair and a correctly collected medical history. Can be done general analysis blood, in the presence of infection, an increase in the erythrocyte sedimentation rate and an increase in the number of leukocytes will be observed. Such tests indicate the presence of an inflammatory process in the body.

What should be normal in a smear?

Previously, it was believed that normally a smear should not contain any pathogenic microorganisms other than lactobacilli. Over time, it became clear that it is impossible to keep the vaginal microflora in a “sterile” form; there may still be isolated Gardnerella, mycoplasma, and ureaplasma.

At the moment, there is a certain indicator of the norm called titer. The titer tells how many gardnerella are found in 1 ml of liquid. Normal indicator equal to 10*4 CFU/ml. Anything above this titer means the presence of the disease.

The level of gardnerella in the transcript of the analysis in women whose treatment ended favorably should show a titer below 10 * 4 CFU/ml, which will indicate that the patient is healthy.

Treatment regimen

The course of treatment for gardnerellosis usually consists of 2 stages:

Treatment consists of 2 tasks:

• destroy pathogenic microorganisms,
• “populate” normal microflora.

Medications are available in the form of tablets, injection solutions, ointments, gels, and suppositories.

Medications

Antibiotics used to treat gardnerellosis can be divided into local and systemic drugs.

As local remedies, women are prescribed:

• Metronidazole (available as a 0.75% gel),
• Fluomizin (a tablet inserted into the vagina every night),
• Clindamycin (2% cream).

The course of treatment with the above drugs is 5-7 days.

TO system tools can be attributed:

• Metronidazole and its analogues (Klion, Metrogyl);
• Tinidazole;
• Clindamycin.

All of the above drugs should not be taken together with alcohol.

Otherwise, the following complications may arise:

• dizziness;
• headache;
• drop in blood pressure;
• collapse;
• dysfunction of the urinary tract.

Before you start taking medications that restore the normal microflora of the vagina, you need to take repeated tests and make sure that there is no gardnerella in the body. If the treatment was successful and no pathogenic microorganisms were detected, you can start taking medications that contain lactobacilli.

Such means include:

• Lactobacterin;
• Acylact;
• Gynoflor.

The cost of funds is about 200-300 rubles. The course of treatment is usually 12-15 days.

Traditional methods of treatment

It should be noted that folk remedies cannot replace antibiotic therapy; they can only speed up the healing process. Gardnerella in women: symptoms and treatment folk remedies cannot be used as a main drug, without auxiliary medications, otherwise it will not be effective.

Recipe No. 1

You can make a bath from 300 g of oak bark. First, the bark is filled with water, brought to a boil, and cleaned. Then the filtered broth must be diluted in 3 liters of water. The procedure should be carried out within 15-20 minutes.

Recipe No. 2

It is necessary to mix juniper fruits, pharmaceutical chamomile and walnut leaves in equal proportions. The mixture should be filled with water, boiled for 2 minutes, and then filtered. Next, you need to prepare a tampon from gauze, soak it in the prepared broth and insert it into the vagina.

Recipe No. 3

You can prepare an infusion of chopped sage. To do this, pour 1 tbsp of dry plant into 1 liter of boiling water. Next, the broth should be allowed to brew for 3-4 hours.

The infusion should be taken orally 2 times a day (morning and evening), 1 glass.

Will douching help?

Douching has a positive effect in the treatment of gardnerellosis. The most important thing is to discuss therapy with your doctor, do not overuse medications and follow the dosage described in the prescriptions.

The most popular douching is using apple cider vinegar. It is diluted per 1 tbsp. vinegar 1 glass of water. The procedure must be carried out daily, once a day for 7-14 days. The main effect of this method is aimed at normalizing the acidity of the vagina. In an environment with normal Ph, it will be much more difficult for Gardnerella to reproduce.

Douchings from:

Features of treatment during pregnancy

Pregnant women are strictly prohibited from using Clindamycin to treat gardnerellosis. In the first trimester, Metronidazole should be excluded from taking. It can be used again in the second and third trimester. The only drug that has no contraindications during pregnancy is Ampicillin. It can be used regardless of trimester.

Pregnant women are allowed to use almost everything local remedies(creams, ointments, gels), since they do not in any way affect the development of the child and his pregnancy.

How long does it take to treat the disease?

The duration of treatment depends on the timeliness of contacting a doctor, the stage of the disease, individual characteristics body and health status of the patient. When a disease is detected on initial stages, treatment is 9-12 days. In advanced cases, treatment may take about 1-1.5 months.

If the process becomes chronic, the path to recovery will be even longer – more than 2 months.

Treatment of gardnerella in women after a favorable recovery should be additionally supported for 1-1.5 months with the help of yoghurts (with lactobacilli) and immunomodulators.

What danger does it pose, possible consequences and complications?

Unlike most diseases in the field of gynecology, gardnerellosis can proceed calmly with little discomfort. Microorganisms in small quantities are not dangerous, and even at the stage of inflammation they only cause unpleasant symptoms. This often causes late visits to the doctor, where patients learn about complications.

Gardnerellosis is not dangerous, but it is these pathogenic bacteria that are conductors for other diseases, including venereal diseases. The main complications include the onset inflammatory processes in the pelvic area, urethral syndrome, neoplasia, endometritis and even infertility in women.

At timely treatment the disease goes away without a trace and does not cause any complications, but in some cases(most often with untreated gardnerellosis) may occur:

• salpingitis;
• salpingo-oophoritis;
• endometritis;
• inflammation in the genitourinary system.

Men have a list possible complications not so big, but here cystitis, prostate, non-gonococcal urethritis and balanoposthitis can develop as complications.

If complications are not treated, infertility may result.

Can the disease go away on its own?

Without treatment, gardnerella cannot go away on its own. Pathogenic bacteria will multiply and harm the woman’s body, leading to complications. Gardnerella manifests itself quite quickly in women. The first symptoms can be noticed independently, and treatment must begin immediately when pathology is detected.

Important diagnostic sign The disease is that when washed with soap, the unpleasant “fishy” smell only intensifies and does not disappear. To protect yourself from gynecological diseases, you should always take a closer look at the state of your body, active image life and regularly carry out hygiene measures.

Conducting preventive actions you can easily protect yourself from the development of gardnerella and concomitant diseases. When the first signs appear, it is important that the doctor quickly determine the source of the infection in order to prevent relapse after treatment.

Article format: Lozinsky Oleg

Vileo about gardnerella in women

Treatment in women with medications, douching and folk remedies:

Instructions

Gardnerella was discovered in 1955 in a woman suffering from bacterial vaginosis. That is why gardnerella has been called the main cause of bacterial vaginosis. Later, when the level of diagnostics made it possible to identify other microorganisms, the determining role of Gardnerella in the pathogenesis of vaginosis was rejected. It was called a “marker of vaginosis”, since gardnerellosis was most often found in women suffering from vaginosis. Specific signs such as “fishy smell”, itching, burning, copious discharge characteristic of both vaginosis and gardnerellosis.

More serious studies have revealed what is found in the vagina of healthy women without a deficiency of normal microflora and in women with a deficiency of vaginal lactoflora, but without signs of vaginosis. This was the reason for transferring Gardnerella to the category of opportunistic microorganisms.

The main route of transmission of Gardnerella is sexual, infection occurs during unprotected sexual intercourse. There is evidence that gardnerellosis can be transmitted through oral-genital and oral-anal contact, as well as during anal intercourse. These data are confirmed by studies in which gardnerella were identified in rectal lavages and back wall throats of women practicing homosexual acts and different kinds sex.

The likelihood of transmission of infection from mother to child during childbirth or in everyday life is low, since gardnerella feeds on glycogen in epithelial cells, the percentage of which is regulated by estrogens. In girls before puberty, estrogen levels are insufficient, and therefore gardnerella quickly dies due to lack of nutrition. Although cases of child infection during childbirth and intrauterine infection have been clinically confirmed. Household way infection should not be ruled out, since this is the only way to explain the presence of gardnerella in the vagina.

Men do not suffer from gardnerellosis, but they are the main link in the transmission of infection. A few days after contact with infected woman It clears itself, but during this time it is potentially dangerous and can infect healthy women. Long-term carriage is typical with chronic urethritis and prostatitis. Gardnerella can be detected only in the first few days after contact with a sick woman. The disease occurs extremely rarely and is a sign of reproductive ill health in a man.

The presence of gardnerella in the vagina, even in the absence of signs of vaginosis, is already a risk factor, since any decrease in immunity or stress can trigger the development of vaginosis. Some diagnosticians associate the absence of signs of inflammation in the presence of Gardnerella not with its conditional pathogenicity, but with its ability to disrupt the activity of leukocytes.

Garnirelosis needs to be treated even if there are no symptoms of vaginosis. This opinion is shared by the majority of obstetricians and venereologists. It responds well to treatment and a single course of drugs from the tinidazole group, which are prescribed orally and locally in the form of vaginal tablets or suppositories, is sufficient. Using a condom almost completely eliminates infection with gardnerellosis.

Gardnerella is found quite often in women with weakened immunity and vaginal dysbiosis; it is the one that causes Gardnerella vaginosis, which will be discussed in this article.

Gardnerella in women - what is it?

Very often, bacterial vaginosis is caused by gardnerella (gram-variable or gram-negative rods). This bacterium belongs to the facultative anaerobes; it does not form capsules and spores, and exhibits good adhesion on the surface of the mature vaginal epithelium. Actively multiplying in the vaginal environment, gardnerella secretes its metabolic products - amino acids. From these amino acids, volatile amines arise - compounds that give vaginal discharge an unpleasant fishy odor.

The main sign of this pathology is considered to be “key cells”. This is the name of mature epithelial cells, on the surface of which a huge number of coccobacilli or gram-variable rods are attached: Gardnerella vaginalis, Mobiluncus spp., obligate anaerobic bacteria.

Gardnerella in a smear

Gardnerella in women - where it comes from

An infectious syndrome of a non-inflammatory nature, which is based on vaginal dysbiosis, is called bacterial vaginosis in the scientific literature. This pathology is characterized by very high level obligate anaerobic microbes and a significant decrease in the number of lactobacilli in vaginal secretions, up to their complete absence.

Due to a pronounced decrease in the level of lactobacilli that produce lactic acid, the pH in the vagina increases, causing it to become neutral. These conditions promote reproduction in the vagina various organisms(both pathogenic and opportunistic). So, bacterial vaginosis is a consequence pronounced violation microflora balance, in which the natural vaginal flora is replaced by anaerobic bacteria - Gardnerella vaginalis, Bacteroides spp., Mobiluncus spp., Mycoplasma hominis, peptostreptococci and some others. The concentration of these microorganisms can exceed the permissible values ​​very much - 1000 times. Thus, the opportunistic gardnerella living in the woman’s genitals begins to actively reproduce.

Factors for the development of gardnerellosis in women

An increased risk of spreading gardnerella is associated with the following factors:

Inflammatory processes of the genital area.

Menstrual irregularities.

Taking some medical supplies(antibiotics, drugs containing hormones, immunosuppressants).

Long-term use of intrauterine contraception.

Weakened immune system.

Disturbed intestinal biocenosis.

Mental stress and stress.

How is gardnerella transmitted?

Gardnerella can be passed from one sexual partner to another. In men who have sexual contact with a woman who has been diagnosed with gardnerella, it is also often found in the urethra. True, treatment of the sexual partner is not required if there are no additional pathogens of sexually transmitted infections and acute symptoms.

Gardnerella in women: symptoms

Gardnerellosis can occur in chronic or acute form. At chronic course symptoms may not be present or may be very sparse. The symptoms are not specific, they are typical for many STDs. In the acute form of gardnerellosis the following is noted:

Itching and burning in the genitals;

Pain during sexual intercourse;

Copious discharge;

An unpleasant fishy smell is perhaps the only difference from other infections.

We have a detailed differential diagnosis of bacterial vaginosis with trichomoniasis, ureaplasmosis, and thrush in women on our website.

Symptoms of the disease become obvious when the leukocyte response is reduced. Scientists have suggested that gardnerella is capable of producing a leukotoxic factor. Under its influence, functional and even structural changes leukocytes.
Changes in vaginal flora associated with gardnerellosis can lead to serious consequences. Endometritis or salpingoophoritis may develop. Pregnant women face a difficult birth and a high risk of spontaneous abortion.

Gardnerella in women: photo

Methods for diagnosing gardnerella in women

Diagnostic criteria for this pathology are:

■ Presence of so-called “key cells” in smears. Lactobacilli, as well as polymorphonuclear leukocytes, are absent.

■ Homogeneous creamy consistency of the discharge.

■ Positive result with amino test. (A sample of the secretions is placed on a glass and a little potassium hydroxide solution is added. When gardella is present, the smell of rotting fish appears).

■ The pH value in the vagina is greater than or equal to 4.5.

If at least three of the four specified criteria are present, the diagnosis can be considered confirmed.

Normal indicators in a smear

Additional diagnostic methods include:

Gas chromatography vaginal discharge, mass spectrometry (trimethylamine is detected).

High-voltage electrophoresis for the detection of volatile amines.

Microbiological tests (detection of Gardnerella vaginalis). The norm in tests is less than 10 to 5 degrees CFU or no more than 103 - 105 CFU/ml.

LSC (laser correlation spectroscopy) method.

Gardnerella in women: treatment

The goal of treatment is to kill gardnerella and restore normal vaginal microflora.

Antibacterial therapy for gardnerellosis in women

Gardnerella exhibits high sensitivity to such drugs: ornidazole, ampicillin, clindamycin and metronidazole. But this bacterium is resistant to aminoglycosides, tetracyclines, sulfonamides, and cephalosporins.

Treatment regimen for gardnerellosis in women

For gardnerellosis, the drugs of choice include the following:

- metronidazole (efloran, metrogil, metrid, flagyl, trichopol) – take 1 g per day in 2 divided doses for a week;

Ornidazole (meratin, tiberal) - take 500 mg 2 times a day, for a ten-day course;

Nimorazole (naxogin) - 500 mg twice a day, for a six-day course. (recommended when vaginosis is combined with trichomonas and bacteroides).

Alternative drugs

List of alternative remedies for the treatment of gardnerella:

- Dalacin (clindamycin hydrochloride) in capsule form (considered the main alternative means) – 300 mg twice a day. Duration of treatment is a week.

- Dalatsin C in the form of a cream (2%) – 5 g once a day topically for a week.

- Ampicillin. Used in combination with metronidazole 4 times a day, 500 mg. Duration of treatment: from a week to 10 days.

- Tinidazole. Take according to the following scheme. On the first and second days - 2 g once a day. On the third and fourth days - 0.5 g twice a day. Total for the course – 6 g.

- Terzhinan. 1-2 candles per day. The duration of the course is 12 days.

- Meratin-combi. 1 candle before bed. Course – 12 days.

- Betadine. 1 candle per day. Course duration is from 1 to 2 weeks.

- Ginalgin. 1 candle at night. Course – 10 days.

- Klion-D 100. One tablet is placed deep into the vagina before bed. The course of treatment lasts 10 days.

All medications can only be used after consulting a doctor; only a specialist can prescribe the treatment you need.

Restoration of normal vaginal microflora

After etiotropic treatment, they move on to the next stage of therapy - restoration of the natural biocenesis of the vagina.

Preparations for restoring normal vaginal microflora:

Contains lyophilisate of bifidobacteria. The product is used vaginally once a day. To do this, 5 or 6 doses need to be diluted with boiled water. The full course lasts from 5 to 8 days. Used in the form of suppositories twice a day for 5-10 days.

- Lactobacterin. Contains lyophilisate of lactobacilli. 5 doses of the drug are diluted in clean water and used vaginally once a day (from 5 to 10 days).

Vaginally, 5 or 6 doses are applied once a day. Treatment course lasts from a week to 10 days.

- Dry colibacterin. 5-6 doses once a day for 5-10 days.

- Vagilak(a drug based on lactobacilli). Use vaginally, one capsule twice a day. Course – 10 days.

- Acylact. For 10 days, one candle every evening before bed.

- Simbiter 2. One bottle of the drug is added to boiled water in a ratio of 1:2, the resulting composition is injected into the vagina with a syringe. Duration of therapy: at least 10 - 15 days.

Treatment of gardnerellosis in pregnant women

Treatment for gardnerellosis can begin after the 2nd trimester of pregnancy. The drugs of choice are:

Ornidazole 2 times a day, 1 tablet for 5 days

Metronidazole 250 mg - 1 tablet 2 times a day.

The course of treatment for pregnant Gardnerella is 10 days.

In addition, they produce local treatment metronidazole or Neo-Penotran forte in the form of cream or suppositories.

Acylact in suppositories can also be used on early pregnancy if there is no thrush.

Prevention of gardnerellosis in women

Preventive measures should be aimed at complying with the following rules:

1. maintain personal hygiene of the genitals;

2. during menstruation, change pads and tampons as often as possible;

3. underwear should be made from natural fabrics and should not rub;

5. lead healthy image life: eat right, exercise, don’t get overtired, etc.

6. undergo examination by a gynecologist once a year.

Despite the fact that gardnerellosis in women is not dangerous and can be treated quite easily, it significantly worsens the quality of life and can become a platform for the development of other pathological processes reproductive organs, therefore, if any abnormalities in the discharge occur, consult a doctor immediately.