Bacterial culture from the cervical canal - why is it needed.

Modern medicine has successfully mastered many techniques for diagnosing diseases. However, such a simple and long-known method as taking a smear during a gynecological examination does not lose its relevance to this day.

Analysis of a gynecological smear will determine the presence of sexually transmitted diseases, inflammatory processes, and the onset of menopause. However, it is impossible to determine pregnancy or AIDS using this method.

The undoubted advantage of this procedure is its accessibility, low cost and ease of implementation. Microflora smear results can be obtained within two days (usually the next day).

A preventive medical examination by a gynecologist involves taking a smear from the vagina, urethra and cervical canal. Any initial appeal regarding complaints of discharge, when registering for pregnancy or during the initial appeal to establish the fact of pregnancy, during the treatment of gynecological diseases, before procedures (installation of an intrauterine device, etc.) are indications for taking a smear.

Direct indications for taking a smear are the following situations:

The patient complains of itching, burning, discharge with an unpleasant odor and/or color.
Copious mucous or purulent discharge.

The presence of the above symptoms indicates the development of an inflammatory process caused by a decrease in immunity, the ingress of pathogenic microorganisms (Escherichia coli, cocci, trichomonas, candida, etc.), and the development of thrush.

In women who have no complaints (conditionally healthy), the following are considered indications for taking a smear:

Conducting an annual medical examination (smear for microflora, degree of purity).
Control during the course of treatment (antibiotic therapy, hormonal treatment).
Before performing gynecological manipulations (installation of an intrauterine device, abortion, etc.).
Initial contact with a gynecologist.
It is recommended to take a smear test when changing sexual partners.
Registration due to pregnancy.

Monitoring the state of the vaginal microflora allows you to start treatment in a timely manner and identify sexually transmitted diseases.

Separate mention should be made of taking smears during pregnancy. The first smear is taken from a woman during pregnancy registration. If the test result is good, then repeat smears will be taken at 30 and 36 weeks.

This frequency of examination allows you to avoid the development of complications during childbirth and in the postpartum period (the chance of intrauterine infection of the child and penetration of infection into the uterine cavity is excluded).

Preparation

No special preparation is required before taking a smear. Manipulation is not carried out during menstruation (except in emergency cases). The most appropriate time is the middle of the menstrual cycle, approximately 9-21 days from the start of menstrual flow.

The day before the smear test, refrain from sexual contact.
Stop taking antibiotics or other antimicrobial drugs two weeks before the test. If this is not possible, notify the gynecologist before the procedure.
Do not use candles or lubricants. If possible, do not use scented hygiene products for washing.
The last urination should be 2 hours before the procedure. This will allow you to collect the most reliable smear from the urethra (since urine will wash away pathogenic microflora).
Do not use douching on the eve of a visit to the gynecological office!
Before visiting the gynecological office, you can wash yourself with warm water.

Following these recommendations will allow you to obtain the most reliable analysis results. Sometimes women try to improve the result of a smear by douching. During the douching procedure, a larger amount of microflora (including pathogenic ones) is washed out of the vagina.

As a result, it is possible to obtain an ideal analysis result. But is it worth doing this? Of course, a categorical no! The gynecologist does not need a perfect analysis of your smear. Your health is important to him. A disease detected in time is much easier to treat than advanced cases. Treat the procedure conscientiously, this will help you maintain your health.

In some cases, if the level of leukocytes is high, but the pathogen has not been identified, a repeat smear with provocation is prescribed. Eating salty foods (herring, pickles, etc.) and/or smoked foods, beer, the evening before a smear test is called provocation.

Methodology

The procedure for taking a smear does not require special conditions. The analysis is taken in the gynecologist’s office, on a gynecological chair. Taking a smear is quick (within 3-5 minutes) and painless. Sterile instruments and gloves are used.

A special gynecological speculum is inserted into the woman's vagina; it allows you to see the cervix as closely as possible. Using a medical spatula, a sterile cotton swab or a brush, material is collected from the cervical canal, vagina and urethra (opening of the urethra).

Each analysis is taken with a separate sterile instrument! The resulting analyzes are applied to glass slides with special marks: V – a smear taken from the vagina, C – a smear from the cervical canal of the cervix, U – a smear from the urethra. After the preparation has dried, the material is sent for testing to the laboratory.

The result of the analysis will be ready within 24 hours from the date of submission. The test result is considered valid for 10 days; after this period, a second smear is taken. If you are undergoing gynecological manipulation (for example, installation of intrauterine contraceptives), do not delay visiting a gynecologist. Otherwise, the procedure will have to be rescheduled.

If the smear is sent for bacterial culture, the test result will appear no earlier than in 5 days. It is impossible to speed up the process because bacteria take time to grow.

A cervical smear (Pap test) is often prescribed to women when examined by a gynecologist. In this article we will try to answer the questions: what kind of study is this, how is it performed, does it require pain relief, is it always possible to obtain accurate data? These questions are important, because it is the Pap test from the uterine cervix that makes it possible to detect oncology at the earliest stages and get a chance to prevent the development of cancer.

What is it: a cervical smear

Usually, when visiting a gynecologist, the patient is always looked at in a gynecological chair and a smear is taken from the vaginal area, but she can be examined in various ways. The most popular medical procedure is the “degree of purity,” culture. However, their results cannot show the likelihood of developing cancer. But a cancerous tumor of the uterine cervix passes without symptoms and at the initial stage of development it can be detected by examining a smear from the cervical canal.

What you need to know:

The test should be taken during the middle period of the menstrual cycle. About a week after your period stops.
A few days before the test, you should not have sexual intercourse, use vaginal devices, contraceptives, or douching. It is also prohibited to go to the gynecological chair or do colposcopy. Only then is a cytological examination such as a smear from the vaginal area reliable.
It is necessary to take the test if your microflora is completely healthy. If a woman experiences pathological discharge, a foul odor from the vaginal area, itching, or a rash, she must first be treated, it is better if she can achieve the first degree of cleanliness of the vaginal area. Then there is a high probability that there will be no inflammation on the uterine cervix, since it affects the result, making it inaccurate. It is better to take a smear for flora before cytology; there should be no more than 30 leukocytes.
A Pap test is allowed once every 12 months. It is especially important to do this for those who often change sexual partners, have HPV 16, 18 and other oncotypes.
A specialist should take the analysis using a special medical mini-spatula. Attention! In antenatal clinics, devices are not always available, and the gynecologist can take a smear directly from a special examination mirror that touched the cervix. This analysis will not be accurate!
If there is ectopia, leukoplakia and other pathological changes on the cervix, the material should be taken from them, since these are background diseases for a cancerous tumor.
The collection is not painful. This misconception arose due to the fact that the study is confused with aspiration of the endometrium - this is completely different; the instruments do not penetrate into the female organ. If you bleed after taking a smear, this is normal.

When the test is taken, the norm during pregnancy is the same as outside of it. Another thing is that this study is not necessary for pregnant women, unlike a microsmear examination, which is performed 2 times.

Analysis from the cervical canal: what is it and explanation

The analysis is deciphered by a gynecologist. However, the woman should know that the doctor is looking to see if atypical cells are present in the material that was collected. They may be present in small quantities when there is inflammation in the organ.

That is why it was said above that you should take a smear only when the number of leukocytes does not exceed normal values.

A smear is considered normal when there are no atypical cells. If they are detected, the doctor diagnoses dysplasia of 1, 2, 3 degrees, or oncology - if a typical type of cancer cells is detected. If grade 1 dysplasia is detected, if there are no underlying pathologies on the cervix, the patient is recommended to be observed by a doctor.

For grades 2 and 3 pathology, it is necessary to do:

Colposcopy;
Biopsy;
Often also conization.

The fact is that grade 3 pathology usually turns out to be a cancerous tumor in situ. And then the therapy is performed by a gynecological oncologist at an oncology clinic.

Indicators of a smear from the cervical canal during pregnancy

During the period of bearing a baby, the permissible norms for the content of microscopic organisms in the cervical canal are the same. There cannot be leukocytes during pregnancy. However, the number of leukocytes may increase slightly due to hormonal changes in the pregnant woman's body. A Pap test is not a mandatory medical examination when carrying a baby, but the doctor may prescribe this procedure as an addition if he suspects that inflammation is worsening or a latent genitourinary infection is awakening. Inflammation in the reproductive system of a pregnant woman poses a serious threat to the expectant mother and child.

Infections can disrupt pregnancy and provoke:

Miscarriage;
Premature birth;
Weak labor.

Infections can also enter the child’s body during delivery. That is why, when planning conception, doctors advise the woman and her sexual partner to be thoroughly examined and, if there are infections, to treat them completely. Attention! During pregnancy, you cannot take more medications.

Taking a smear from the cervical canal: does it hurt?

In no case, taking the test does not hurt at all. Some women, while carrying a baby, do not even think about the fact that this is the cervical canal and why it is needed in the body at all. Others, on the contrary, carefully study this information, since they have been diagnosed with isthmic-cervical insufficiency.

This means the incompetence of the uterine cervix, which opens already in the first stages of bearing a child and cannot hold the developing fertilized egg.

Usually, this happens at 16-18 weeks, when the child is rapidly gaining body weight, and is also actively moving. With isthmic-cervical insufficiency, there is a risk of threatened miscarriage. The reason for the development of this situation may be a large number of male sex hormones, which make the uterine cervix softer and looser. Another cause of insufficiency may be multiple pregnancy, which puts strong pressure on the cervix. Other causes of pathology include injury to the uterine cervix and abnormalities of its development.

A timely visit to the doctor makes it possible:

Quickly diagnose pathology;
Carry out treatment;
Save pregnancy.

Sometimes the doctor may prescribe surgery, and stitches will be placed to prevent the canal from opening. When the time comes to deliver the baby, these stitches will be removed. In some cases, especially after the 24th week, the gynecologist may use some medical devices - gynecological rings, pessaries.

What is a cervical smear (video)

Attention! A woman should definitely undergo a preventive gynecological examination at least once a year, preferably more often. This will help prevent the development of terrible pathologies, for example, a cancerous tumor, which in the first stages of development can be asymptomatic.

Analysis of cervical microscopy allows you to assess the composition of the microflora. With the development of pathological processes, the composition of microorganisms changes towards an increase in opportunistic pathogens and/or the appearance of pathogenic pathogens. Cervical smears are performed in two main ways: microscopy And sowing material.

Taking a smear from the cervical canal for flora is carried out no earlier than 24 hours after douching, because This procedure reduces the number of microorganisms for inoculation.

WHAT DOES A CERVICAL CANAL smear show?

Normally, the cervical canal is sterile. A large number of leukocytes in a smear from the cervical canal is a consequence of inflammation (cervicitis). The causes of leukocytosis can also be: failure to comply with hygiene rules, hormonal changes (lack of estrogen in girls and women during the premenopausal and menopausal periods), metabolic disorders, diseases of the genitourinary organs, and the consequences of other therapy.

The development of the inflammatory process depends on the characteristics of the causative agent of the disease and the state of the woman’s immune system. This can be acute or chronic inflammation. Sometimes endocervicitis occurs in an erased form from the very beginning of the disease. The localization of the pathology (uterus, appendages, cervical canal) can only be determined after a gynecological examination.

CULTURING FROM THE CERVICAL CANAL

The study allows us to evaluate the qualitative and quantitative composition of the microflora of the biomaterial under study and assess the sensitivity of microorganisms to the main range of antibiotics, which will allow the doctor to prescribe adequate therapy.

Normally, the flora contains lactobacilli at least 10x7, and it may also contain enterococci up to 10x2, Escherichia coli up to 10x2, yeast fungus up to 10x2 CFU/ml. Also in the smear, opportunistic strains of bacteria that cause an inflammatory reaction of the cervix, such as staphylococci, enterococci, E. coli, Citrobacter, Enterobacter, Proteus, and yeast fungus (Candida albicans), can be detected.

The culture study is aimed at detecting the growth of bacteria in the cervix: enterobacteria (genus Escherichia, Klebsiella, Enterobacter, Proteus, etc.); non-fermenting gram-negative bacteria (genus Pseudomonas, including Pseudomonas aeruginosa, Acinetobacter, etc.); streptococci (Streptococcus agalactiae (group B), Streptococcus (group A), etc.); enterococci (Enterococcus faecalis, Enterococcus faecium, etc.); staphylococci (Staphylococcus aureus, Staphylococcus epidermidis, etc.);

At the next stage of laboratory research, the sensitivity of the pathogen to antibiotics and drugs is determined. The result of the study is issued in accordance with the identified microorganisms in a quantitative format, contains an antibiogram and a conclusion.

INDICATIONS FOR ANALYSIS

Presence of symptoms of infectious and inflammatory diseases;
Selection of antibacterial therapy;
Evaluation of the effectiveness of antibacterial therapy.

CYTOLOGY OF THE CERVICAL CANAL

The vaginal part of the cervix, the ectocervix, is lined with stratified squamous non-keratinizing epithelium. In women of reproductive age, it is constantly rebuilt during the menstrual cycle through renewal-maturation-rejection and is completely replaced by a new population of cells every 4 - 5 days. Cellular composition depends on the presence/absence of the menstrual cycle and its phase. Flat epithelium performs a protective function. The cervical canal - endocervix - is lined with cylindrical mucus-producing epithelium. Cyclic changes in the epithelium of the endocervix are weakly expressed. The main function of the columnar epithelium is secretory.

The transformation zone is the area at the junction of stratified squamous and cylindrical epithelium in women of reproductive age, which basically coincides with the area of the external os of the cervical canal. Depending on age and hormonal balance in the body, it can also be located on the vaginal part of the cervix.

In women of older reproductive and postmenopausal age, the border line is actually localized within the external pharynx. According to statistical data, precancer occurs from the transformation zone. For these reasons, regular testing for oncocytology of a smear from the cervical canal is of particular importance. Due to its high accuracy, it is one of the leading research methods for diagnosing background, precancerous and cancerous processes of the cervix.

During a preventive examination of women, it is advisable to obtain smear cytology material from the cervical canal from the surface of the vaginal part of the cervix (ectocervix) and the walls of the cervical canal (endocervix).

In women of reproductive age, it is necessary to take smears for cytology of the cervical canal no earlier than on the 5th day of the menstrual cycle and no later than 5 days before the expected start of menstruation. You should not take cellular material for research within 24 hours after sexual intercourse, vaginal sanitation, extended colposcopy, or insertion of medications into the vagina.

Smears for cytological examination should be taken from all women over 18 years of age, regardless of clinical data, once a year. In the presence of pronounced pathological changes in the cervix, cellular material is taken specifically, the frequency of delivery is determined by the attending gynecologist.

COST OF SERVICES

Cervical smear:	Type of analysis	Price
To the flora	microscopy	450
Cytology	microscopy	2 500
For PCR infection	DNA	450
Culture from the cervical canal	microbiology	1 750
For mycoplasma/ureaplasma	microbiology	1 750
Antibiotic sensitivity (extended spectrum)	microbiology	2 000
For Escherichia coli (Escherichia coli)	microbiology	1 750
Cervical canal culture for listeriosis	microbiology	1 450
For gardnerella / thrush	microbiology	1 750
Taking analysis		350

A cervical canal culture is a smear that is taken from a woman's reproductive organ - the uterus in the area of the cervix (the area connecting the vagina and the uterine cavity). A smear from the cervical canal allows you to determine not only the composition of the microflora, but also the sensitivity of pathogens to various antibiotic drugs.

The culture of the pathogen obtained in this study is pure and can be accurately identified. At the same time, it is possible to identify pathogens such as enterobacteriaceae, Klebsiella, E. coli, various types of fungi, etc.

Bacteriological culture is a secondary analysis that follows a general smear (to determine the degree of purity). If the initial general analysis reveals a lot of leukocytes, only then is a bacterial culture of the flora and its sensitivity to antibiotics prescribed, in order to simultaneously prescribe adequate treatment.

The cause of the increased content of leukocytes can be diseases of organs in the pelvis: endometritis, cervicitis, adnexitis, etc.

How is a bacteriological culture taken?

A woman, upon arriving at the office, takes off her shoes, takes off her clothes and underwear from the waist down, and sits in a gynecological chair. First, a special mirror is inserted into the vagina, which helps control the process of treating the cervical canal with a special brush.

This technology for collecting material for examination from the cervix involves inserting a special probe (brush) directly into the cervical canal to a depth of approximately 0.5 to 1.5 cm.

The collected substance is placed in a test tube with a gel-like or liquid medium and hermetically sealed.

Pregnant women are also prescribed this smear. And worries about harming the embryo are in vain. Taking a smear cannot in any way provoke a miscarriage, because the cervical canal is quite long. And the penetration of a thin instrument into it by 0.5 cm is not dangerous in terms of a threat to the health of the unborn child. This research is not mandatory. And to carry it out, appropriate testimony is needed.

The contents, which are taken with a sterile instrument, represent the cells and secretions of local glands, on which microflora is necessarily present. Then the collected material is lowered into a test tube, which contains a special nutrient medium for finding microorganisms. Fungi and bacteria, feeding on the substances necessary for life, begin to multiply. It is important not to destroy them at this stage by creating unsuitable conditions. Even their partial death will no longer be a guarantee of a complete cure for the patient.

There are nutrient media for which no special conditions are required until the test tube with the scraping arrives at the bacteriology laboratory. Therefore, the woman herself can deliver a tightly sealed test tube for testing.

However, most medical institutions practice an approach where the collected material from the cervical canal is placed in a test tube, closed and placed in a thermostat. The thermostat provides the temperature necessary for the growth of flora (37º). Transferring these tubes from the doctor's office to the laboratory also requires special conditions.

When the test tubes arrive at the bacteriological laboratory, they are uncorked, and the contents are removed and transferred to another medium placed in a Petri dish. The cup is placed in a thermostat and kept there for 3 to 5 days, allowing the bacteria to grow to the required extent. And after this they are separated, the intraspecific number of units is calculated, and tested for antibiotics.

Who should get tested for bacterial culture?

Bacteriological culture is indicated in the following situations:

scheduled annual examination;
inflammation in the cervix;
pregnancy planning;
detection of coccal flora in a smear;
the presence of a large number of leukocytes in the smear;
relapses of inflammatory pathologies of the external genitalia and vagina.

How to prepare for research?

To obtain a reliable result, proper preparation for the test is required. Preparation includes:

refusal to douche and use any vaginal suppositories and creams about a day before sowing;
avoiding sexual intercourse for 24 hours before the test;
exclusion of the study for up to two days if colposcopy was performed;
Avoid taking antibiotics in the form of injections, tablets or droppers (about 2 weeks should pass from the time of antibiotic therapy before performing a culture test).

The period of menstruation at which the test is supposed to be taken should not fall during the period itself and on the 2 subsequent days after it.

Pregnant women cannot be excluded from undergoing the study, but only on the condition that the material for culture is collected directly by an obstetrician-gynecologist.

How to interpret the results of sowing?

Once the culture from the cervical canal has been obtained, the results will be known no earlier than 5 days later. This period is enough for the bacteria to grow.

The analysis form contains data on the bacteria inhabiting the cervical canal of the cervix. The analysis does not normally contain mushrooms. But lactobacilli and bifidobacteria are found (their number is at least 107). The presence of E. coli (10.2 enterococci) is acceptable.

In addition to the names of microorganisms and antibiotics (to which bacteria are sensitive), the number of microbes is noted. In accordance with this, the transcript can show one of 4 degrees of channel purity:

Bacterial growth occurs only in liquid media.
Bacteria also grow on solid media in the amount of 10 colonies of the species.
From 10 CFU to 100 on solid medium.
Over 100 CFU on solid media.

The reason for the deterioration of the microflora inside the cervical canal is the penetration of infection through the genital tract during sexual intercourse or during medical intervention in the vagina or uterus.

The development of the inflammation process is facilitated by hormonal imbalances, weakened immune defenses, inflammation in nearby organs, use of antibiotics, and failure to comply with hygienic conditions.

What do tank cultures and smear cytology have in common?

Flora can also be determined when examining the cervical canal for cytology. However, it is not the subject of cytological examination.

The cytology of the smear in a situation with bacteriological culture cannot be studied. Bacterial culture is a method of detecting only yeast, diplococci, gardnerella and other microorganisms. And cytology shows morphological changes in epithelial cells and represents a completely different direction in the laboratory diagnosis of precancerous and cancerous conditions of the uterus and cervix. A correctly taken smear for cytology from the cervical canal normally reveals cylindrical (prismatic) epithelium, a small number of leukocytes and depleted microflora. The latter could penetrate here from lower located sections (for example, from the vagina).

The interpretation of the analysis for both flora and cytology is done by a doctor.

The above information is provided for informational purposes only, so that you have some idea of what is reflected on the analysis form.

Laboratory diagnostic methods in obstetrics and gynecology are an important component of assessing the health status of the female body.

Among their diversity, a simple smear on the flora has stood apart for many decades.

Its other names: smear for the degree of purity, smear for GN, gynecological smear, bacterioscopy of discharge from the genitourinary organs, microscopy of discharge from the urethra, vagina and cervix.

This study allows you to assess the composition of the microflora, count the number of leukocytes and epithelial cells, and also diagnose some STDs (gonorrhea, trichomoniasis).

This is a routine, non-invasive, economical and quite informative method, widely used in the work of a gynecologist.

Based on its results, the doctor has the opportunity to determine further tactics for managing the patient and prescribe appropriate treatment.

When is the analysis performed?

As a rule, a smear on the flora is taken during any initial visit of a woman to a gynecologist.

Also, indications for taking a smear and its subsequent microscopy are:

1 Scheduled preventive examinations and medical examinations.
2 Pathological leucorrhoea (vaginal, cervical, urethral discharge), unpleasant odor, profuse nature, discoloration.
3 Pre-conception preparation as part of planning natural and IVF-induced pregnancy.
4 Screening during pregnancy.
5 Unpleasant, painful sensations in the lower abdomen, which the woman does not associate with the menstrual cycle.
6 Painful urination, dysuria, including symptoms of urethritis, cystitis. Urological pathology in women, as a rule, requires consultation and examination by a gynecologist.
7 Completion of the course of antibiotics in order to determine the nature of the flora and the possibilities of its restoration.

2. Collection of material for research

Taking a gynecological smear is possible from three points: the urethra (if necessary), the posterolateral vaginal vault and the vaginal part of the cervix.

The material for analysis is vaginal discharge, discharge from the cervical canal, discharge from the urethra (according to indications).

Vaginal discharge is multicomponent, it includes:

1 Mucus of the cervical canal - needed for the penetration of sperm into the uterine cavity and higher for fertilization. Its thickness depends on the level of estrogen in a woman’s body; its viscousness can be used to judge the phase of the menstrual cycle.
2 Secretion of the glands of the external genitalia.
3 Desquamated vaginal epithelium.
4 Bacteria (vaginal flora). Normally, the microflora in the smear is represented by a large number of lactic acid bacteria (Gram-positive Doderlein bacilli) and a small amount of opportunistic flora (most often coccal).

2.1. Preparing for a smear collection

Before collecting material, a woman must meet certain conditions:

1 It is better to take the analysis on days 5-7. The collection of discharge is not carried out.
2 Avoid the use of vaginal suppositories, lubricants, douching and sexual intercourse 24 hours before the test.
3 Before taking a smear, you do not need to use scented products for intimate hygiene; it is better to toilet the external genitalia with running water.
4 It is not advisable to take a hot bath on the day of the test.

2.2. Technique for obtaining material

A smear on the flora is taken strictly before a bimanual examination, the woman is on a gynecological chair.
A Cusco-type bicuspid speculum is inserted into the vagina, and the vaginal part of the cervix is exposed (exposed).
Focusing on it, the doctor uses a special spatula to collect material from the posterolateral vaginal vault and transfers it to a glass slide, which, after filling out the directions, is delivered to the laboratory for microscopic examination.
Analysis from the external opening of the urethra is taken with a bacteriological loop or a Volkmann spoon. If available, it is advisable to take them, lightly pressing on the outer hole from the outside.
Analysis is taken from the surface of the vaginal part of the cervix with an Erb spatula.

3. How to decipher the results?

3.1. Normal flora

Recently, special attention has been paid to the normal composition of the vaginal microflora, since it has been proven that it is this factor that determines a woman’s reproductive health, provides local immunity, protection from pathogenic bacteria, and the normal onset and course of pregnancy.

Normally, 95% of a woman’s flora consists of lactic acid bacteria (otherwise known as Doderlein bacilli, lactobacilli, lactobacilli).

During their life, lactobacilli process glycogen released from epithelial cells to form lactic acid. It is this that provides the acidic environment of the vaginal contents, which prevents the proliferation of facultative and pathogenic flora.

Each woman has 1-4 types of lactobacilli in her vagina, and their combination is purely individual.

When deciphering the results of the analysis, it is impossible to conduct a detailed analysis of the vaginal microflora; the laboratory assistant evaluates only the ratio of rods and cocci.

The absence of cocci and a large amount of gram-positive rod flora (++++) is equated to grade 1 vaginal cleanliness. This is observed quite rarely; this situation is more typical for control smears after vaginal sanitation or taking antibiotics.
A small number of cocci (+, ++) is considered normal and indicates 2 degrees of purity, but only if rod flora (++, +++) is also detected. This is a good stroke.
Pathological is considered (+++, ++++) against the background of a decrease in the number of rods (+, ++). This result is called grade 3 vaginal cleanliness. This situation requires a detailed examination.
A large number of cocci (++++) and the complete absence of gram-positive rods (Gram + rods) in the smear indicate 4 degrees of purity. In this case, the woman requires mandatory treatment.

Table 1 - Normal indicators assessed when interpreting the results of smear microscopy for flora and GN. To view, click on the table

3.2. Gonococci and Trichomonas (Gn, Tr)

3.7. Yeast-like fungi

– unicellular microorganisms of round shape. The vaginal environment is ideal for their growth and development due to the high glycogen content.

But due to the competing lactobacillary flora, with a normal level of immunity, their active growth is not observed. To acquire pathogenic properties, fungi of the genus Candida require certain conditions:

1 State of immunosuppression,
2 Presence of endocrine pathology,
3 Malignant neoplasms,
4 Pregnancy period, childhood and old age,
5 Therapy with glucocorticosteroids.

Should not be detected. In exceptional cases, their single detection is allowed in material taken from the posterolateral vaginal vault, as a component of the facultative flora. It is important to take into account the presence/absence of complaints and clinical manifestations.

The detection of spores and mycelium of the fungus in a smear indicates vaginal candidiasis and requires appropriate specific treatment.

Although it is a fairly informative diagnostic method, it is relevant only when comparing the microscopy result with complaints and clinical manifestations.

The main disadvantage of this research method is the inability to identify the specific causative agent of the disease. Based on the results of a smear analysis, it is impossible to assess the level and depth of tissue damage.

Therefore, if an inflammatory process is detected in a smear, the doctor may prescribe additional diagnostic methods aimed at identifying the pathogen (PCR, bacteriological examination of genitourinary organ discharge and determination of sensitivity to antibiotics).