An analysis for mycoplasma is standardly prescribed for delivery in combination with other studies that are aimed at detecting other latent sexually transmitted diseases in a patient. Their list includes the following STDs: trichomoniasis, chlamydia and ureaplasmosis. There are several ways to get the above infections, but the main route of transmission is through unprotected sex. An analysis for mycoplasmosis may not give an unambiguously positive or negative result, since the peculiarity of this infection is an asymptomatic course.
The first signs of an infection are urethritis, urination disorders, burning, discharge, itching. It is these reasons that should be the impetus to be sure to take a blood test for mycoplasmosis.
Tests for mycoplasmosis and ureaplasma: where to pass and get the results?
How do they take an analysis for mycoplasma and where to take it? The study is carried out as follows: the patient must, necessarily on an empty stomach, visit the laboratory, where they take blood from a vein. You can take tests for mycoplasma and ureaplasma only early in the morning, preferably at least 12 hours after the last meal. Otherwise, this can significantly affect the results of the analyzes, and the procedure will have to be repeated. No special preparation is required for the study. For a blood test for mycoplasma, the polymerase chain reaction or PCR method is usually used, which gives a more detailed decoding at the output, besides, its price is very reasonable, and in social clinics a similar analysis for ureaplasma and mycoplasma can be done free of charge. PCR must be taken simultaneously with enzyme immunoassay, or ELISA. In addition to blood, biological scrapings are taken for examination from the epithelium of the urethra, cervical canal and vagina. ELISA decoding will help compare the results with the results of PCR, which in turn contributes to a more accurate determination of mycoplasmosis and ureaplasmosis in the blood and epithelial cells of internal organs. It is these two analyzes that are most widely used in medical practice - due to the high efficiency and low cost of the study.
Mycoplasmosis: a blood test to detect pathogen resistance
To determine the resistance of mycoplasma and ureaplasma to a certain type of antibiotics, it is recommended to donate blood for research and sow bacteria in a specific environment. Based on the results of deciphering this analysis, the doctor can select and prescribe the correct therapy. Unlike diagnostics by blood, the principle of bakposev is based on the delivery of a different biomaterial, and it is based on the artificial cultivation of pathogens of mycoplasma and ureaplasma in a special cultural environment. The reliability of the interpretation of the results of the analysis for mycoplasma largely depends on the equipment and qualifications of the attending physician. In the presence of pathogens ureaplasma and mycoplasma - the results of the tests, with such a study, will be obtained only after 7-9 days.
Deciphering the analysis for mycoplasma
During direct treatment, the patient will need to take repeated blood tests and smears several times, which are taken until the decoding of the results shows a minimum of colony-forming units. After 3-4 weeks, it is necessary to retake all tests, this is done to check the effectiveness of the prescribed therapy and to identify intermediate results of treatment. If the final transcript shows the presence of mycoplasmosis and ureaplasmosis, then it is better to pass the control test again. A false result in decoding can be obtained due to incorrect and untimely blood sampling. In order to avoid such errors, blood is taken only in specially equipped laboratories.
Specific Tests
An analysis for Mycoplasma pneumonia, antibodies of the IgM type is a study in which blood is taken for diagnosis, such a donation of biomaterial serves to detect specific antibodies in Mycoplasma pneumonia. Based on the results, specific immunoglobulins are determined that the defense system produces in the presence of infection. For the test, you need to donate blood from a vein. After the resulting serum is sent to the laboratory, where it is examined by ELISA. If the indicators are normal, then the decoding should show negative results. In the presence of IgM antibodies in the serum, it is the first sign of an acute course of mycoplasmosis. This study is carried out weekly for a month. The price for this test depends on the level of the clinic and the diagnostic laboratory. It is important to understand that even after a complete cure, a residual amount of IgM type antibodies remains in the human body. For a complete diagnostic picture, it is also necessary to conduct tests for antibodies such as IgG and IgA. They will help identify pathogens such as hominis and genitalia. To detect these antibodies, certain parts of pathogen DNA are isolated from serum or mucosal epithelium, and then studied by cloning until a complete picture of the disease is obtained. To obtain reliable data, the biological material taken for diagnostics must be fresh, it cannot be stored, frozen or subjected to heat treatment for a long time. You can donate blood for a test in any laboratory, the speed of obtaining results and the price of the study will vary depending on the complexity of the tests.
Researchers suggest that three types of tiny bacteria are responsible for a number of pathologies of the respiratory system, urogenital tract, and digestive system. These are unicellular microorganisms Mycoplasma pneumoniae, M. genitalium, M. hominis, which do not have a strong cell wall. Mycoplasmas often infect the epithelial cells of the upper respiratory tract. In second place are infectious diseases of the genitourinary system. Active reproduction of bacteria disrupts the functions of many organs.
Mycoplasma pneumoniae causes tonsillopharyngitis, sinusitis, tracheobronchitis, mild atypical pneumonia. The child feels a sore throat, he has an obsessive cough, subfebrile temperature. Symptoms and treatment of mycoplasma in children is similar to SARS; cases of occurrence of mixed infections are known. Further reproduction of pathogens in the respiratory tract often leads to the development of pneumonia.
Mycoplasmas are found in association with ureaplasma, chlamydia, combined with a viral infection, namely with adenoviruses, influenza and parainfluenza viruses.
Outbreaks of acute respiratory diseases in children from 5 to 15 years old are recorded throughout the cold period of the year. In the structure of acute respiratory infections, mycoplasmosis accounts for only about 5%, but this figure increases by about 10 times every 2–4 years during epidemics. Mycoplasma causes up to 20% of acute pneumonia.
Symptoms and diagnosis of mycoplasmosis of the upper respiratory tract
The incubation period of the pathogen ranges from 3–10 days to 4 weeks. The difficulty of recognizing the respiratory form of mycoplasma lies in the fact that the clinical picture usually resembles SARS. Children, unlike adults, react more sharply to the activity of the pathogen. There are manifestations of intoxication, runny nose, paroxysmal cough, which can result in vomiting.
Initial symptoms of mycoplasma in a child:
- Elevated temperature persists for 5–10 days up to 37.5°C;
- perspiration, itching and sore throat;
- runny nose, stuffy nose;
- conjunctivitis;
- headache;
- dry cough;
- weakness.
When examining the throat, redness of the oropharyngeal mucosa can be noticed. It is the similarity of the course of respiratory mycoplasmosis in children with ARVI that makes it difficult to diagnose the disease. Parents give the child antitussives, syrups to improve expectoration. However, such treatment most often does not work, and the cough continues for several months. Against the background of mycoplasma activity in the upper respiratory tract, newborns, premature infants and children under 8 years of age develop sinusitis, bronchitis, and pneumonia.
Mycoplasmosis of the lungs
Clinical manifestations of mycoplasmal pneumonia resemble chlamydia of the lungs. Therapy of diseases also has many common features. The similarity of the two different microbial infections is due to their small size compared to other bacteria and the lack of a solid cell wall. Mycoplasmas cannot be seen under a conventional light microscope.
Signs of the pulmonary form of mycoplasmosis in children:
- the disease begins suddenly or as a continuation of SARS;
- chills, fever up to 39 ° C;
- dry cough is replaced by wet;
- sputum scanty, purulent;
- headaches and muscle pain.
The pediatrician, listening to the child's lungs, notes hard breathing and dry wheezing. X-ray shows that there are scattered foci of inflammation in the tissues of the lungs. The doctor suggests taking an analysis for mycoplasma in children - a blood test from a vein that will confirm or refute the initial diagnosis. For the recognition of mycoplasma infection, the methods of enzyme immunoassay and polymerase chain reaction (ELISA and PCR, respectively) are used. The accumulation of antibodies belonging to the IgG and IgM types occurs during the body's immune response to the activity of mycoplasma.
Mycoplasmosis of the kidneys and other organs
Children can become infected from adults through direct contact - this is sleeping in a shared bed, using one toilet seat, towels. It happens that the kindergarten staff becomes the source of mycoplasma. In the respiratory and urogenital form of mycoplasmosis, epithelial cells are mainly affected. Dystrophic changes in the tissue begin, its necrosis.
Infection of the urogenital system in adolescents leads to cystitis, pyelonephritis, vaginitis. Mycoplasmas initiate pathological processes in the liver, in the small intestine, in various parts of the brain and spinal cord. Mycoplasmosis in adolescent girls manifests itself in the form of vulvovaginitis and mild lesions of the urogenital tract. The course of the disease is most often asymptomatic, in the case of severe forms pain occurs in the lower abdomen, mucous discharge appears.
Mycoplasma in the blood of a child can cause the development of a generalized form, which is characterized by damage to the respiratory system and a number of internal organs. The liver increases in size, jaundice begins. Perhaps the development of meningitis, brain abscess, meningoencephalitis. A pink rash appears on the body, watery and red eyes (conjunctivitis).
Treatment of a bacterial infection
If only a runny nose is bothering you, the temperature is subfebrile, then antibacterial drugs will not be required. Antibiotic treatment is a specific therapy for mycoplasmosis. The drugs of choice are macrolides, fluoroquinolones, tetracyclines. Other medicines are given depending on the symptoms.
Oral antibiotics:
- Erythromycin - 20–50 mg per 1 kg of body weight per day for 5–7 days. The daily dose is divided into three doses.
- Clarithromycin n - 15 mg per 1 kg of body weight. Give in the morning and evening, with an interval between doses of 12 hours.
- Azithromycin - 10 mg per 1 kg of body weight on the first day. In the next 3-4 days - 5-10 mg per kg of body weight per day.
- Clindamycin - 20 mg per 1 kg of weight per day 2 times a day.
Mycoplasmas grow more slowly than other bacteria. Therefore, the duration of treatment is not 5–12 days, but 2–3 weeks.
Clindamycin belongs to the lincosamide antibiotics. Clarithromycin, erythromycin and azithromycin belong to the group of macrolides. Tetracycline antibiotics are being used less and less due to the spread of bacterial strains resistant to them. There is a practice of combining antimicrobial drugs that differ in the mechanism of action. For example, doctors may prescribe a combination of erythromycin and tetracycline. Another option is to change the antibiotic during a long course of treatment. The choice of remedy is influenced by an allergy in a child to substances belonging to certain groups of antibacterial drugs.
Tablet forms of antibiotics are more difficult to give to babies, especially if it is necessary to calculate the dose and divide one capsule into several doses. Doctors recommend treating children under 8–12 years old with suspensions that are prepared from an antibacterial substance in the form of powder and water. They produce such funds in glass vials, supply with a dosing pipette, a convenient measuring cup or spoon. The drug in children's dosage is usually sweet in taste.
Concomitant treatment (by symptoms)
A child infected with mycoplasma is given non-steroidal anti-inflammatory drugs at a high temperature to alleviate the patient's condition. Children are prescribed ibuprofen or paracetamol in the form of a suspension for oral administration, rectal suppositories. You can use a vasoconstrictor nasal spray, take antihistamine drops or syrup inside (Zyrtec preparations or similar "Zodak", "Loratadin", "Fenistil" for younger patients).
Concomitant treatment reduces irritation and sore throat, but does not affect the causative agent.
Cough remedies, for example "Sinekod", it is recommended to give only in the first days. Then the child will be able to rest from bouts of painful coughing. In the future, the doctor prescribes expectorant drugs to thin and facilitate sputum discharge. The use of pharmaceutical preparations and folk remedies that strengthen the immune system for the treatment of mycoplasma is justified.
Mycoplasmas in children after an acute period of the disease remain in the body, although in small quantities. Full recovery does not occur, immunity to the pathogen is not developed. Against this background, laryngitis, pharyngitis, bronchitis periodically occur. Often respiratory and urogenital mycoplasmosis becomes chronic.
Mycoplasma prevention
A child with mycoplasmosis is recommended to be isolated from other children for 5–7 days with a respiratory form of a bacterial infection, for 14–21 days with a pulmonary variety. The same preventive measures are taken as in other acute diseases of the upper respiratory tract - SARS, influenza, tonsillitis. There are no drugs that a child or adult could take to prevent mycoplasma infection.
Mycoplasma - the causative agent of respiratory and other diseases in a child updated: September 21, 2016 by: admin
An analysis for mycoplasma in women is a fairly common test. Most often, mycoplasma in women is determined by the results of scrapings and blood. Particles for scraping are taken from three places. These are the urethra, uterine cervix and vagina. In addition, you can apply for blood donation for mycoplasma, which is taken from a vein. Regardless of which type of diagnosis you choose, you can get results in a couple of days or a few weeks. It's about bakposev. Depending on the amount of mycoplasma and the presence of other infections or viruses, the doctor will prescribe treatment.
Before dealing with tests for mycoplasma, where it comes from is worth understanding. Mycoplasmosis is understood as a pathology of an infectious nature, which is dangerous primarily for its complications. Therefore, it is important to be tested for mycoplasmosis as soon as the first signs have been noticed.
The problem with this infection lies in its severe impact on the respiratory system and urine output. Mycoplasmas act as a provocateur of the corresponding reaction, of which two options represent the maximum danger. We are talking about Micoplasma hominis and Micoplasma genitalium.
These classes of bacteria can be in the body of a healthy person, with no self-manifestations. Most often, an analysis for mycoplasma in children or adults becomes necessary to pass against the background of immunity, which was somehow knocked down. You can not do without analysis and women who have undergone a complex operation on the gynecological part.
In addition, there is a compatibility of the disease with already present infections of the sex spectrum. A smear for mycoplasma becomes positive due to unprotected sexual intercourse. A feature of the disease is its mild symptoms at the initial stage, which does not cause concern to the patient.
Any situation of a stressful nature leads to the disguise of the disease as an infection that has affected the genitourinary system. Approximately four to five weeks after the infection occurred, you may encounter symptoms with a vivid expression. If we talk about mycoplasmosis in women, then it can be determined by vaginal discharge of varying intensity, which are not colored. When urinating, burning and itching are recorded. There is pain in the lower abdomen, and it does not go away during sexual intercourse.
Mycoplasma and ureaplasma during pregnancy is a dangerous combination, since it can end in a miscarriage or premature delivery. In the period after childbirth, an infection manifests itself with a fever.
If we are talking about the strong half of humanity, then they have such an ailment manifested as moderate discharge from the urethra without color. There is pain and burning during urination. The lower abdomen may suffer from pulling pains. In addition, prostate-type glands can also be affected by mycoplasmal bacteria. In this case, the patient is faced with prostatitis symptoms. If the lesion reaches the epididymis, the scrotum becomes red, the epididymis becomes larger, which provokes pain.
Indications for verification
Inflammatory problems associated with the pelvic organs, in most cases, are formed against the background of infections, including mycoplasmosis. Doctors emphasize that recently the statistical indicators of the presence of urethritis, vaginosis, cervicitis and tubal infertility in women have increased. In order to identify what exactly caused urogenital problems, it is recommended to perform seeding for mycoplasma and ureaplasma. As part of the treatment, the patient's biomaterial can be taken several times.
Such an analysis is indispensable for patients who have a chronic genitourinary infection, especially if the blood test for chlamydia, gonococcus or Trichomonas was positive. The logical reason for the appointment is the doctor's suspicion of mycoplasmosis. Not to do without it and future parents who are planning a pregnancy.
Bakposev should not be abandoned if the woman has not previously been able to bear the fetus, and miscarriages have occurred repeatedly. Sowing on mycoplasma is performed before IVF, if preparations are being made for operations related to the pelvic organs. It also acts as a control after the completed therapeutic course.
If we talk about the diagnosis of mycoplasmosis, then doctors most often focus on the indicators of three tests:
- sowing tank;
- PCR check;
- search for antigens for infection.
Much less often, you may encounter verification through the method of activated particles or probes of a genetic type. Direct microscopy is not performed in this case, because mycoplasmosis prokaryotes are too small or there are no clear morphological characteristics. This analysis will be useful only in terms of assessing the number of leukocytes in vaginal and other samples.
Submission of bakposev
The search for mycoplasma is an important diagnostic procedure. With the help of bakposev, you can detect the amount and type of mycoplasmosis. At the moment, experts use several diagnostic methods. Quite often preference is given to bacteriological research.
If we are talking about a female audience, then a smear will act as the material under study. It is taken by a doctor from the urination canal. Sometimes the fence is made from the uterine cervix or from the walls of the vagina. In men, the urethra is used for sampling, but semen or urine can also be tested.
If a specialist has reason to suspect the development of mycoplasmosis in the body, it is required to first perform tests, and then prescribe treatment. A distinctive feature of mycoplasmas is their high “stickiness” to epithelial cells; for this reason, cells from the mucosa are carefully selected for the smear.
For diagnostics, various test systems are currently used that allow you to quickly determine mycoplasma. With the help of a study of a special order, the number of cells in the liquid, their variety and duration of stay in the human body can be diagnosed. Test systems help to understand which drugs a microorganism is sensitive to. Based on these data, treatment will be selected.
Blood check
The search for mycoplasma in the blood of a child and adults is performed quite often, especially in the early stages of the disease, when there are no specific symptoms yet. Blood, in turn, is able to confirm or refute suspicions.
Due to this analysis, the search for antibodies is performed, which are formed almost instantly when an infection enters the human body. Antibodies are present in humans even after the infection is over, but their norm should not be exceeded. The blood test is performed twice.
First of all, a check is used to confirm or refute a preliminary diagnosis, in the second case, the stage of the disease and a number of details that were not found during the first check are determined. The advantage of a blood test is the rapid emergence of antibodies. Already 10 days after infection, you will know if an infection is present.
PCR and ELISA
The PCR method as a basis uses the genetic traces of mycoplasma in a sample, a fragment, and a portion of the DNA of the pathogen is determined. There can be no confusion with other infectious representatives. For research, scrapings are required, the sampling of which is performed from the genital tract.
A polymerase chain reaction is an analysis that allows you to detect plasmosis, even if the infection does not give itself away, including at those moments when it has already become chronic. Other methods cannot boast such high accuracy rates.
In addition, PCR helps with the detection of mycoplasmosis even within the incubation period, when there are no clinical manifestations. PCR at the same time acts as a quick diagnostic method, the results of the study will be available after a day or two.
However, it is important to understand that sometimes PCR can show false order results. This is possible if the patient underwent a course of antibacterial therapy less than a month ago. The fact is that when DNA mycoplasma is detected, it is impossible to assess whether this cell is dead or viable. That is, the presence of bacteria during PCR diagnostics is recorded even against the background of an absent acute process.
False reactions are possible if the sampling of biological material was performed incorrectly, or the sample was stored incorrectly. If all the rules are followed, then PCR can demonstrate one hundred percent accuracy.
An enzyme immunoassay type allows you to detect the presence of mycoplasmosis by isolating certain antibodies in the blood. We are talking about antibodies G, A, M. This method will help to demonstrate what stage the disease is in: chronic or acute.
If it was possible to isolate type A antibodies, then we are talking about a recent infection. The presence of G antibodies in the blood in combination with the absence of M indicates that the body has already encountered such an infection and managed to defeat it. At the same time, we must not forget that such an analysis result may indicate the carriage of mycoplasmosis.
The accuracy of this analysis option is up to 80 percent. False indications are most often due to the fact that antibodies may be present in the body that have formed as a result of a disease that has been transferred for a long time, and they were activated against the background of other mycoplasmal infections or with respiratory damage.
Description
Method of determination Immunoassay.
Material under study Serum
Mycoplasmas - a group of intracellular microorganisms - gram-negative bacteria 115 - 200 nm in size, which do not have a dense cell wall, covered with a three-layer cytoplasmic membrane. Several strains of mycoplasmas have been described.
Conventionally, mycoplasmas are divided into 6 groups, depending on the diseases they cause in humans. The group of mycoplasmas that cause lesions of the urogenital tract in men and women includes Mycoplasma hominis type I and type II, Ureaplasma urealyticum.
Mycoplasmas are characterized by polymorphism and a peculiar life cycle. The source of infection is a person with mycoplasmosis, or a healthy carrier of mycoplasmas.
Mycoplasma infections of the urogenital tract occupy one of the leading places among STIs. They are often combined with gonococci, Trichomonas and opportunistic microorganisms, are transmitted through sexual contact, can cause non-gonococcal urethritis and prostatitis, inflammatory diseases of the small pelvis, pathology of pregnancy and fetus, infertility in women and men, as well as perinatal infection of newborns.
Diagnosis of Mycoplasma hominis infection using microbiological methods is difficult because it is difficult to cultivate this microorganism in vitro. An adequate modern method for diagnosing M. hominis infection is a PCR method aimed at identifying the pathogen's DNA (in the INVITRO laboratory tests,).
Serological methods (detection of antibodies in blood serum) are of lesser use, since, due to the intracellular localization of M. hominis, the body's immune response against these microorganisms is often weakly expressed. A positive test result for IgM antibodies may indicate the likelihood of an ongoing infection.
Mycoplasmatosis: causes, symptoms and diagnosis of the disease
Among a sufficiently large number of mycoplasmas found in humans, only 4 species can cause disease under certain conditions. One of them - mycoplasma pneumonia - affects the respiratory system, causing inflammatory diseases of the throat, bronchi, and lungs. The remaining three - mycoplasma genitalium, mycoplasma hominis, ureaplasma urealiticum - are the causative agents of genitourinary mycoplasmosis - one of the most common sexually transmitted diseases.
Mycoplasma causes:
1. Diseases of the upper respiratory tract (atypical pneumonia, mycoplasmal bronchitis, etc.).
The causative agent of this group of diseases is the microorganism of the species mycoplasma pneumoniae.
The main route of transmission of diseases: - airborne.
The source of infection is a sick person and a healthy one (carrier).
The possibility of infection persists throughout the year, but in the autumn-winter period, infection is activated.
Clinical manifestations:
cough is the most common symptom of respiratory tract infection in patients with mycoplasma infection. As a rule, a dry, hysterical cough with light sputum is present throughout the disease, but among those who cough only 3-10% of patients with pneumonia.
Diagnostics:
one of the main tools for laboratory diagnosis of infections caused by mycoplasma pneumoniae are serological tests, partly due to their wide availability and ease of sampling - using venous blood to detect antibodies (Ig A, IgM, IgG).
These methods are widely used in clinical practice. In recent years, an increase in their sensitivity has been achieved through the separate detection of different classes of antibodies (IgM and IgA). An elevated IgM level is a reliable indicator of mycoplasmal infection in children. In adults, methods based on the determination of IgA have a higher sensitivity.
Ig G is an indicator of a current or past mycoplasma pneumoniae infection, these antibodies appear later than Ig A and Ig M, and persist for a longer time (more than a year).
Another modern method for diagnosing mycoplasm pneumoniae is PCR diagnostics. PCR (polymerase chain reaction) is a method that allows you to find in the studied clinical material a small section of genetic information (DNA) of any organism among a huge number of other sections and multiply it many times.
The clinical material for the study can be venous blood, saliva, sputum, separated from the ear, throat and nose.
2. Diseases of the urogenital tract in men and women (mycoplasma genitalium, mycoplasma hominis, ureaplasma urealiticum).
Currently, mycoplasmas are considered to be opportunistic microbes. Only mycoplasma genitalium is considered by most researchers as a pathogenic microorganism that can cause urethritis, epidymitis in men, and cervicitis, vaginitis, inflammatory diseases of the pelvic organs and pregnancy pathology in women.
The frequency of detection of mycoplasma hominis, ureaplasma urealiticum varies widely and ranges from 10% to 50%. These microorganisms are often detected in clinically healthy individuals and, being opportunistic microorganisms, can normally colonize the organs of the urogenital system.
Genital mycoplasmas (mycoplasma hominis, mycoplasma genitalium, ureaplasma urealiticum) can be infected in several ways:
during sexual contact;
when the infection is transmitted from mother to fetus through an infected placenta or during childbirth;
in transplantation (transplantation) of organs;
indirectly (in women, especially girls, through household items).
Clinical manifestations of urethritis caused by genital mycoplasmas:
dysuria (itching, burning, pain when urinating);
discomfort, itching, burning in the urethra;
frequent urination or urge to urinate;
pain during sexual intercourse (dyspanuria).
Clinical manifestations of vaginitis caused by genital mycoplasmas:
mucous or mucopurulent discharge from the genital tract;
discomfort, itching, burning on the mucous membrane of the genital tract.
Clinical manifestations of cervicitis caused by genital mycoplasmas:
spotting after sexual intercourse;
discomfort or pain in the lower abdomen;
soreness during sexual intercourse.
Diagnosis of urogenital infectious diseases
Indications for examination for mycoplasma hominis, ureaplasma urealiticum:
clinical and / or laboratory signs of inflammation of the urogenital tract (urethritis, prostatitis, cystitis, cervicitis, cervical erosion, pyelonephritis, vaginitis);
recurrent pathological processes associated with an imbalance in the vaginal flora (bacterial vaginosis);
pre-gravid (pregnancy planning) examination of sexual partners;
upcoming surgical manipulations on the pelvic organs with a high risk of infectious complications;
the presence of a burdened obstetric or gynecological history (miscarriage, perinatal losses, infertility);
the possibility of infection of the fetus with a complicated course.
An additional indication for testing for the presence of mycoplasma genitalium is the detection of mycoplasma genitalium in one of the partners, as well as a change of sexual partner in the absence of the use of barrier methods of contraception.
Material for laboratory tests for the presence of urogenital infections is obtained: 1) in men - from the urethra, prostate gland, and it is also possible to study the ejaculate and the first portion of morning urine, 2) in women - from the urethra, vagina and cervical canal (cervix).
For the qualitative laboratory diagnosis of urogenital infections, it is important to correctly obtain clinical material for research from the patient. To obtain the most reliable test result, it is recommended to comply with a number of requirements:
Donate biomaterial before the start of treatment or not earlier than 1 month after the end of antibiotic therapy;
Observe the time frame for obtaining biomaterial: a) from the urethra not earlier than 3 hours after the last urination, b) in the presence of abundant urethral discharge - 15-20 minutes after urination, c) from the cervical canal and vagina before menstruation or after 1-2 days after its completion;
To carry out the taking of biomaterial in sufficient quantities for laboratory research.
Methods of laboratory diagnostics of urogenital infectious diseases
Currently, for the purpose of diagnosing urogenital infections, a number of methods are used that differ in sensitivity, specificity, ease of use and general availability.
The independent laboratory INVITRO offers a wide range of tests to detect the presence of mycoplasma infection.
For the identification of mycoplasma genitalium, the only research method is the PCR method. PCR diagnostics of mycoplasma hominis is based on the detection of the genetic material of the pathogen (DNA) in the biological material.
The advantages of the method are:
the possibility of using a variety of biological material (scraping, urine, prostate secretion, semen, saliva, synovial fluid) depending on the location of the alleged pathogen localization;
high sensitivity of the method allows early diagnosis of urogenital infections;
high speed of analysis.
To detect mycoplasmahominis and ureaplasmaurealiticum, a cultural (bacteriological) study is carried out with a quantitative determination of isolated microorganisms and sensitivity to antibiotics. Clinically significant is the detection of mycoplasma hominis and ureaplasma urealiticum in an amount of more than 10^4 cfu/ml.
In addition, in order to assess the condition of the epithelium of the genital organs, the presence of an inflammatory process and concomitant sexually transmitted infections, it is recommended to conduct a microscopic examination of a Gram-stained smear.
Literature
- Manual of Infectious Diseases with an Atlas of Infectious Pathology. Edited by Yu.V. Lobzina, S.S. Kozlova, A.N. Uskov. www.infectology.spb.ru, St. Petersburg. 2000
Indications for appointment
- In a complex of studies with non-gonococcal urethritis in men.
- Inflammatory diseases of the pelvic organs.
- Infertility in women.
- epidemiological screening.
Interpretation of results
The interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.
The results are given in terms of:
anti-myc. hominis IgM:
- negative;
- positive;
- doubtful.
anti-myc. hominis IgG:
- negative;
- positive;
- doubtful.
Positive result:
- likely current infection with Mycoplasma hominis;
- bacillus carrying.
Negative result:
- early or late terms of Mycoplasma hominis infection;
- weak immune response to Mycoplasma hominis;
- no infection (with negative PCR results).
Mycoplasma hominis- a small bacterium that lacks the typical bacterial peptidoglycan cell wall. Because of this property, the microorganism is difficult to visualize with simple laboratory research methods.
Mycoplasma belongs to the genus Mollicutes, which is a group of opportunistic bacteria. They can co-exist with normal human microflora without provoking pathological processes. But, at the same time, the absence of a cell membrane makes the microorganism resistant to many antibiotics, in particular to tetracyclines.
Today, it is customary to divide mycoplasma into six groups, depending on the pathologies that it provokes. The most common are two types - M. hominis and U. urealiticum (genitalium), affecting the mucous membrane of the genitourinary system.
Mycoplasma is a fairly common infection among STIs. Often combined with other pathogenic bacteria - Neisseria gonorrhoeae (gonorrhea), Chlamydia (chlamydia) trachomatis, Treponema pallidum (syphilis). Mycoplasma is often the cause of the development of urethritis, cystitis, inflammation of the prostate gland.
According to some microbiological studies, the rate of colonization of Mollicutes in the urogenital tract (in the presence of signs of disease) ranged from 21% to 54% in women, and from 4% to 13% in men. In the upper respiratory tract, the rate ranged from 1% to 3% among healthy adults.
Among patients with chronic respiratory diseases, 7-8% (in particular, in the presence of pneumonia).
In children with chronic tonsillitis, bacterial colonization ranged from 20% to 30%.
- Inflammation of the urinary tract. It is diagnosed as urethritis, with mycoplasma it is difficult to treat, prone to relapse.
- Bacterial vaginosis. A condition caused by a change in the vaginal bacterial flora.
- Inflammation of the fallopian tubes. Salpingitis, which often develops against the background of STDs, can lead to the formation of adhesions and subsequent infertility.
- Inflammation of the cervix. The medical term is cervicitis. Often it is asymptomatic, turning into a chronic form and accompanied by the formation of erosions on the uterine mucosa.
- Infertility of unknown etiology.
An analysis for mycoplasma and ureaplasma is mandatory in the presence of the following clinical manifestations:
- pathological discharge from the vagina and urethral canal;
- burning, sore, itchy sensation during urination;
- discomfort during sexual intercourse;
- rashes, redness on the skin of the external genital organs.
With a long-term mycoplasmotic infection, a number of complications may develop. For example, a violation of the menstrual cycle, the appearance of acyclic spotting, pain in the rectum.
In more severe cases, male infertility and a violation of the ovulatory cycle develop, which is accompanied by the impossibility of conception.
How do I prepare for mycoplasma testing?
Diagnosis does not require special preparation from the patient.
But to get the most accurate results, it is recommended to follow the following rules:
- Biological material is taken from women a few days before or after menstruation.
- Two to three days before the analysis, it is necessary to exclude sexual intercourse, taking antibiotics and alcoholic beverages.
- Before taking the biomaterial from the urethral canal, men are not recommended to urinate for 2 hours.
To determine the opportunistic agent Mycoplasma, three types of laboratory tests are used:
- bacteriological culture (bakposev);
- enzyme immunoassay (ELISA);
- polymerase reaction (PCR).
Bacteriological culture
The most common and budget option for diagnosing a pathogen. Based on the cultivation of bacteria from a sample area of the material on nutrient media, in laboratory conditions.
The analysis allows you to identify the presence of bacteria and clarify its exact amount. Diagnosis takes quite a long time, it takes at least two weeks to get the result. However, the accuracy of the study is almost 100%.
At present, experts rarely recommend bakposev, more modern methods for detecting mycoplasma are increasingly being prescribed - PCR, ELISA. This is due to certain shortcomings of bacteriological seeding. This is the duration of execution, the need to transport the biomaterial in a special environment, the increased demands of mycoplasma on the nutrient fluid.
For laboratory testing, material is taken from the urethral canal or a portion of urine. It is often recommended to study both types of biological material to obtain more informative results.
To minimize the risks of obtaining a false positive / false negative result, material sampling is carried out according to the following principle:
- 4-6 weeks after the end of antibacterial therapy;
- in male patients - three hours after the last urination;
- in women - a few days after the end of menstruation.
PCR study
It is considered the most informative method for studying infections caused by pathogenic microorganisms.
The polymerase reaction has an ultra-high sensitivity, therefore, the accuracy of the results reaches 99%. In addition, PCR analysis is able to detect the presence of pathogenic microflora at the preclinical stage, when there are no obvious signs of the disease. Today it is generally accepted that PCR is the only accurate method for detecting mycoplasma.
Several diagnostic methods are used - qualitative and quantitative.
The first technique allows you to identify a specific type of bacteria and indicate the time when the patient was infected.
The second technique (quantitative method) is aimed at determining the exact amount of the pathogen and the effectiveness of the therapeutic effect. Quantitative PCR is usually prescribed for patients with previously diagnosed mycoplasmosis and for those who have undergone antibacterial treatment.
PCR is one of the most expensive ways to detect an infectious process. However, it allows you to detect the causative agent of the disease in just a few hours. In this case, almost any type of biological fluid can act as a material. This is urine, pathological discharge from the vagina, a secret from the mucous membrane of the urethral canal.
Also, for the study, blood and ejaculate are taken. The speed and accuracy of the analysis makes it possible to identify the earliest stages of the infectious process, thereby increasing the effectiveness of therapy tenfold.
ELISA testing
Immunoassays are antibody-based analytical methods for pathogen detection using quantitative/qualitative methods for their identification.
The principle of immunological assays is based on a specific antigen-antibody reaction. Therefore, ELISA is used worldwide for the diagnosis of infectious, viral diseases. Also in pharmacology to detect certain types of drugs in the body.
Antibodies are produced in response to infection, and therefore ELISA can indicate past infection with 98% certainty.
ELISA has high sensitivity and relatively inexpensive cost, which makes it useful as a preliminary diagnostic manipulation.
The analysis is widely used in testing HIV and a number of other pathologies of the urogenital tract.
For mycoplasma, ELISA indicates whether the patient has been previously infected and whether the immune system was able to cope with the infection.
As a standard, when antibodies to mycoplasma are detected, a qualitative type PCR or real-time PCR is prescribed.
Analysis results: transcript
The interpretation of the results obtained is carried out by the attending physician.
The doctor will explain in detail what the analysis shows and, if necessary, prescribe the appropriate treatment.
Bacteriological culture
This type of analysis determines the concentration of pathogenic microorganisms; at the end of the analysis, the results are indicated in the form of titers.
It is quite easy to decipher the diagnosis, if there is a value of 10 ^ 3 CFU / ml - there is no infection, if the indicator is higher - treatment is required. If necessary, a polymerase reaction is carried out to more accurately determine the bacterium.
Polymerase reaction (PCR)
In the diagnostic report, the patient can see two options for the result: “positive”, “negative”.
In the first option, we are talking about the absence of an infectious process. Therefore, a pathogenic microorganism in a sample of biological material.
In the second case, there is an infection, which means that therapy may be required.
ELISA
When diagnosing by ELISA, it is possible to obtain three variants of results: “doubtful”, “positive”, “negative”.
A negative result can only be spoken of when there is less than 8 IgM antibodies and less than 5 IgG. However, such results do not always indicate that there is no mycoplasmic infection.
If infected less than two weeks ago, in 90% of cases laboratory testing will show a negative result.
Upon receipt of a dubious result, a second study is carried out or another type of diagnostic measure is prescribed. In this case, it is recommended to conduct an analysis after a few weeks.
If the laboratory result is positive, the patient is infected.
In this case, an increased amount of immunoglobulin M antibodies is observed - more than 9.
With a positive study, the patient is assigned a diagnosis for the determination of individual antibodies. These are immunoglobulins A and G, which make it possible to identify a specific type of mycoplasma (hominis or urealyticum).
To determine these types of infection, their DNA is isolated from biological material. Next, the replication process is started, which makes it possible to obtain complete information about the disease.
Why are additional tests performed when detecting mycoplasma?
In most cases, the presence of mycoplasma in the body is accompanied by the presence of other pathogenic bacteria involved in the development of sexually transmitted infections. For this reason, when mycoplasma is detected, the patient is strongly recommended to undergo an STD diagnosis, even in the absence of a clinical picture of the disease.
Women may additionally be prescribed a colposcopic examination, in order to study the condition of the vagina and cervix.
