Diagnosis of ureaplasmosis gardnerellosis. Suppositories for gardnerellosis and ureaplasmosis

Ureaplasma and gardnerella are microorganisms that are usually classified as opportunistic microflora. They live on the mucous membranes of the genitourinary organs, but do not cause diseases. At the same time, there is a risk of developing inflammatory processes. The risk of developing inflammation is significantly aggravated if both microorganisms are on the mucous membranes at the same time. It should be noted that vaginal dysbiosis often leads to an increase in the number of gardnerella, as well as ureaplasma.

Features of the microflora of the genital organs

Various bacteria can appear on the mucous membranes of the genital organs, and their number may vary.

Beneficial bacteria belong to normal microflora. The goal is to keep the genitals clean and prevent the risk of developing the disease.

Opportunistic bacteria can actively multiply, as a result of which the mucous membranes cease to be intact and the risk of developing the disease increases.

Normally, there should be a fluid balance between normal and opportunistic microflora, and beneficial bacteria should prevent the growth of opportunistic microflora. However, sometimes the volume of normal microflora begins to decrease significantly, and it ceases to control the growth of opportunistic microflora, resulting in active growth of the latter and an imbalance. This condition is commonly called dysbiosis. This is usually caused by situations such as taking antibiotics or douching with antiseptics.

Gardnerella, as well as ureaplasma - bacteria of opportunistic microflora

In women, vaginal dysbiosis, which is also bacterial vaginosis, develops due to gardnerella. With this disease, women begin to have copious discharge, characterized by the presence of an unpleasant fishy odor. Bacterial vaginosis must be treated, because it can lead to serious inflammation. It is important to note that inflammation can be caused by gardnerella or other representatives of opportunistic microflora, which are capable of multiplying and becoming more active in their own manifestations. Among such pathogens is ureaplasma. For this reason, ureaplasma and gardenerella are often combined with each other and must be treated. In some cases, these microorganisms can peacefully exist with each other in opportunistic microflora and without the risk of developing bacterial vaginosis, an infectious-inflammatory process.

It should be noted that in men gardnerella cannot remain on the mucous membranes of the genital tract for a long time, since very often it dies. However, diseases in men can develop from other opportunistic microorganisms. The detection of such bacteria and ureaplasmas in men should not lead to the initiation of treatment if there are no signs of dysbacteriosis.

Symptoms of an infectious-inflammatory process

Inflammatory processes with a combination of gardnerella and ureaplasma are typical for women. Inflammation is caused by reduced immunity or the entry of ureaplasma into the genital tract, if there is bacterial vaginosis developing due to gardnerella, or vice versa (inflammation of ureaplasma worsens with the penetration of gardnerella).

Symptoms include discomfort, burning, and itching in the genital area. In addition, frequent urination with pain may occur. Acute inflammation can lead to fever and malaise. The disease in the presence of only ureaplasmas usually occurs without any symptoms. If the inflammation is caused by the presence of ureaplasma, as well as gardnerella, symptoms will certainly appear.

A woman must undergo an examination and find out about the presence of all inflammatory processes. If inflammation cannot be identified, treatment is not required. Otherwise, you need to take antibiotics and restore normal vaginal microflora using probiotics. See a doctor and you will definitely be healthy!

Back in the first half of the 20th century, doctors debated whether Gardnerella and Ureaplasma were dangerous for humans. Now doctors agree that there is a threshold amount of these microbes, exceeding which leads to inflammation in the reproductive organs of men or women.

Unfortunately, there are frequent attempts at unprofessional treatment of such infections. They serve as the basis for unfounded negative reviews about the ability of modern medicine to cope with these pathogens.

Microbiological characteristics of pathogens

Gardnerella vaginalis and representatives of the genus ureaplasma (Spp. ureaplasma) belong to completely different families and classes of microorganisms.

The following points are common to them:

• sexual transmission;
• frequent relapses;
• lack of immunity, which causes repeated cases of infection;
• negative impact on the reproductive abilities of men and women;
• high frequency of combined infections, when in one patient the infectious process is caused by pathogens from both groups at once.

There are also plenty of differences and features, and we will look at them below. Since it is the differences in microbes that lead to the low effectiveness of treatment for patients with mixed infections. Due to anatomical features, women predominate among patients with gardnerellosis and ureaplasma.

In men, inflammation is less common and can spread to the genitals.

Gardnerellas

These are bacteria with an anaerobic type of life activity; they multiply without access to oxygen. Their typical habitat is the female vagina and the male urethra. It is believed that active reproduction of Gardnerella occurs against the background of a decrease in the number of lactobacilli. They cause a disease called gardnerellosis or bacterial vaginosis.

The main pathological process in gardnerellosis is nonspecific inflammation. As a result, the activity of tissue immunity decreases. Conditions are created for the attachment of other pathogenic microorganisms.

Ureaplasma

The family includes more than 30 different types of microorganisms, but only 2 are pathogenic for humans:

• Ureaplasma urealyticum.
• U. parvum.

A characteristic feature of these microorganisms is that they are found in small quantities in absolutely healthy men and women.

Studies have shown that inflammation develops only when local immunity is weakened or simultaneous superinfection with a large number of ureaplasmas.

The danger of ureaplasma and gardnerella for women

With gardnerellosis (bacterial vaginosis), inflammation is not limited to the walls of the vagina. It affects the urethra and cervical canal, causing a lot of inconvenience and discomfort. However, the biggest danger is that gardnerellas seem to prepare the ground for other pathogenic microorganisms. Against this background, ureaplasma joins the process. These microbes are already capable of spreading to all the internal genital organs of a woman.

Thus, local inflammation of the vaginal mucosa caused by Gardnerella is transformed into much more serious processes:

• Cervicitis involving the epithelium of the cervical canal.
• Endometritis is an inflammation of the layer lining the inside of the uterine cavity.
• Salpingitis is a lesion of the fallopian tubes.
• Adnexitis is the transfer of ureaplasma to the ovaries and their appendages.
• Urethritis and cystitis, when microbes penetrate the organs of the urinary system.

In women, ureaplasmosis in combination with gardnerellosis can be sluggish and without pronounced clinical symptoms. But even then, a man who has unprotected sex runs a very high risk of catching both of these infections.

Symptoms

Symptoms of infection consist of two components: gardnerellosis and ureaplasmosis.

In the first case, the clinical picture is more clear:

• burning and itching in the vagina;
• discharge from the vagina (leucorrhoea) of a mucous or mucopurulent nature;
• The discharge has an unpleasant odor (rotten fish).

The internal genital organs are rarely affected by gardnerellosis, except for cervicitis. Therefore, when pelvic symptoms are added to the clinical picture of bacterial vaginosis, it is necessary to suspect a mixed infection.

Damage to the reproductive system is indicated by:

• discomfort in the lower abdomen;
• nagging or aching pain in the pelvis;
• increase or decrease in the volume of menstruation.

If the process reaches a significant extent, then symptoms from the genitourinary system are accompanied by signs of general intoxication. These are fever, weakness, headache, malaise.

Consequences of infection

Inflammatory phenomena caused by ureaplasma are characterized by low activity and steady progression.

The functional epithelium in the foci of infection dies and is in some places replaced by connective scar tissue. As a result, the internal genital organs become unable to fully perform their assigned functions.

Menstruation disorders appear and the cycle loses regularity. Torpid subacute inflammation of the fallopian tubes leads to disruption of their patency. Because of which the egg cannot be fertilized.

Even if fertilization occurs, the weakened endometrium cannot ensure the development of the embryo.

Frequent miscarriages occur in the early stages. Because of this, normal pregnancy and long-term persistence of ureaplasma in the female body are not compatible. But after a full examination, when pathogens are found in the tests, a course of effective treatment is carried out and recovery is confirmed. A woman's ability to become pregnant and give birth usually returns.

The danger of ureaplasma and gardnerella for men

The male body is also vulnerable to these microorganisms. The weakest place in this regard is the epithelium of the urethra, the most common process is urethritis.

In men, gardnerella, by analogy with female pathology, initially weakens the protective barriers on the urethral mucosa. Moreover, these microbes themselves almost never spread further. But ureaplasma, despite its immobility, infects the internal genital organs of a man in a few weeks.

Possible diseases:

• prostatitis;
• epididymitis;
• orchitis;
• vesiculitis;
• urethritis;
• bulbourethritis.

Due to the characteristics of the urethra (it is narrow, long and has two bends), ureaplasma and gardnerella very rarely penetrate into the bladder in men. This is the main difference between the course of genitourinary infections in women and men.

Manifestations

There are no specific symptoms; signs of damage to certain genitourinary organs come to the fore:

• With prostatitis - difficulty urinating, pain and discomfort in the perineum.
• With epididymitis or orchitis - swelling and pain in one or both testicles.
• Vesiculitis is manifested by pain in the pelvis, intensifying with ejaculation.
• Urethritis and bulbourethritis (inflammation of small glands in the wall of the urethra) are recognized by a burning sensation in the urethra, pain when urinating, and slight discharge from the opening of the urethra.

Another difference between “male” gardnerellosis and ureaplasmosis. In men, these pathogens cause active inflammation much less frequently than in women. The picture can be so blurry that the infection is sometimes detected only in tests taken for one reason or another.

Consequences

This feature leads to the fact that in men these infections last a long time. This means they cause more pronounced changes in the activity of the reproductive organs.

The main disorder is a decrease in the ability of men to conceive.

Thus, quite serious studies were carried out, the results of which revealed the following.

In men with a mixed infection of gardnerellosis + ureaplasmosis, the number and activity of sperm are noticeably reduced. Old processes that are several years old (unfortunately, these occur quite often) sometimes lead to irreversible changes. However, in most cases, complete and qualified treatment allows you to completely restore reproductive function.

Treatment of ureaplasmosis and gardnerellosis

Since the pathogens under consideration belong to different classes of microorganisms, a special approach is required to effectively combat them:

• Examination and treatment of both sexual partners.
• Refusal to have sex until negative tests are obtained.
• Carefully follow all medical recommendations.
• Regular laboratory monitoring to monitor the effectiveness of therapy.

The basis for the course is drugs from different groups of antibiotics and antiprotozoal drugs.

The main means to combat Gardnerella are metronidazole, tinidazole and other nitroimidazole derivatives.

Second-line drugs – amoxicillin, ampicillin.

The last row is drugs of the tetracycline group. But in modern conditions they are least effective against gardnerella.

Plus, microbes are often resistant to them.

Regarding ureaplasmas, it’s the other way around: tetracyclines have good activity. And to penicillin derivatives (amoxicillin) and cephalosporins (ceftriaxone), these microorganisms are less sensitive.

A typical treatment regimen for a patient of any gender when a mixed infection is detected is as follows:

• Metronidazole in a course dose of 1 gram.
• Erythromycin + oxytetracycline 0.25 grams every 12 hours.
• Pyrogenal as an immunostimulating agent.

The duration of treatment for an acute case is at least 3 days. In case of chronic infection with a duration of more than 2 months, the course is extended to 5-6 days. Since the majority of patients are women, complex suppositories for Gardnerella and mycoplasma have been developed for local intravaginal use.

The most relevant:

• Terzhinan. The composition includes neomycin, ternidazole, nystatin and prednisolone.

• Macmiror, based on a nitrofuran derivative - nifuratel.
• Metrovit is a single drug, metronidazole.
• Lactonorm, Acylact are suppositories that help quickly restore normal vaginal microflora.

It should be borne in mind that only local treatment will not completely get rid of gardnerella and especially ureaplasma.

Qualified doctors always prescribe a combined course with the gradual addition of drugs from different groups. And, of course, the scheme is drawn up individually.

Based on survey data on the severity, prevalence, duration of infection and the sensitivity of pathogens to drugs.

Suppositories for gardnerella and ureaplasma help normalize the vaginal microflora and cure certain types of bacteria.

Indications for use

These drugs are used to treat two separate women's diseases:

1. Bacterial vaginosis, which is also known as gardnerellosis.
2. Ureaplasmosis.

Names of candles from Gardnerella

First of all, you need to pay attention that the treatment of gardnerella takes place in two stages. Moreover, the second stage without the first will not be effective at all.

First, the doctor prescribes suppositories with antiseptic and antibacterial effects, which eliminate the causative agent of the disease. Then the vagina is “populated” with normal microflora using suppositories with live lactobacilli.

The most common Gardnerella suppositories are:

• McMirror. The active ingredient of the drug is nifuratel (a derivative of nitrofuran).

It has antiprotozoal, antimicrobial, antifungal effects. For bacterial vaginosis, one suppository is used three times a day. Therapy continues for a week. The main contraindications to the use of the drug are: pregnancy, intolerance to the components. Side effects are rare: allergies, nausea, headache.

• Terzhinan. The active ingredients of the drug are neomycin sulfate, nystanine and ternidazole. Thanks to this, the candles have an antifungal effect. It is nystanin that fights gardnerella.

To treat gardnerellosis, Terzhinan is administered once a day (preferably in the evening, since after administration of the drug the woman needs to lie down). Therapy lasts ten days. The drug is contraindicated during pregnancy and in case of intolerance to its main components. Side effects are: itching, burning in the vagina, allergies.

• Metrovit. The active ingredient of the drug is metronidazole, which effectively fights gardnerella.

Use once a day (preferably at night) in a dosage of 500 ml of the drug (1 candle). The duration of therapy is determined by the doctor. Do not take for: blood diseases, organic lesions of the central nervous system, pregnancy, liver disorders. Among the main side effects are the following: vomiting, appetite disturbances, unpleasant taste, headaches, poor sleep, allergies, leukopenia, burning in the urethra, irritability.

For the second stage of therapy, the following is usually used:

• Lactonorm. Vaginal capsules based on live lactobacilli, which help to completely restore the vaginal microflora after gardnerellosis. Use one candle twice a day. The course of therapy lasts from seven to fourteen days.

• Acylact. Vaginal suppositories, which are based on the live mass of lactobacilli acidophilus. To improve the vaginal microflora, the drug is used for five to ten days. One suppository is administered per day.

Dalatsin

The active ingredient of the drug is clindamycin. It is a semi-synthetic lincosamide antibiotic. Shows active action against some gram-negative bacteria (including gardnerella).

The dosage is prescribed by the doctor. To avoid complications, you must strictly adhere to its recommendations. Typically, adults administer one suppository three to four times a day. The duration of therapy is two weeks.

The main side effects from using Dalatsin are: nausea, which is often accompanied by abdominal pain and vomiting, jaundice, stomach ulcers, allergic reactions (rash, itching, redness, urticaria), leukopenia, thrombocytopenia, vaginitis.

The drug is contraindicated for use in: gastrointestinal diseases, myasthenia gravis, chronic liver diseases, pregnancy, lactation, intolerance to components.

Galina asks:

Hello. In February of this year, I contacted a gynecologist about planning a pregnancy, with the goal of undergoing a preventive examination. As a result of bacterial culture tests, the following were found: mycoplasma, ureaplasma 2.7x10^5, gardnerella. No complaints other than some slight discharge and odor. There is also erosion. Treatment was prescribed:
1. Imunofan, aloe injections, methyluracil suppositories, vitamin E, folic acid, macropen (3 weeks - 2 times a day), fluconazole
2. Bifidumbacterin, trichopolum
3. Lactobacterin, genferon suppositories 250
In addition, I went to the same doctor for a fee for baths with some medicine and injections. Sex life with protection. 4 months have passed since treatment. I took a second test and found: mycoplasma, ureaplasma 3.3x10^4, gardnerella. Treatment prescribed:
4. Yogulact, Genferon suppositories 500.
I haven’t taken the third test yet.
In this regard, I have a question. How effective was the treatment I was prescribed? Should I continue to be treated by this doctor or change? To be honest, I’m already tired of treatment; is it worth doing this at all if there are no results from it?

The treatment you were prescribed was absolutely correct. The fact is that these infections are difficult to treat, so treatment requires repeated courses of different antibiotics. Along with antibacterial treatment, the doctor also prescribed drugs that restore the natural microflora and drugs that stimulate the immune system.

Vika asks:

Hello.
Found: gardnerella and ureaplasma (nothing particularly bothers me, just a white-yellow discharge and a fishy smell). treatment was prescribed, but, it seems to me, a little harmful and dangerous:
Stage 1: douching with boric acid
Stage 2: trichorol, fluconozole, unidox solutab, vobenzin, viferon, terzhinan (you can take everything at once, of course, your doses are prescribed)
Stage 3: bifidum bacterin
Do I need to add more medications or undergo treatment according to this regimen?

Vika comments:

Hello again!
After drinking the full course, the problem stopped for 3 days, and then everything was the same.
Gynecologists, as usual, cannot say the reason and prescribe an effective remedy. Currently, I have a creamy white discharge with an odor and no itching. Are there special douches or medications that can easily help me?
thank you in advance.

INNA asks:

I AM PLANNING PREGNANCY, THAT'S WHY THE CULTURE WAS DONE. RESULT: GARDNERELLA 7 MULTIPLIED BY 10*2, CANDIDA ALBICANS ALSO 7 MULTIPLIED BY 10*2, ENTEROCOCCUS 10*4, Escherichia coli 7 MULTIPLIED BY 10*2. LACTOBACTERIA LESS THAN 10*2. THE LABORATORY SAID THAT EVERYTHING IS WITHIN ACCEPTABLE LIMITS, BUT ON THE VERGE OF PATHOLOGY. DOES THIS NEED TO BE TREATED WITH ANTIBIOTICS OR IS IT ENOUGH TO TRY TO INCREASE LACTOBACTERIA WITH VAGILACOM AND WILL THE DYSBACTERIOSIS ITSELF DECREASE? MAYBE IT IS WORTH INSTALLING LOCAL CANDLES LIKE TERZHINAN?

In this case, all indicators are within such limits that treatment in the absence of clinical manifestations of infection is not required. The correct treatment for dysbiosis can be prescribed to you by your attending gynecologist. Read more about this issue in the section of our website: Dysbacteriosis

Natalya asks:

In order to plan a pregnancy, I underwent tests and found: Mycoplasma, gardnerella, the gynecologist made a prescription: For my husband, intramuscular cycloferon, vilprofen, a complex of strong enzymes, one-time tinidazole (4 tablets), local miramistin and candida ointment. I need cycloferon intramuscularly, vilprafen 500, pimafucin 100, trichopolum (tinidazole), a complex of strong enzymes, flemaxin solutab, local douching with tea tree solution, + Lexicon suppositories, after the Klion D suppositories. Please advise whether this prescription can completely rid us of the problem?

The prescribed medications correspond to the established diagnosis, therefore we recommend that you use this course of treatment. However, we recommend that you undergo an antibiogram if this study has not been carried out, which will make it more likely to assume the effectiveness of treatment with antibacterial drugs.

“Gardnerella vaginalis” is the name of a conditionally pathogenic microscopic organism that can cause a disease called “Gardnerella” or, as it is called in a slightly more understandable language, “bacterial vaginosis”. The disease process leads to the disruption of the normal ratio of beneficial lactobacilli and conditionally pathological gardnerella bacteria. With dysbacteriosis, a decrease in the normal amount of lactic acid and hydrogen peroxide occurs, therefore, because of this, the rate of reproduction of Gardnerella gets out of control. Of course, in a “healthy” state the human body is filled with anaerobes, but they are present in small quantities and do not cause harm.

Bacterial vaginosis is being studied as part of AI, therefore it can be sexually transmitted. The incubation period is approximately ten days, after which the symptoms of the disease do not always appear, but there are certain characteristic signs. Gardnerellosis has become widespread among women for the most part; men get sick, but most often they are only carriers of the infection. Twenty percent of all fertile women have bacterial vaginosis. This is quite a large number. It will be true to say that these women, for the most part, have active sexual practices, while not paying attention to physical contraceptives. In vain, because the same condoms can create the same barrier that will not allow even such small microorganisms to pass through. In this case, the risk of infection arises in both one and the other sexual partner.

When using chemical contraceptives, an artificial disruption of the microflora occurs, which leads to dysbacteriosis.

Favorable conditions for the development of the disease:

Drug-induced changes in the bacterial and hormonal levels of the body. Decline or leap upward.

Inflammation against the background of other diseases, such as ureaplasmosis or mycoplasmosis, prostatitis in the case of men.

Treatment with antibiotic drugs that kill not only pathogenic and conditionally pathogenic, but also symbiotic beneficial bacteria such as lactobacilli or E. coli in the human large intestine.

Symptoms of the disease

Signs of the disease are not something new, here they are:

The consistency of the discharge is reminiscent of cream, with a yellowish or grayish color. Wet and sometimes sticky.

The putrid smell of fish, which is formed due to the breakdown of amine and amine-derived substances as a result of the activity of anaerobic bacteria.

Inflammation caused by this particular type of bacteria.

Burning sensations, itching, frequent scratching or rashes.

For a pregnant woman, the following consequences are typical:

Infection of a non-viable fetus.

Flow of blood from the uterus outside in the middle of the menstrual cycle.

Chronic, periodically exacerbating diseases of the urinary system.

“Fading” of pregnancy, miscarriage, early birth as a result of a violation of the placental membrane of the fetus.

Endometritis after childbirth.

If a child is removed from the uterus due to surgery, complications may occur in the internal organs of the small pelvis.

Pneumonia in infants.

To reduce the risk of complications, it is necessary to carry out timely treatment of gardnerella and ureaplasma, since they often go hand in hand with the latter.

Diagnostics will show the general picture of the disease, and the doctor will prescribe treatment. In the absolute majority of cases, the gynecologist will prescribe an antibiotic, and possibly even several.