False positive result on ureaplasma. Normal amount of ureaplasmas in a smear in women. False positive analysis for ureaplasma.

04.04.2020

Ureaplasmosis very often occurs without obvious symptoms. Sometimes only analysis allows you to identify this disease. The cause of ureaplasmosis is pathogens present in human microflora. They are of 2 main types: Ureaplasma urealyticum and Ureaplasma parvum.

These unicellular bacteria are harmless when their number is kept within permissible value. At favorable conditions Ureaplasma urealitikum and Ureaplasma parvum begin to multiply, disrupt the integrity of healthy cells in the mucous membranes of the genitourinary system. An inflammatory process develops in the affected areas, which can lead to more serious diseases.

Most often, pathogenic bacteria are transmitted during sexual intercourse, but there are other reasons for the development of ureaplasmosis:

hypothermia;
complications after a cold;
decrease in general immunity;
hormonal changes after abortion, childbirth and during menstruation;
ignoring hygiene rules;
stress
prolonged use of antibiotics;
dysbiosis;
other infectious diseases.

Ureaplasma urealiticum is more common, although the presence in the body of any of the 2 types of bacteria in large quantities indicates the need for treatment.

If ureaplasmosis is confirmed during laboratory research at least one sexual partner needs to be treated by both.

This will help avoid a relapse of the disease and prevent the development of complications, including infertility.

After all, ureaplasma urealitikum and parvum, multiplying in the body of a woman, affect not only the mucous membranes of the vagina and cervical canal. They penetrate the fallopian tubes, causing an adhesion process, which leads to the impossibility of conception. The growth of pathogenic microflora during pregnancy can even provoke a miscarriage and premature birth.

Symptoms and types of analysis

Ureaplasmosis is often accompanied by other diseases, so it is difficult to isolate the symptoms inherent only to this disease. But there are a number of signs indicating the need to consult a doctor:

Pain in the lower abdomen and urination.
The presence of mucous discharge with an unpleasant odor.
Itching, burning and pain in the intimate area.
The presence of concomitant diseases of the genitourinary sphere.
Infertility for an unknown reason.

When a person complains about one of these symptoms, the doctor prescribes a microflora test and checks the patient for sexually transmitted diseases. If the result of the analysis on the microflora shows an imbalance between beneficial and pathogenic microorganisms, the doctor should conduct additional studies to identify the causes of violations. The diagnosis of diseases of the genitourinary organs, as a rule, also includes an analysis of ureaplasma.

To determine ureaplasmosis, there are several research methods. Analysis for ureaplasma in men differs little from the diagnosis of this disease in women. In both the first and second cases, we are talking about a smear from the urogenital organs. Men donate biomaterial from the urethra. Women - from the urethra, vagina and cervical canal. But a smear on ureaplasma is not the only way to determine the presence of a pathogen. Sometimes a blood test is taken from a patient to make an accurate diagnosis.

Bacteriological culture and polymerase chain reaction method

One of the most common methods of research is bacosowing on the flora. It allows you to analyze the composition of the microflora of a woman’s vagina. According to the ratio of beneficial and harmful microorganisms, a specialist can suggest the development of ureaplasmosis or other diseases. To clarify the diagnosis, additional studies are prescribed.

Material for bacteriological culture is taken during a gynecological examination. You can take a smear 2 days after the end of menstruation. A few days before the analysis, it is recommended to refrain from sexual activity, taking contraceptives, douching and using local medicines. Reception of antibiotics and other medicines should be canceled a week before a visit to the doctor. Before the delivery of the material, it is advisable not to take a shower or go to the toilet.

A more complex, but reliable analysis of ureaplasma is the polymerase chain reaction method, which allows you to determine the bacterium even in the singular. PCR involves the study of material taken from the cervical canal. Biomaterial analysis lasts up to 5 hours. In the course of an in-depth study, ureaplasmosis in any form, including hidden, can be detected. Preparation for PCR on ureaplasma does not differ from preparation for the usual delivery of a smear. But unlike bacterial sowing, such an analysis can be carried out in the middle of the menstrual cycle, and not immediately after the end of critical days.

Cultural culture and immunofluorescence analysis

Another type of analysis that allows you to identify the causative agent of ureaplasmosis is known as culture. During the study, material is taken from the urethra, vagina and cervical canal. The contents of the smear is placed for 3 days in a special environment where pathogenic bacteria can multiply freely. Then the specialist makes an assessment of the results, which will make it possible to judge the presence of one or another causative agent of the disease. This type of analysis does not require special preparation. But it is better to refuse the shower on the day of the collection of material so that the study on the flora is objective.

There is another type of analysis for ureaplasma, which differs from all other test material. For immunofluorescence analysis, blood is taken from a vein. It is analyzed for antibodies. Immunoglobulin DNA is able to confirm or deny the presence of the causative agent of the disease. The patient needs to give up antibiotics about 7 days before the analysis. No other special preparation for this type of study is required.

Analysis for ureaplasma in women has become a cause of controversy in scientific medical circles. Some insist on the insidiousness of the microorganism, the latent threat of delayed ailments and breakdowns, complicated pregnancy, up to a miscarriage. At the same time, some earn good money by exploiting human fear for their health. Others tend to rely only on facts confirmed by experiments, shifting the responsibility of choice to the patient, and the clinical significance of the infection itself is called into question.

Let's try to cut off commercial myths from medical data, to talk about the true danger of ureaplasma, so that a person realizes what he is facing.

Information about ureaplasma

The microorganism belongs to the family of mycoplasmas - the smallest bacteria that do not have their own cell wall, which makes them less vulnerable to most antibiotics. Mycoplasmas (mollicuts) occupy an intermediate position between viruses and unicellular microbes.

The fact that ureaplasma is found in most women (60 - 80%) and a significant part of the male sex (45%) allows us to consider the microbe as part of the normal microflora. But when local immunity fails, the bacterium tends to grow rapidly, provoking ureaplasmosis.

Although this diagnosis is not listed in the International Classification of Diseases, it is considered when no more significant pathogenic factors have been identified in the presence of inflammation. Ureaplasma and mycoplasma as a specified pathogen, are included in the diagnoses:

Cervicitis (code N72.0 + B96.8);
Urethritis (code N34.0 + B96.8);
Vaginitis (code B07.0 + B96.8).

Given the recent start of research on ureaplasma and its pathogenic role, the study of the microorganism continues. 2 biologically significant variants of ureaplasma were found: urealyticum and parvum, and the urealyticum biovar is less common and more dangerous. A person can be a carrier of one of them, or both at the same time. Mycoplasmas are considered to be opportunistic flora, capable of harming only people with a deficiency of immunity.

Today, a consensus has been adopted: the very fact of detecting ureaplasma parvum and urealitic in a woman is the norm in the analyzes, if the numbers are insignificant, there are no complaints. Treatment for the sole reason - a positive analysis, is not carried out.

If the disease is present, and laboratory data do not show other pathogens, except high level ureaplasmas are diagnosed with ureaplasmosis. They are treated with broad-spectrum antibiotics (tetracycline, erythromycin, doxycycline, ofloxacin, azithromycin), based on the results of the sensitivity tests.

Tetracycline
Erythromycin Doxycycline Ofloxacin
Azithromycin

Important! A different picture before the planned pregnancy or during its course. A woman whose analyzes showed the presence of ureaplasma has the right to know that hormonal changes can reduce local immune defense. This provokes the multiplication of pathogens suspected of causing miscarriage, premature fetus, pneumonia of the newborn.

How is ureaplasma detected

Exact today laboratory methods in the aggregate, they allow with high reliability to identify both the ureaplasma itself and the antibodies to it produced the immune system . Any single method will show a contradictory picture, so a complex of analyzes is prescribed. Responsible doctors simultaneously take tests for ureaplasma in women, which includes:

Serological examination of blood serum (IgG, IgA);
Microbiological analysis (inoculation with antibiotic sensitivity control);
PCR (polymezar reaction) technique for the detection of pathogen DNA.

For serology, venous blood sampling is done, for microbiology and PCR - biological fluids (urine, in men also prostate secretions, sperm), urinary tract epithelial cells.

Note! Before passing the analysis, a woman needs to know that menstrual cycle affects the hormonal background and the balance of microflora. In order not to receive a false positive response, you should choose according to the recommendation of a doctor optimal time for taking material.

A repeated take of the test after 2 weeks is desirable in order to trace the dynamics of the growth of microorganisms.

After antimicrobial therapy, it is important to control the cure of the disease - if the result is negative, exclude ureaplasma and other bacteria as a pathogenic factor.

Problems of interpretation of analyzes for ureaplasma

Practicing doctors are of the opinion that the incidence rate is up to 104 CFU per 1 ml acceptable, above - considered dangerous and must be treated. In the scientific literature there are no convincing data on such figures, there are only assumptions.

The problem of interpreting ureaplasma tests remains unresolved - each doctor takes on his own responsibility by analyzing clinical picture each individual patient, makes an informed decision on the feasibility of combating the microbe.

An honest doctor is obliged to inform the patient about the risks discovered by medical research, but at the same time leave an attempt to intimidate and cash in on his credulity. Some sin with a commercial temptation, attributing mythical horrors to mycoplasmas, thereby inducing the patient to expensive, often useless, treatment.

Ureaplasma hazard information

What are mycoplasmas really guilty of, what are they suspected of based on research results?

Some data on the effect of dissemination of ureaplasma urealyticum on women's health concern:

Inflammation of the urogenital tract, uterus, genital appendages;
The pathological course of pregnancy;
Miscarriages;
Cases of ectopic pregnancy;
Education in the pipes of adhesions;
Low weight newborn;
Pneumonia of the newborn;
Infertility

The male sex is at risk for urethritis, impaired spermatogenesis (sedentary and motionless sperm), prostatitis, and damage to the organs of movement.

Arguments about the relative harmlessness of mycoplasmas

Examining healthy women with no complaints and clinical signs diseases, ureaplasma parvum found in analyzes in 80 - 90% of women of reproductive age, urealyticum - in 30%. At the same time, women normally bear the fetus and give birth to healthy babies.

Analyzing individual data on the dangers of mycoplasmas, it is difficult to trace a causal relationship. Indeed, in patients with these ailments, an increased contamination of urealyticum was revealed, but its role as a trigger is not yet clear.

Note! It is fair to talk about the risks for people with impaired function immune defense, imbalance of microflora, immunodeficiency states. Such people must definitely treat ureaplasmosis.

Regarding the feasibility of treating asymptomatic ureplasm, then preventive therapy not practiced in the world. Treatment is prescribed solely for clear indicators - the presence of complaints, obvious symptoms, positive laboratory results.

Important! In the case of diagnosing urethritis, cervicitis, vaginitis, therapy is required, even when the pathogen is not identified.

During pregnancy, if detected genital infection, which is included in the list of TORCH infections (dangerous for the fetus), then when the pathogen is destroyed by antibiotics, ureaplasma will also suffer, since it is sensitive to the prescribed drugs.

Mycoplasmas themselves are not currently included in the list of TORCH infections, therefore, they should not be treated only when the test is positive, they should not be carried out during the gestation period, especially if the pregnancy proceeds without problems from the genitals. The negative effect of therapy may outweigh the therapeutic result. There is evidence that antibiotics during pregnancy do not save from premature birth.

Responsibility for the treatment of ureaplasmosis

Often, as a result of the examination, the patient finds out that they found ureaplasma. Naturally, he has questions: "Where does the infection come from, is it treatable and what to do in order not to infect the partner?"

To begin with, do not panic, but ask the doctor: where do women come from?

Ureaplasma: what is it
Diagnosis of ureaplasmosis
Symptoms of ureaplasmosis
Treatment of ureaplasmosis
What to do during pregnancy?

Ureaplasma: what is it

In fact, the bacterium belongs to opportunistic microbes. And it can be present in the body in humans, without causing any concern.

If the bacteria does not exceed 10 * 4, then this is not a disease and the patient does not need treatment. But there are times when bacteria seem to be, like not. But patients complain and discomfort when urinating. In this case, an additional examination is carried out and adequate therapy is prescribed.

Ureaplasmosis: causes of the disease

The causes of ureaplasmosis in men and women do not differ.

The most common way to transmit the infection is through unprotected sex. There are two types of microorganisms that are found in women and men. This is ureaplasma ureatilicum and parvum.

A person who often changes sexual partners does not even make sense to think about where the infection came from. Since any of them can be a potential source of infection.

In some cases, this is the case. The man complains that "my wife found ureaplasma during the examination, but I have no pathology in my analyzes."

How can this be?

The thing is that normally the infection can be present, but not manifest itself in any way. Under certain conditions, the pathogen activates and begins to multiply.

The causes of the appearance of pathology in women is a change in the acidity of the vaginal flora. When the number of sticks (lactobacilli) decreases and a mixed flora begins to develop, including ureaplasma.

To the question: "Where do the ureaplasma come from patients who have never had sexual intercourse?"

Moreover, in 5-25% of cases, the pathogen is detected even in virgin schoolgirls.

A definite answer to this question cannot be given even by a specialist. The thing is that there are other ways of penetration into the body. Including the contact-household way of infection is not excluded. Other causes of the disease in women are:

decreased immunity;
availability ;
aggravation inflammatory process in organism;
after menstruation, surgical interventions;
in the postpartum period;
against the background of the use of an IUD (intrauterine device).

Among common causes ureaplasmosis in men should be distinguished:

Ureaplasma: how the pathogen is transmitted

Routes of infection may be as follows:

sexual intercourse with an infected partner;
vertical (ascending) path, i.e. from the vagina and urethra to other organs;
infection may occur in the process patrimonial activity while promoting the fetus through the birth canal of the mother. In newborn infants, the infection is often diagnosed in the nasopharynx and genitals, especially in girls;

In very rare cases, transmission of the infection during pregnancy to the fetus may occur. Even less often, ureaplasma can be infected by contact healthy person with the patient.

Diagnosis of ureaplasmosis

After presenting complaints and examination by a doctor, a specialist may suspect that the patient has ureaplasmosis. In order to clarify the alleged diagnosis, an additional examination of the patient is carried out. For this, the doctor may prescribe a number of studies:

If a woman has identified:

genital inflammation;
burdened obstetric history
or she suffers infertility
menstrual irregularities,
cervical erosion,
cervicitis or colpitis,

then it is necessary to conduct a study for the presence of ureaplasma infection.

Symptoms of ureaplasmosis

Microorganisms, destroying the cell wall, penetrate into the cell.

The incubation period for men and women is at least fourteen days.

In some cases, the incubation period with ureaplasma, parvum increases to several years. Therefore, if one of the partners has a pathogen, then the other also has it.

Preventive and preventive treatment of the pathological process will help to quickly deal with the infection even at the stage of the development of the disease. In most cases, there are no signs of the disease. Or patients feel mild discomfort during urination and the presence of weak vaginal discharge. Moreover, such symptomatology does not last long and soon disappears.

The disease becomes chronic. With a decrease in body resistance, an exacerbation of the disease occurs. And pronounced symptoms of the inflammatory nature of the genitourinary system appear. Such manifestations may be:

In the presence of a concomitant infection, for example, chlamydial, mycoplasma, etc., the symptoms will be more pronounced. If the patient is a carrier of ureaplasma, then the following factors can trigger the development of infection:

the presence of other genital infections;
a shift in hormonal status associated with the menstrual cycle;
decreased immune defense of the body;
during pregnancy;
in the postpartum period.

Treatment of ureaplasmosis

The causes of ureaplasmosis in women can be very diverse. But regardless of them, treatment should be carried out immediately. To warn possible complications diseases, therapy should be carried out without fail:

if patients present complaints that are symptoms of ureaplasmosis;
in the presence of a high concentration of infection in the test material during inoculation or by PCR;
at the stage of pregnancy planning;
in the presence of a burdened obstetric history;
with infertility.

What to treat?

A feature of the treatment of the disease is an integrated approach to the prescription of medications.

At the end of the course of therapy, control tests are prescribed.

The effectiveness of the treatment is as follows:

lack of complaints and symptoms;
negative results of PCR and bacteriosis;
restoration of vaginal flora.

It often happens that the symptoms of the disease pass spontaneously without treatment. True, in some people the disease never manifests itself, in others it gives relapses.

Possible causes of self-healing from ureaplasma are not yet fully understood and remain a mystery.

When a disease is detected, both sexual partners should be treated, otherwise it is impossible. The presence of infection in some cases is not a disease. So the decision about the need for therapy should be made by the attending physician.

Found ureaplasma: what is the danger of infection

Even if the infection does not manifest itself in women, it still carries a certain danger to her health:

When a woman is affected by ureaplasma, urealitikum and parvum may develop negative consequences, the causes of which are caused by:

decreased immune responses;
the duration of the pathogen in the urogenital tract;
physiological instability of protective reactions during pregnancy.

Is it necessary to treat if ureaplasma is found

With damage to the genitourinary system, the risk of developing an ectopic pregnancy and infertility increases. The causes are associated with inflammatory changes in the structure and the formation of adhesions in fallopian tubes, which contributes to the violation of their patency and prevents the penetration of the egg into the uterine cavity.
In the postpartum period, pathology can be complicated by endometritis. With lesion by ureaplasma parvum, chorionamnionitis can serve as the cause of the pathology.
If the infection spreads in an ascending way, it can provoke the development of urolithiasis.
If ureaplasma is adjacent to a mycoplasma infection, then the development of acute hemorrhagic cystitis is possible, leading to damage to the overlying sections of the urogenital system.

What to do during pregnancy?

At the stage of pregnancy planning, a woman needs to go through. This should be done because:

The presence of even a normal ratio of microorganisms during pregnancy can provoke their reproduction and cause ureaplasmosis.
The use of antibiotics in the early stages of pregnancy is highly undesirable.

What should a woman do if she has a ureaplasma infection during pregnancy? Most likely, the doctor will postpone treatment until the baby is born. In extreme cases, appoint an appointment with immunostimulants.

Ureaplasma in the body of pregnant women is a high risk. And not only for bearing the fetus, but also possible consequences for the health of the newborn. At the same time, very strong antibacterial drugs are used to treat the disease. But pregnant women are prescribed drugs that do not give a teratogenic and toxic effect. This drug is josamycin.

How to prevent the possibility of complications during pregnancy and the postpartum period?

And also the infection of the baby at the time of birth?

After 22 weeks, antibiotic therapy is carried out with the simultaneous administration of immunostimulants.

If you suspect ureaplasma, contact competent venereologists.

In humans, only two species of this genus can cause the development of a pathological process: ureaplasma urealiticum and. The habitat of these microbes is the genitourinary sphere. In more rare cases, the microorganism is found in the tissue of the lungs and kidneys.

Ureaplasma urealyticum and ureaplasma parvum cause. This disease is more often diagnosed in women, since in men acute symptoms are usually absent. Ureaplasmosis refers to sexually transmitted diseases. In women, one pathogen is more often found, and in rare cases, two at once, which allows us to conclude that ureaplasma spp is present. Ureaplasma parvum has more pronounced pathogenic properties than ureaplasma urealyticum. Treatment of infection caused by ureaplasma parvum is more complex and lengthy, the risk of complications is very high.

Ureaplasma infection is currently widespread. Experts note a high degree of colonization of the urogenital organs ureaplasma urealiticum: in men - 25%, in women - up to 60%.

Ureaplasma urealyticum

Ureaplasma urealyticum got its name due to its ability to split urea. This is its main difference from those belonging to the same genus. The ability to urealysis is a trigger for the development of urate nephrolithiasis and urolithiasis.

U.urealyticum is a causative agent of genital infection. The disease is characterized by signs of prolonged inflammation with complications and sexual transmission of the pathogen. Ureaplasma urealyticum can cause asymptomatic carriage and realize its pathogenic properties only under certain conditions.

Factors that provoke inflammation of the urogenital tract:

Genital diseases
Decreased immune defense,
Genital infections
Inflammation of the prostate
Immunodeficiencies and violation of local protection factors,
Vaginal dysbiosis in women.

Ureaplasma urealyticum refers to T-mycoplasmas capable of forming small colonies. Microbes grow at a temperature of 37 ° C and an optimal pH of 6.5-7.0. Ureaplasmas are catalase-negative, inert to sugars, cause beta hemolysis of rabbit erythrocytes and guinea pig. A feature of ureaplasma is the need for urea and cholesterol. They break down uric acid to ammonia, grow well on dense, rich media, and practically do not grow on liquid media.

According to generally accepted medical standards in women, ureaplasma urealyticum is a conditionally pathogenic microorganism that manifests its pathogenic properties only under the influence of adverse factors. In association with other pathogenic or conditionally pathogenic microbes, ureaplasma can lead to the development of a number of pathologies requiring urgent treatment. In most cases, this microorganism is highly resistant to modern antibiotics and is difficult to treat.

Transmission routes

The spread of ureaplasma infection occurs as follows:

Ureaplasma urealyticum is a causative agent of genital infection. Infection occurs during unprotected intercourse with an infected person. The microorganism feels great on the surface of sperm and on the epithelium of the vagina.
In an ascending way, microbes penetrate into genitourinary system and the uterus. Vertical path transmission of infection occurs when the ureaplasma penetrates from the vagina and cervical canal into the ureter and kidneys.
Transmission of infection from mother to fetus occurs transplacentally. Intrauterine infection is possible through the gastrointestinal tract, skin covering, eyes and organs of the urinary system of the fetus.
During childbirth, during passage through the birth canal, a mechanical infection of the newborn occurs.
Organ transplant patients may be infected. This is the transplant route of infection.
In more rare cases, anal and oral contact.
The contact-household method accounts for less than 1%.

What causes ureaplasma urealyticum?

Among women

The microbe can cause in women the development of pelvic diseases, bacterial, cervical erosion, cervical insufficiency, infertility.

Ureaplasma infection in women often proceeds covertly. The pathology clinic is determined by the location of the pathological process. Women have mild mucous discharge, pain and burning sensation when urinating, aching and cramping abdominal pain, genital itching. Symptoms are usually mild and disappear quickly. Infection is activated with nervous strain, physical fatigue, weakening of the body's defenses.

An infected woman does not feel any effects of the microbe on the body. Usually she leads an active sex life, is not protected, plans the birth of a child. Complications in women develop extremely rarely. Weakened individuals with reduced general resistance develop the diseases described above that require antibiotic therapy.

In men

In men, ureaplasma urealiticum provokes development, cystitis, and dysfunction. The first symptoms appear a month after the moment of infection. Ureaplasma infection in men disrupts spermatogenesis and promotes kidney stone formation. With urethritis, the glans of the penis reddens, itching and burning in the urethra, pain intensifying during urination, transparent discharge. In advanced cases, the infection can spread to the prostate and kidneys.

Chronic ureaplasmosis in men proceeds without subjective symptoms. In the mornings or after a long urine retention, scanty, unclear discharge appears. The external opening of the urethra often sticks together, urine becomes cloudy, and a “urinary” odor appears. In men, carriage is practically not observed.

Diagnostic Methods

To determine the etiological significance of ureaplasma urealyticum in the development of the disease, it is necessary to establish the number of microbial cells in the excreted urogenital organs.

Usually, people who are preparing to become parents and are supervised by specialists at the family planning center are sent for analysis.
Pregnant women are examined for this infection.
Persons with a chronic pathology of the genital organs must be examined to determine the etiology of the pathological process.
All persons with a suspected sexually transmitted disease should be examined.

The main diagnostic methods for ureaplasma infection are:

Treatment

If there are appropriate symptoms and when the pathogen is released in an amount of more than 10 4 CFU / ml, the disease must be treated. Patients are shown antibiotic therapy.

During treatment, patients need to abandon sexual activity, do not drink alcohol, do not sunbathe in the sun and in the solarium, do not drink milk, soda and mineral water. The duration of treatment is 10-14 days. Both sexual partners should be treated.

In the absence of timely and adequate treatment, ureaplasmosis can lead to the development of formidable complications: prostatitis, salpingo-oophoritis, pyelonephritis. The cause of infertility in men is a violation of the sperm formation process. Ureaplasma urealyticum causes impaired sperm motility and their quantity, the appearance of pathologically altered forms. In women, infertility is caused by infection of the endometrium with ureaplasmas or infection of the ovum.

Prevention of ureaplasmosis

Preventive measures to prevent the development of ureaplasmosis and other sexually transmitted diseases:

The use of condoms.
Use after intercourse antiseptic solutions - “Miramistin”, “Chlorhexidine”, candles - “Polygenax”, “Hexicon”.
Strengthening immunity.
Genital hygiene.
Periodic screening for STIs.

Ureaplasma urealyticum is the causative agent of a typical sexually transmitted disease that requires treatment to avoid complications and the spread of sexual infection in society.