The study of scrapings by PCR mycoplasma. Ureaplasma and mycoplasma

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Mycoplasmosis and ureaplasmosis are diseases that do not have any specific symptoms that are unique to these infections. Therefore, laboratory research methods are decisive for making a diagnosis.

In order to reliably establish a diagnosis, urogenital mycoplasmosis" or " ureaplasmosis”, 2 prerequisites are necessary:

The presence of an inflammatory process of the urogenital system.
The presence of the causative agent of mycoplasma or ureplasma, proven by laboratory methods. In this case, other possible pathogens should be absent.

Who should be screened for chlamydia first?

Women and men suffering from infertility of unknown cause for more than 2 years.
Women with chronic inflammatory diseases of the genitourinary system of unknown etiology (especially when planning pregnancy).
Pregnant women who previously had spontaneous miscarriages, premature births, polyhydramnios, etc.
Pregnant women with an unfavorable course of this pregnancy.
Sick urolithiasis and pyelonephritis, because they are at high risk for mycoplasmosis.
Patients with prostatitis, long-term urethritis.
Before gynecological and urological operations.

Is it necessary to undergo an examination if there are no symptoms of the disease?
Required only in the above cases. At the same time, there is no need to conduct special examinations for myco- and ureaplasmosis during preparation or during pregnancy, if the woman is not worried about anything. The fact is that normally these bacteria are found in about 50% of women, therefore, even in the absence of complaints, they can be detected, but it is not worth treating the asymptomatic carriage of these microbes.
In all other cases, it is also not necessary to take tests for myco- and ureaplasmosis "just in case".

What are they researching?
To detect myco- and ureaplasmas, it is necessary to take the material. It can be a scraping containing cells of a diseased organ - the vagina, cervix, prostate secretion, scraping from the urethra, conjunctiva of the eye. Such material can also be blood, urine and semen in men.

What tests are prescribed for mycoplasmosis and ureaplasmosis?
With myco- and ureaplasmosis, the following tests are most appropriate:
1. Polymerase chain reaction (PCR) - determination of pathogen DNA.
2. Enzyme immunoassay (ELISA) - determination of antibodies to the pathogen.
3. Microbiological research (cultural method) - finding directly the pathogen itself.

1. Polymerase chain reaction (PCR).

The method is based on the detection of the genetic material of the pathogen in the test sample. Using PCR, a specific site or DNA fragment of myco- and ureaplasmas is detected in the test material, therefore, in comparison with other methods, it is impossible to confuse them with some other infection.
PCR allows you to detect the pathogen even in latent, chronic and asymptomatic forms of infection, when other research methods are not informative.
Using PCR, it is possible to detect myco- and ureaplasma even in the incubation period, when there are no clinical manifestations mycoplasmosis.
For PCR analysis, very little material is needed, and the results are ready in 1-2 days.
When diagnosing a primary infection, it is more informative to identify this infection in the places of initial localization, i.e. the material should be scrapings from the genital tract.
In the analysis of PCR, false positive results are possible. This can happen if the study was conducted earlier than a month after the course of antibiotic therapy. The fact is that when a DNA fragment of mycoplasmas is detected, it is impossible to assess whether it is a dead or viable microbial cell. In this case, the viability of mycoplasmas is assessed using a microbiological method. If the bacterium is not viable, then despite the presence of a DNA fragment, microbial cells will not grow in cell culture.
False-negative results are also possible if the process of sampling, transporting the material and conducting the analysis itself is violated.
To date, the accuracy of this method, if performed correctly, is the highest - up to 100%.

If the PCR test for mycoplasma is positive, and there are no symptoms of mycoplasmosis, other methods of research should be carried out.

2. Enzyme immunoassay (ELISA)- determination of antibodies to the pathogen.

ELISA is a method for indirect detection of bacteria, i.e. the pathogen is not directly detected, but specific antibodies (IgG, IgA, IgM) to it and the body's reaction to its introduction are determined.
ELISA allows you to determine at what stage the disease is - acute or chronic, and evaluate the effectiveness of the treatment.
Specific Ig A are produced during fresh infection, IgM indicate the presence of an active infection. The presence of only IgG without IgM indicates a past infection, which is currently absent or carrier. For more information on evaluating the results of the ELISA analysis, see the article "".
The accuracy of the ELISA is about 80%. This is due to the fact that antibodies to chlamydia can be present in healthy people due to a previous illness, as well as to be determined in respiratory and other types of mycoplasmal infections.

3. Microbiological examination (cultural method) with antibiotic susceptibility testing.

The essence of this method is that the studied material is sown on a special medium and grown. Then, the pathogen is identified by the nature of growth and other signs. The cultural method allows not only to identify viable myco- and ureaplasmas, but also to select the antibiotic to which they are sensitive.
Diagnosing mycoplasmosis is quite difficult, because. mycoplasmas can be a component of the natural microflora of the genitourinary organs in healthy individuals. The presence of myco- and ureaplasmas in the test results is not yet a disease. For accurate diagnosis, it is necessary to know the number of bacteria in the urinary organs.
Only the cultural method makes it possible to determine the amount of the pathogen in the test material, and therefore to distinguish the asymptomatic carriage of myco- and ureaplasmas from the corresponding diseases. To do this, the number of colonies grown on the medium is counted, which are called colony-forming units (CFU). This number indicates the number of live bacteria that can multiply to form colonies.
With asymptomatic healthy carriage of myco- or ureaplasmas, less than 104 CFU / ml is determined. In the presence of a disease, the number of colonies of mycoplasmas or ureaplasmas in the test material will be more than 104 CFU / ml.
The accuracy of detecting bacteria with this method reaches 95%.
For more information about the method, see the article "?".

So, all these 3 methods are quite accurate, but they are all complementary.
Why? To do this, you need to clearly understand the capabilities of each method.

Possibilities and limitations of laboratory tests.

ELISA: allows you to assess the state of immunity and the body's response to the pathogen, indirectly indicates the presence of myco- or ureaplasmas throughout the body, but does not indicate a specific affected organ. Allows you to evaluate the effectiveness of antibiotic therapy. But with a weak immune response, for example, in patients with immunodeficiencies, ELISA is not informative.
PCR: allows you to accurately determine the location of the pathogen, but this is not always available (for example, in the ovaries). Allows you to detect the pathogen even in latent, chronic and asymptomatic forms, as well as in the incubation period. It is characterized by the highest accuracy of pathogen identification. It does not allow evaluating the effectiveness of antibiotic therapy, distinguishing carriage from the disease, and assessing the viability of the pathogen.
Cultural method: allows you to identify viable bacteria, determine their number, evaluate the effectiveness of antibiotic therapy, distinguish carriage from the disease. Does not evaluate the body's reaction to the pathogen.

conclusions

There is no method that would detect mycoplasmas in 100% of cases. Therefore, laboratory diagnostics should include at least two methods.
If it is impossible to take material from the organ under study, ELISA is used.
To assess the effectiveness of treatment, a cultural method is used. If it is impossible to conduct it - ELISA.
To determine the stage of the disease - ELISA.
In patients with immunodeficiencies, ELISA is not informative; PCR and the cultural method are used.
You should not rely too much on the results of determining the sensitivity of mycoplasmas to antibiotics. After all, as you know, microorganisms behave differently in a test tube (in vitro) and in a living organism (in vivo).

Mycoplasmosis is a disease that, when developed, can cause serious complications in the body. Therefore, the appearance of the first symptoms of the disease should serve as a reason for conducting research on the presence of the pathogen in the body. To identify and promptly begin treatment of mycoplasma, tests should be carried out as early as possible. The causative agent of the disease is quite dangerous, especially during pregnancy, so it is necessary to consult a doctor if its signs are detected.

Features of the disease

The disease is caused by a microorganism belonging to the class Mycoplasma, which is located on the mucous membranes of the genital organs, and in some cases in the respiratory tract. A feature of this pathogen is that it can be asymptomatic in the human body for a long time, that is, without any manifestations.

The progression of the disease is usually noted after serious gynecological diseases in women, as well as with a significant decrease in the protective functions of the body. It is worth noting that mycoplasmosis often occurs against the background of such diseases of the reproductive system as trichomoniasis, gonorrhea and herpes.

Infection in the vast majority of cases occurs sexually, but penetration of the pathogen is also possible in a domestic way - through personal hygiene products. Therefore, for preventive purposes, you should strictly observe hygiene and use only your personal hygiene items. Also, infection can occur in utero - and this microorganism is extremely dangerous for the fetus.

The onset of the disease is usually accompanied by mild symptoms, which is why patients do not immediately pay attention to them. The development of mycoplasmosis and the aggravation of the manifestation of its signs occur several weeks after infection. The main symptoms of the disease include:

Among women transparent selection from the vagina (scanty or very abundant);
Discharge (clear) from the urethral canal in men;
Aching pain in the lower abdomen;
Discomfort when urinating (burning, itching);
Pain during intercourse.

In men, mycoplasmosis can also affect the prostate gland, in which case signs of prostatitis begin to appear.

Mycoplasma often causes respiratory and urogenital diseases, since this pathogen is one of the most aggressive among all intracellular organisms. That is why, at the slightest suspicion of this ailment, tests are urgently done that can confirm its presence.

Types of pathogens of mycoplasmosis

pathogenic disease-causing are microscopic organisms capable of causing infectious and inflammatory processes in the body of men, women and even children. Testing for mycoplasmosis can reveal different types mycoplasmas:

Pneumonia (Mycoplasma pneumoniae);
Hominis (Mycoplasma hominis);
Mycoplasma Genitalium (Mycoplasma genitalium);
Urealitikum (Ureaplasma urealyticum).

Of these microorganisms, only the first can cause respiratory diseases, while the rest are the cause of diseases of the genitourinary tract.

Indications for analysis

IN without fail Mycoplasmosis is diagnosed in the following cases:

When planning pregnancy (both spouses);
Before the IVF protocol;
Before surgery in the pelvic organs;
If there is a history of miscarriages, miscarriage;
If the causative agent of the disease is found in the sexual partner;
Infertility of unknown origin;
Frequent manifestations of candidiasis;
With inflammatory processes in the urethra or vagina for unknown reasons;
The appearance of symptoms of mycoplasmosis.

It is especially important to test for mycoplasma in women during pregnancy, as this infection can lead to miscarriage.

Since the symptoms of mycoplasmosis do not manifest themselves immediately, research will help to detect the disease in a timely manner in order to begin treatment.

What analyzes are carried out?

To detect mycoplasmosis, diagnostics is needed, which is carried out by several methods. Three types of studies are widely used today:

Bacteriological;
Polymerase chain reaction method;
Enzyme immunoassay (ELISA).

There are other methods, but they are much less effective, so experts have abandoned their use.

Bacteriological method

Otherwise, it is called cultural. This method is considered the most accurate study to detect the causative agent of mycoplasmosis in the body. It is carried out by growing microorganisms from the biological material of the patient in special environments in the laboratory.

"The seeding tank allows not only to detect mycoplasma, but also to find out the number of microorganisms in a milliliter of the biological material under study."

Another advantage of this analysis is the ability to check how microorganisms react to various antibiotics in order to find the optimal treatment for the disease.

Read also related

Mycoplasma in men - causes, signs and treatment

A significant disadvantage of such a study is its duration - sowing on mycoplasma can take up to two weeks to obtain a result. But the reliability of the obtained indicators will be very high. To detect these microoranisms in domestic medicine, they use special tests that can detect Mycoplasma hominis and ureaplasma. But not all types of the pathogen can be detected as a result of bacteriological research. Mycoplasma genitalium is not detected with bakposev, as it grows too slowly (it may take up to 5 months from the moment the smear is taken to obtain reliable results).

Biological material for research in men is obtained from the first portion of urine or by taking a smear from the urethra. Women donate morning urine, vaginal scrapings, or cervical swabs. If the presence of mycoplasma causing respiratory disease is suspected, sputum is collected for analysis.

The result will be most accurate if there are no foreign impurities in the smear or urine, so the biological material in men is collected no earlier than 3 hours after urination, and in women a couple of days before or after the end of menstruation. Also, an important condition for the reliability of the results is the absence of treatment with any kind of antibiotics in the last month before donating biological material.

Serological studies

Enzyme immunoassay is also a common way to determine the presence of mycoplasma in the body. Such a study is based on the detection of special antibodies in the blood - IgA.

Detection of antibodies to mycoplasma in the blood is possible almost immediately after infection. And after complete recovery, they are also present in the results of the ELISA, but their quantitative indicators in this case do not exceed the norm. It is recommended to analyze twice to accurately detect the disease, since it takes about 10 days to produce IgA immunoglobulins from the moment the pathogen enters the human body. An increase in the titer of IgM and IgG indicates the presence of an infectious process that requires treatment.

The presence of IgM in the results of a blood test indicates an acute course of infection, and the detection of IgG indicates that the body has previously met with this microorganism. If both titers are present, they speak of an exacerbation of the chronic process. So, when analyzing for mycoplasma hominis, IgG titers indicate that at the moment there is no acute course of the disease.

It is important that the results of the study are correctly deciphered according to the reference values (the norm and deviations from it). Negative results can indicate both the absence of mycoplasma in the blood, and a recent infection (less than 10 days), when antibodies have not yet developed (which is why it is necessary to take the test again). A doubtful result indicates a sluggish infection or a disease that has a chronic form. Positive numbers indicate the presence of a current infection at the moment. Upon receipt of a positive result, experts also recommend undergoing the PCR method or passing the seeding tank.

Blood sampling for analysis does not require special preparation from the patient. Blood is donated to morning time on an empty stomach, and the results of the study will be ready in about 1.5 hours.

But the effectiveness of such a study is somewhat reduced due to the peculiarity of the interaction of mycoplasmas with the human body. This pathogen can interact with a human cell, which helps them evade the immune response. Because of this, healthy patients may have IgA antibodies that indicate the presence of the disease, and those who have an infection sometimes do not respond to the presence of the microorganism in the blood. That is why this method is used less frequently than a smear for mycoplasma.

ELISA is usually used for infertility and recurrent miscarriage, some types of complications after childbirth, if the blood test for chlamydia, Trichomonas, gonococci and other negative. In such cases, the study is most revealing.

polymerase chain reaction method

This type of study is the most effective, as it allows you to detect mycoplasma DNA in a patient. The PCR method gives positive results much more often than other methods, allowing you to start treatment in a timely manner. An important feature This method is that it detects mycoplasma genitalia - this is the only way to detect the presence of such a microorganism.

And mycoplasmas are not absolute pathogens, and their detection in the analyzes does not require treatment, but not in the case of pregnancy planning. When planning, everything is very difficult: (Doctors themselves cannot agree on the need to treat these pathogens.

Therefore, the question of the need treatment of ureaplasma and mycoplasma should be discussed with a trustworthy personal physician.

Our personal opinion is that "treating analyzes" is still not correct. And you should not drink antibiotics, provided there are no complaints from the woman, with a normal smear on the flora and total absence clinical symptoms.

Ureaplasmas and mycoplasmas have no clinical significance in obstetrics and gynecology. These are the causative agents of nonspecific urethritis, more often in men. In 30% of cases or more - representatives of the normal microflora of the genital tract. Their detection by PCR is not an indication for their targeted treatment, even if there are symptoms of an inflammatory process - it is necessary to treat more frequent pathogens, and since they are chlamydia, and the drugs used against them and urea- and mycoplasmas are the same, then the question of the treatment of myco- and ureaplasmosis is removed. Even if we accept that they exist and matter, they are still treated with the same drugs, therefore it makes no sense to determine them.

Do I need to take a culture for mycoplasma and ureaplasma

Diagnosis of myco- and ureaplasmosis is not needed. There is no need to take tests for them - neither blood for antibodies, nor culture (especially since only in a few metropolitan laboratories they really do it, and determining sensitivity to antibiotics is technically unrealistic, in ordinary places they write the results of PCR as culture), nor PCR.

If, for some reason, an analysis is made, one should not pay attention to its results, it is not a criterion for either making a diagnosis, much less prescribing treatment.

Pregnancy planning and pregnancy itself is not an indication for PCR diagnostics in general, and even more so for PCR diagnostics of urea and mycoplasmas. Management in this case does not differ from that of non-pregnant women - complaints and a smear.

They do not treat tests, but complaints. If there are no complaints, and a normal smear on the flora shows a normal white blood cell count, no further examination and treatment is needed. If an additional examination is nevertheless done, and something is found in the PCR, this is not a criterion for prescribing treatment. In addition to the lack of clinical significance of urea- and mycoplasmas, it is necessary to remember the high frequency of false positive PCR results. To prescribe this analysis in the absence of complaints at all, and in the presence of complaints - before or instead of a smear - incompetence and a waste of money.

If there are complaints, and a smear made in a good laboratory is good, there are no indications for antibiotics, you need to look for other causes of complaints - dysbacteriosis, concomitant diseases, hormonal imbalance, allergies, papillomatosis.

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If there are complaints and signs of an inflammatory process in the genitourinary system, antibiotic therapy is prescribed - either based on the results of additional examinations (PCR and culture with sensitivity determination) - for various pathogens (chlamydia, gonococci, trichomonas, streptococci, E. coli, etc., etc.), but not on urea- and mycoplasmas, or "blindly" - against the main pathogens of such diseases (gonococci and chlamydia). An antichlamydial drug is mandatory, in any case, regardless of the test results, since this is the most common pathogen, and since it does not have resistance to antichlamydial antibiotics (seeding with the determination of the sensitivity of chlamydia is also a profanity). All myco- and ureaplasmas are sensitive to antichlamydial drugs (with the exception of a certain proportion of ureaplasmas resistant to doxycycline). Therefore, even if after some time they prove the pathogenicity and clinical role of these microorganisms, all the same, adequate treatment of inflammatory diseases without their definition eliminates them, along with chlamydia. So again - there is no point in defining them. Contrary to what they say now in many commercial centers, the treatment in this case does not depend on the results of the tests, there is only one scheme.

This scheme is very simple and inexpensive, a multi-component list of antibiotics on two sheets against a positive PCR for ureaplasma is incompetence and a waste of money. Doxycycline is an old drug, but the main causative agents of inflammatory diseases in gynecology have retained sensitivity to it. However, the duration of treatment is not shorter than 10 days. Equivalent in efficacy against the main pathogens is a single dose of 1 g of sumamed. For those who continue to be afraid of ureaplasmas, this is the drug of choice, since those ureaplasmas that are genetically insensitive to doxycycline are sensitive to sumamed. Scientific research proved the equivalence of a course of treatment with a single dose of 1 g. Fast, simple, cheap.

Malyarskaya M.M. gynecologist

Mycoplasmosis and ureaplasmosis

The question of the clinical significance of genital mycoplasmas is difficult to give an unambiguous answer, at least at this point in time. The fact is that studies of their etiological role in various pathological conditions of both the female and male urogenital systems began relatively recently.

If there is a clinic of cervicitis and / or urethritis in women or urethritis in men, then at the initial stage it is economically screening for genital mycoplasmas is not appropriate. Even if gonococci and chlamydia are not detected by available methods for these diseases, then they need to be treated in any case. It is recommended to prescribe an antigonococcal drug (ceftriaxone or ciprofloxacin once) in combination with an antichlamydia drug (azithromycin once or a 7-day course of other drugs). If treatment is ineffective, then a second examination by cultural methods for gonorrhea and chlamydia is necessary. If gonococci are detected - re-treatment after determining the sensitivity or if it is impossible to determine it - with a drug from another group. In chlamydia, no clinically significant resistance to specific drugs (tetracyclines, erythromycin, azithromycin) has yet been identified.

Antichlamydial drugs are also effective against genital mycoplasmas in the same doses.. Tetracyclines act on both myco- and ureaplasmas. However, it has recently been established that about 10% of ureaplasmas are resistant to tetracyclines, therefore, if the treatment of urethritis using doxycycline is ineffective, it is necessary to prescribe erythromycin or azithromycin or ofloxacin.

The species Ureaplasma urealyticum consists of 14 or more serovars, which are divided into 2 biovars. Previously they were called biovar 1 or parvo and biovar 1 or T960. Currently, these biovars are regarded as 2 different kind: U.parvum and U.urealyticum, respectively. They vary in prevalence. U.parvum occurs in 81-90%, U.urealyticum in 7-30% of women, and sometimes they are combined - 3-6% of cases. Species U.urealyticum, i.e. the former biovar 2 (T960) predominates in women with inflammatory diseases of the pelvic organs, complications of pregnancy, and is also more often resistant to tetracyclines. Determination of these biovars is carried out for research purposes and is neither necessary nor economically viable in routine clinical practice.

pregnant should be screened for gonorrhea, genital chlamydia, trichomoniasis, bacterial vaginosis and, if detected, receive antibiotic therapy. There are no grounds for purposeful examination of them for genital mycoplasmas and eradication of these microorganisms. Antibiotics should not be routinely given to prolong pregnancy if pregnancy is threatened, except for gonorrhea, trichomoniasis, or bacterial vaginosis.

S.V. Sekhin, Research Institute of Antimicrobial Chemotherapy

Ureaplasmas and mycoplasmas. Q&A/h2>

What are ureaplasmas and mycoplasmas?

Mycoplasma that causes pneumonia (Mycoplasma pneumoniae), which lives in the oropharynx and upper respiratory tract of a person
and three genital (sex) mycoplasmas found in the genitourinary system: Human mycoplasma (Mycoplasma hominis)
Ureaplasma (Ureaplasma species), which is divided into 2 subspecies (Ureaplasma urealyticum and Ureaplasma parvum)
Genital mycoplasma (Mycoplasma genitalium)

Recently, pathogenicity (harmfulness to the body) has been found in two more mycoplasmas found in humans. This

Enzymatic mycoplasma (Mycoplasma fermentans) found in the oropharynx
Penetrating mycoplasma (Mycoplasma penetrans), living in the human genitourinary system.

How common are mycoplasmas in humans?

Ureaplasma (Ureaplasma sp.) is detected in 40-80% of sexually active women who do not complain. In men, the frequency of detection of ureaplasmas is less and amounts to 15-20%. About 20% of newborns are infected with ureaplasmas.
Human mycoplasma (Mycoplasma hominis) is detected in 21-53% of sexually active women and 2-5% of men.
About 5% of children older than 3 months and 10% of adults who are not sexually active are infected with genital (sex) mycoplasmas

How can you get infected with mycoplasmas?

Genital mycoplasmas (M. hominis, M. genitalium, Ureaplasma sp., M.penetrans) can be infected in only three ways:

through sexual contact (including oral-genital contact)
when the infection is transmitted from mother to fetus through an infected placenta or during childbirth
in transplantation (transplantation) of organs

Respiratory mycoplasmas (M.pneumoniae, M.fermentans) are transmitted by airborne droplets. Genital mycoplasmas cannot be contracted when visiting swimming pools, toilets and through bed linen.

What diseases can be caused by mycoplasmas?

Mycoplasmas are often found in healthy people. The reasons why mycoplasmas cause disease in some people infected with them are still completely unknown. Naturally, most often mycoplasmas cause disease in people with immunodeficiency caused by HIV infection and with hypogammaglobulinemia (decrease in the number of certain antibodies), but often mycoplasmas cause disease in people who do not have immunodeficiency and with normal levels of antibodies.

In women, mycoplasmas can cause the following diseases:

Cervicitis (inflammation of the cervix) in women is caused by genital mycoplasma (Mycoplasma genitalium)
Vaginitis (inflammation of the vagina) - there is no proven evidence that genital mycoplasmas cause vaginitis, but ureaplasma and M. hominis are often found in women with bacterial vaginosis
Pelvic inflammatory disease (PID) in women - M. hominis was detected in 10% of women with salpingitis, there is also evidence of a possible role in the development of PID Ureaplasma sp. and M. genitalium
Postpartum and post-abortion fever - approximately 10% of sick women are determined by M. hominis and (or) Ureaplasma sp.
Pyelonephritis - in 5% of women with pyelonephritis, the cause of the disease is M.hominis
Acute urethral syndrome (frequent and uncontrollable urination) in women is often associated with Ureaplasma sp.

In pregnant women, mycoplasmas can lead to the following consequences: infection of the placenta is possible, which leads to premature termination of pregnancy, preterm birth and the birth of newborns with low birth weight.

In both sexes, mycoplasmosis can lead to sexually related reactive arthritis (joint damage) caused by M. fermentans, M. hominis, and Ureaplasma sp.

There is evidence of a possible causal role for M. hominis and Ureaplasma sp. in the development of subcutaneous abscesses and osteomyelitis.
Some studies show a link between ureaplasma infection and the development of urolithiasis.

Mycoplasma in newborns

Of particular danger are diseases caused by mycoplasmas in newborns. Infection of the newborn occurs either with intrauterine infection during pregnancy or during childbirth.

The following are associated with genital mycoplasmas in newborns:

Acute pneumonia (inflammation of the lungs) of newborns
chronic lung disease
Bronchopulmonary dysplasia (underdevelopment)
Bacteremia and sepsis (blood poisoning)
(inflammation of the meninges)

How are diseases associated with genital mycoplasmas diagnosed?

In the presence of a disease that can be caused by genital mycoplasmas, a cultural study (bacteriological seeding for mycoplasma) and a PCR study are performed.
Determining the presence and amount of antibodies in the blood is not used for diagnosis.

How are diseases associated with genital mycoplasmas treated?

Various antibiotics are used to treat diseases associated with mycoplasmas. The most commonly used tetracyclines (doxycycline), macrolides (erythromycin, clarithromycin), azalides (azithromycin), fluoroquinolones (ofloxacin, levofloxacin, moxifloxacin). It should be borne in mind that different types of mycoplasmas have different susceptibility to different groups of antibiotics.
The effectiveness of the use of drugs that affect the immune system, enzymes, vitamins, local and physiotherapeutic treatment in the treatment of diseases caused by mycoplasmas has not been proven and is not used in the developed countries of the world.

How can you protect yourself from infection with genital mycoplasmas?

If you are not infected with mycoplasmas, then you need to take certain measures to prevent infection. Most effective method protection is the use of a condom.

Ureaplasma (mycoplasma) was revealed in me by PCR, but I have no signs of the disease. Do I need treatment for ureaplasma (mycoplasma) before conception?

If your sexual partner has no signs of a disease caused by mycoplasmas and (or) you are not going to change him and (or) are not planning a pregnancy in the near future, then no treatment is prescribed.

I am pregnant and I have ureaplasma (mycoplasmas). Do I need to treat ureaplasma during pregnancy?

Numerous studies have shown that intrauterine infection and placental damage can occur during pregnancy, which can lead to premature birth and the birth of low-weight newborns, as well as their infection and the development of bronchopulmonary diseases and other complications in them. Therefore, many doctors prescribe treatment in these cases.

I have been diagnosed with a disease associated with ureaplasma (mycoplasmas), and my sexual partner has no signs of the disease and the pathogen identified in me is not determined. Does my partner need to be treated for ureaplasma?

No no need. Some doctors in such cases recommend a re-examination of sexual partners after a certain period of time (from 2 weeks to a month). During this period, sexual intercourse is prohibited.

I underwent a course of treatment for a disease associated with ureaplasma (mycoplasmas) and the pathogen was not detected at control examinations. However, after some time, I again had symptoms of the disease and the pathogen was detected. How can this be if during this period I did not have any sexual contacts?

Most often, the repeated detection of ureaplasma is due to the fact that there was no complete eradication (disappearance) of the pathogen and its number after treatment decreased to a minimum, which modern diagnostic methods cannot determine. After a certain amount of time, the pathogen multiplied, which was manifested by a relapse of the disease.

I passed a quantitative analysis for ureaplasma (mycoplasmas) and they were found in me in an amount (titer) of less than 10x3. My doctor says that I do not need to be treated, since the treatment is prescribed at a higher titer - more than 10x3? Is it true?

The need for treatment is determined not by the amount (titer) of the detected microorganism, but by the presence or absence of the disease caused by it. If you have signs of illness, you should receive treatment. Treatment is also recommended, regardless of the titers detected in the quantitative analysis and the presence of signs of the disease in you, in the following cases: if your sexual partner has signs of a disease caused by ureaplasma (mycoplasmas) and (or) you are going to change your sexual partner and (or) you plan to pregnancy soon.

The article used materials from the reviews

Ken B Waites, MD, Director of Clinical Microbiology, Professor, Department of Pathology, Division of Laboratory Medicine, University of Alabama at Birmingham

DNA of Mycoplasma hominis, in scraping by PCR qualitative analysis

Mycoplasma hominis is one of the types of mycoplasmas, special microorganisms that occupy an intermediate stage between protozoa, viruses and bacteria. It is opportunistic pathogen...

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Study Description

Preparation for the study:

Scraping from the urethra. Before taking the patient, it is recommended not to urinate for 1.5-2 hours. Before taking the material from the cervical canal, it is necessary to remove the mucus with a cotton swab.

Material under study: scraping

Mycoplasma hominis DNA

Method

PCR method- polymerase chain reaction, which makes it possible to identify the presence of the desired section of genetic material in the biological material.
- its varieties, advantages and scope in medical diagnostics.

Reference values - norm
(Mycoplasma hominis (mycoplasmosis), DNA (PCR), qualitative, scraping)

Information regarding the reference values of the indicators, as well as the very composition of the indicators included in the analysis, may differ slightly depending on the laboratory!

Norm:

The study is qualitative, the result is defined as “positive” / “detected” or “negative” / “not found”

Indications

Suspicion of mycoplasma infection, especially with frequent change of sexual partners.
Indolent inflammatory diseases of the genitourinary system (especially in the absence of chlamydia, gonococci, Trichomonas, M. genitalium).
Diseases respiratory system unexplained etiology.
Pregnancy planning (examination must be completed by both spouses).
Miscarriage, infertility.
1 month after the end of antibiotic therapy to monitor its effectiveness.

Increasing values (positive result)

Result "positive"/"detected":

The detection of M. hominis DNA in combination with symptoms of inflammation and the absence of other pathogenic pathogens (chlamydia, gonococci, Trichomonas, M. genitalium) indicates the presence of mycoplasma infection.
Detection of M. hominis DNA in a small amount without signs of pathology of the genitourinary system indicates carriage, or mycoplasma positivity.

Decreasing values (negative result)

Result "negative"/"not found":

M. hominis infection is unlikely.