Бак посев отделяемого из вагинального канала на инфекции урогенитального тракта (UROGEN WELL D‐ONE)

Microscopic examination of female urogenital specimens (microflora), 3 sites—vaginal, cervical, and urethral smears prepared for Gram stain—assesses the composition and relative abundance of the vaginal and endocervical microbiota. The test supports diagnosis of bacterial vaginosis and helps identify select sexually transmitted infections detectable by microscopy, including candidiasis, trichomoniasis, and gonorrhea. It also aids in the differential evaluation of disorders involving the genital or lower urinary tract and in monitoring therapeutic response in urogenital infections. In obstetric care, smear microscopy is incorporated into prenatal screening—typically at the initial visit and again at 30 and 36 weeks—and may be used in preconception assessments. Findings can contribute to investigation of infertility and recurrent pregnancy loss.

The healthy female urogenital tract harbors a diverse community of roughly 40 microbial species. In reproductive-age individuals, lactobacilli predominate and typically account for 95–98% of the vaginal flora. Through production of hydrogen peroxide and lactic acid in a glycogen-rich environment, lactobacilli maintain an acidic pH of 3.8–4.5 that restrains overgrowth of opportunists and suppresses pathogens. The remaining 2–3% often comprises conditionally pathogenic organisms—staphylococci, streptococci, corynebacteria, Klebsiella, Escherichia coli, Gardnerella, and anaerobes such as Bacteroides, Prevotella, Micrococcus, Mobiluncus, enterococci, peptococci, peptostreptococci, Veillonella, Clostridium, Eubacterium, Campylobacter, and Fusobacterium—with occasional small numbers of yeasts of the genus Candida. Disruption of this balance can follow immune compromise, stress, metabolic disorders, broad-spectrum antibiotic exposure, anti-inflammatory, immunosuppressive, or hormonal therapies, and physiologic hormonal shifts at menarche, during pregnancy, at menopause, and in the postpartum or postabortion period. Poor hygiene may further contribute. Diminished lactobacillus dominance promotes dysbiosis and proliferation of opportunistic organisms, which, without timely management, may be associated with inflammatory conditions of the external and internal genital organs (e.g., endometritis, salpingitis, oophoritis), complicated pregnancy courses, miscarriage, and infertility. Smear microscopy provides a semiquantitative view of the total microbial burden at three sites (vagina, cervix, urethra), characterizes community composition, and can reveal specific pathogens detectable by microscopy such as Trichomonas vaginalis and Neisseria gonorrhoeae. It also allows assessment of vaginal epithelial status and the intensity of inflammation based on leukocyte counts. Slides are Gram stained to rapidly classify organisms as gram positive or gram negative; a normal gynecologic smear is dominated by gram-positive rods consistent with lactobacillus morphotypes. This bacterioscopic approach is a preliminary screen: definitive organism identification and antimicrobial susceptibility require culture with susceptibility testing. Conventional urogenital smears do not detect viruses, Chlamydia, Mycoplasma, or Ureaplasma; polymerase chain reaction or immunoassays are used for those pathogens. Because microbiota vary across the menstrual cycle, adherence to standardized collection procedures is essential for reliable interpretation.