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

Microscopic examination of female urogenital tract microflora (three sites) evaluates Gram‑stained smears from the vagina, cervix, and urethra to characterize the local microbiota and inflammatory response. This test, also referred to as a urogenital smear, Gram stain, or bacterioscopic smear, supports diagnosis of bacterial vaginosis and helps identify trichomoniasis, gonorrhea, and candidiasis. It aids in the differential assessment of disorders involving the genital and lower urinary tracts and is used to monitor response to therapy for urogenital infections. The assay also has value in obstetric and reproductive care. It is used to assess vaginal health during pregnancy (commonly at initial prenatal visit and at 30 and 36 weeks) and in women preparing for pregnancy, and it contributes to the evaluation of infertility and recurrent pregnancy loss.

The female urogenital microbiota comprises roughly 40 microbial species. In reproductive‑age women, lactobacilli predominate, typically accounting for 95–98% of vaginal flora. Through production of hydrogen peroxide and lactic acid in a glycogen‑rich environment, lactobacilli maintain an acidic milieu (pH 3.8–4.5) that limits overgrowth of opportunists and suppresses pathogens. A smaller fraction (approximately 2–3%) consists of conditionally pathogenic organisms such as staphylococci, streptococci, corynebacteria, klebsiella, Escherichia coli, Gardnerella, and anaerobes including Bacteroides, Prevotella, micrococci, Mobiluncus, enterococci, peptococci, peptostreptococci, Veillonella, clostridia, eubacteria, Campylobacter, and fusobacteria; yeasts of the genus Candida may also be present in low numbers. Disruption of the lactobacillus‑dominated ecosystem can trigger dysbiosis and proliferation of opportunistic microbes. Contributing factors include immune suppression, stress, metabolic disorders, broad‑spectrum antibiotics, anti‑inflammatory, immunosuppressive, and hormonal therapies, as well as physiologic hormonal transitions (menarche, pregnancy, menopause, postpartum period, or after abortion) and lapses in personal hygiene. Without timely management, dysbiosis may be associated with inflammatory conditions of the external and internal genital organs (eg, endometritis, salpingitis, oophoritis), adverse pregnancy outcomes including miscarriage, and infertility. Smear microscopy from the vagina, cervix, and urethra provides a semiquantitative estimate of total microbial burden, describes flora composition, identifies specific pathogens of trichomoniasis and gonorrhea, assesses the vaginal epithelium, and gauges inflammation by leukocyte response. Gram staining facilitates rapid classification of organisms as gram‑positive or gram‑negative; in gynecologic smears, a predominance of gram‑positive rods reflects normal lactobacillary flora. This study serves as an initial assessment: definitive organism identification and antimicrobial susceptibility require culture with susceptibility testing. Routine smear microscopy does not detect viruses, Chlamydia, Mycoplasma, or Ureaplasma; these agents are evaluated by molecular or immunoassay methods (eg, PCR or immunoassay). Because flora composition varies over the menstrual cycle, strict adherence to collection instructions is recommended.