The danger posed by representatives of opportunistic flora

Smear for flora and cytology- This is a microscopic laboratory study that allows you to determine the nature of the microflora of the urethra (urethra) in men and the vagina, as well as the cervix in women.

The presence of leukocytes in the blood may indicate an inflammatory process in the organs and systems of the urogenital tract, and, in most cases, this is exactly the case. This applies equally to both men and women. A smear helps to determine the presence of leukocytes, however, young guys rarely turn to a diagnostic center for such a simple analysis. In addition, during hospitalization, men are also not taken a smear, since this analysis is not included in the number of mandatory tests when admitted to a hospital. In women, the situation is the opposite: a smear for flora and cytology is always taken during the initial diagnosis, and women themselves regularly take such an analysis for preventive purposes.

Norm and pathology for men and women

If we talk about men, then the norm for them is the presence of single leukocytes, transitional epithelium in the smear and the presence of single rods. This is what the study picture looks like for a healthy man. If the number of leukocytes is increased, then you can immediately see the presence of gonococci, yeast-type fungi, etc., since usually an abundance of leukocytes is accompanied by the presence of infectious bacteria. In this case, the man is prescribed treatment, and then a re-analysis is taken to compare the situation.

If we talk about women, then an increased level of leukocytes may be the norm, for example, if menstruation is about to begin. At any other period of the cycle for women, no more than 30 cells in the field of view will be considered the norm. The mere presence of cells is not a reliable result. It is also necessary to evaluate their morphological state. "Quiet" cells without destruction, which have preserved nuclei and no signs of phagocytosis, already indicate the reliability of the testimony. In order not to draw a false conclusion during the analysis, it is necessary, among other things, to select the material correctly. For example, an almost completely invisible “thick brushstroke”. An invisible and thick material is formed due to the accumulation of layered cells on top of each other, including leukocytes. In these cases, it is necessary to prescribe a repeated analysis of the microflora in order to level the risk of an erroneous diagnosis.

Flora and cytology: distinctive features

The objects of laboratory research are different organs depending on the gender of the person. So, a smear is taken from the male urethra, while there are many female analytical objects ( vagina and cervical canal, cervix and urethra). Sometimes, of course, it is necessary to take an aspirate from the uterine cavity, but this will already be a biopsy material and it is analyzed by a cytologist, who makes a conclusion.

If the examination is carried out for preventive purposes, then aspirates are not taken. Such an analysis can be taken into account only if it is necessary to check the subject for the presence of conditions of a precancerous and cancerous nature that affect the functionality of the reproductive organ. Moreover, when the aspirate is filled with formalin and then applied to slides and stained, a histological preparation is obtained, and it is considered as the last resort in diagnosing malignant formations.

Smear for cytology and flora

When a smear with immersion is taken to analyze the flora, experts have the opportunity to accurately see the number of cells, clearly see diplococci, yeast cells, gardnerella and other microorganisms of the biocenosis of the female genital organs. However, such a smear does not make it possible to determine the deviations of the epithelium in morphological terms. Pathological changes in the very structure of the cell or its nucleus can only be seen by an experienced and knowledgeable doctor.

But let the decoding of the analyzes remain the prerogative of specialists, but we will only get acquainted with the basic provisions so as not to panic if a similar problem is suddenly discovered.

Research on cytology

The possibilities of analysis for cytology are much wider than the analysis of flora. When processing the material, the doctor pays the most attention to the epithelium, the state of its cells.. The sole purpose of such close attention is to compare and detect the inflammatory nature of the pathology, dysplasia and neoplasm, of a potentially substandard type. In parallel with the main task of the study, the specialist also notes the flora.

Often, a vaginal portion of the cervix MPE (stratified squamous epithelium) and the cervical canal are provided for analysis. If a smear for cytological examination from the cervical canal was taken correctly, then it is considered normal when cylindrical epithelium is clearly visible in the preparation, single leukocytes are found and there is a “poor” microflora, with a high probability accidentally introduced, for example, from the vagina.

It is clear that the substance for cytology gives a more informative picture (staining by the Romanovsky, Papanicolaou or Pappenheim method). First, the cells are studied at low magnification in order to evaluate the preparation itself, and then with immersion, in order to see not so much the epithelium itself as its nucleus and whether there are pathological changes in it characteristic of diseases of one kind or another.

In short, a specialist cytologist can see, in addition to the flora, the causes of changes provoked by inflammation, landmarks of infections that are difficult to diagnose, precancerous and cancerous conditions.

Signs of the indirect nature of STIs in cytological analysis

A smear for STIs is extremely important to study in the same way as cytology. The most inexpensive and affordable analysis for flora in all medical institutions - This is a smear stained with methylene blue.. That is why this analysis is the most widely used in gynecology. Nonetheless, such a study for the presence of signs of STDs does not give a complete picture.

If yeast, trichomonas, leptothrix and others are visible in the presence of a violation of the biocenosis in a smear or in the presence of an infection, then even indirect signs of the presence of microorganisms are visible in cytology, which is practically impossible to detect in a microscopic analysis.

Some examples:

that there is a herpes infection (HSV) is evidenced by visible multinucleated cells of a very large size and strange shape, with signs of roughness and / or parakeratosis;
cells with coarse-grained cytoplasm (the so-called "owl's eye") indicate the possible presence of cytomegalovirus;
about HPV infection (papillomavirus), koilocytic atypia is visible (MPE cells have large nuclei with gaps);
if Provachek bodies are seen in the MPE cells, this may indicate chlamydia.

Of course, it is not possible to diagnose herpes, papillomavirus or a cytological smear, but it is possible to identify suspicions with the help of indirect signs. This automatically provides grounds for a more in-depth study and helps to narrow the circle and save time in making a diagnosis.

Preparation for correct analysis of flora and cytology

A smear for the study of flora is the fastest and most affordable way to determine an infectious disease and inflammatory processes for both sexes. In this regard, it makes sense to understand the terms in more detail in order to understand the entries in the form. But first, we will talk about some rules that are mandatory for correct analysis:

a few days before the study, do not have sexual intercourse, and also exclude douching, vaginal suppositories and other local interventions;
the analysis cannot be carried out during menstruation, since the blood will not allow sufficient viewing of the material;
calculate the fluid intake on the day of the analysis so that the last time you go to the toilet to urinate is 3 hours before the analysis;
do not take any drugs (pills, injections, etc.) 10 days before the study;
do not use hygiene products on the day of analysis. It is advisable to use only warm boiled water for women in the morning on the day of analysis, and for men in the evening on the eve of the study.

By carefully considering all the above rules and passing the analysis, you can be sure that the smear will be correct and the color will show the full picture. Having received the opinion of a specialist, you can already delve into its meaning.

What does a male urethral smear show?

Men should be prepared for the fact that the collection of the analysis itself is not a pleasant procedure and may be accompanied by uncomfortable sensations even after a couple of hours after it. To make it easier to postpone the test, the doctor may prescribe a prostate massage even before the test for 3-4 days.

After the analysis, you need to carefully monitor your condition and if burning or discomfort continues the next day after sampling, as well as in the event of a purulent discharge, you should immediately consult a doctor.

In the smear itself from the male urethra, if the subject is healthy, everything is much simpler than in women. And let this moment calm the men who have undergone such an unpleasant procedure a little. Below are characteristics of a normal urethral swab for males:

leukocytes– up to five cells in the field of view;
Flora- the presence of single sticks;
urethral epithelium- diluted with a general background of a transitional nature, from five to ten cells in the review;
slime in small quantities;
conditionally pathogenic flora in a smear- single microorganisms (staphylococci, streptococci, etc.). If there is a need to differentiate the flora, a Gram smear is used.

If there is an inflammatory process, the smear changes its picture:

leukocytes- a rich picture;
rod flora replaced by cocci or cocco-bacillary flora;
the presence of microbes(yeast, Trichomonas, etc.);
for correct diagnosis and accurate determination of the type of pathogen, an additional study is carried out with a culture or (under a microscope it is practically impossible to detect chlamydia, myco- and ureaplasma, and also to distinguish diplococci that cause gonorrhea from enterococci, streptococci);
rarely, in a smear from the urethra of men, it is possible to notice E. coli. This indicates a complete lack of hygiene. E. coli, which is useful in the intestines, can cause cystitis, prostatitis, urethritis and other diseases if it enters the male urethra. To distinguish E. coli, more research is also needed.

According to the picture of female strokes, the same measures are taken. It must be said that the presence of E. coli, enterococci, staphylococci, streptococci and other microorganisms in female smears is diagnosed much more often than in male smears. The reason for this statistics was the structural features of the female reproductive system.

Urogenital tract in women. Ecosystem Features

Leukocytes are by no means the only cells in a woman's smear, taken both for flora and for cytology. Moreover, they only reflect the body's response to changes in the ecosystem of a woman's urogenital tract, such as changes in hormonal levels, various types of inflammation. As you know, from the phase of the cycle, their number increases and therefore always indicate the day of the beginning of the last menstruation when taking.

Inflammations are diagnosed not only by a quantitative indicator of leukocytes, but also by a close study of their nuclei.. Having entered into a reaction, the leukocytes try to absorb the "harmful creature", but destroy themselves. Neutrophilic (destroyed) leukocytes are not indicated in transcripts of studies. But the presence of many destroyed leukocytes, together with a rich coccal or cocco-bacillary flora, provides grounds for diagnosing inflammation.

The anatomy and ecosystem of the female body (the epithelium of the vagina, cervical canal, cervix) suggests the presence of microorganisms: obligate or obligatory and acquired from the outside. The latter are the cause of inflammatory processes. Also, disorders and inflammation can be provoked by other external or internal factors. This contributes to the displacement of natural microorganisms by external microbes. A good example of this phenomenon is the dominance of gardnerella, which displaced lactobacilli, and the result of this process is the widespread gardnerellosis or bacterial vaginosis.

What does a normal gynecological smear look like?

Despite all the abundance of microorganisms that live in the female flora, the norm indicators for them are certainly determined. We will try to acquaint the reader with the main indicators:

leukocytes. For the norm in the field of view when viewed, the quantitative indicators 10 for the urethra and 30 for the cervix. If the quantitative indicators exceed the specified values, the presence of inflammation can be suspected;
epithelium. For this criterion, the indicators of the norm also differ depending on where the material for the study is taken from. For the vagina, urethra and cervix, the epithelium is normally characterized by MPE obtained in the preparation. The material from the cervical canal is a cylindrical epithelium. At the same time, in different phases of the female cycle, the number of cells varies (the average normal indicator is up to 10 cells). These indicators are still very conditional, since everything needs to be considered in context - the morphology of cell nuclei is of great importance in this sense (shows a smear for cytology);
slime. For the norm this component must be present(this is the work of the cervical canal and vagina), but in small quantities. If the material is taken during the ovulatory phase, the mucus has a crystallized structure resembling a patterned leaf pattern. In cytology, this is called the "fern symptom";
rod flora. The presence of single cocci and lactobacilli indicates the norm, their quantitative increase indicates pathology.

Norm and pathology in conditionally pathogenic flora

lactobacilli, which are normally always present in a small amount, perform a "sanitary" function, cleansing the vagina. But a smear can also show the presence of other microorganisms.

Gardanella. As a rule, gardanella does not manifest itself for the norm, and when the pH changes, it quickly becomes active. Almost always, after the manifestation of the activity of the gardanella, the activity of the mobiluncus begins. In this case, changes in the flora occur, and the smear shows a significant increase in cocci. Such coccobacillus flora is called "bacterial sand" because it covers the epithelium. Such a diagnostic picture may indicate the presence of bacterial vaginosis.

Mushrooms Candida yeast-like origin can be seen in a smear, since the normal flora also contains them, but does not allow them to develop and multiply. As soon as the situation becomes favorable for the fungi, Candida will quickly begin to multiply, and for a woman this will not go unnoticed. Itching, inflammation will appear immediately.

Leptothrix- association of multiple types of microorganisms acting as a united front. This community has a certain “smartness”: they can mimic the chains of mycelial filaments or resemble lactobacilli. Therefore, culture is necessary to differentiate the leptothrix.

Actinomycetes - bacteria that resemble cubes and blots in the preparation almost never cause inflammatory reactions, with the exception of cases when a woman uses an intrauterine contraceptive.

Other opportunistic forms. Enterococcus (Enterococcus faicalis), E. coli (Escherichia coli) may also be present in the smear. The reason for this is the anatomy of the female body - the genitourinary system is located close to the lower gastrointestinal tract.

Also, the group of other conditionally pathogenic forms, which can normally be present in small quantities in the female genital tract, includes corynebacteria, staphylococci, mycoplasmas, streptococci and ureaplasmas. In order to differentiate these forms, they turn to other research methods, since they cannot always be well identified in a flora smear.

The listed representatives of the female microflora can be present in a healthy body and do not manifest themselves in any way until a certain point. When the situation for microorganisms becomes favorable, inflammatory processes occur. It must be said that even lactobacilli can become a source of inflammation - an extremely unpleasant disease, lactobacilli occurs in the case of an excess of lactobacilli with a simultaneous rich bacterial flora.

pathogenic microorganisms

With unprotected sexual intercourse, the risk of getting and making yourself a lot of trouble is very high. Inflammatory processes of a local nature can quickly migrate to other tissues, organs and systems of the body, and if ignored for a long time, they can flow into chronic forms of difficult-to-treat diseases.

The presence of pathogenic microorganisms during pregnancy is extremely dangerous, since pathogens often affect the fetus. A smear during pregnancy is a regular and mandatory procedure, and in case of poor results, it is necessary to start treatment without delay.

Microorganisms affecting reproductive function:

A standard smear for the study of flora, if analyzed with a different approach, can become a study on the degree of purity of the vagina. Doctors distinguish four degrees of purity.

Purity grade I. Occurs very rarely. In a clean smear, only rod flora, the optimal amount of squamous epithelium and single leukocytes are present.
Purity II. Flora as in a smear of the first degree of purity, in which single cocci and other non-pathogenic organisms are found. Among healthy women, this is the most common diagnostic result.
Purity grade III. There are already yeasts in the flora with a tendency of activity and reproduction. Such a result may indicate the initial stage of inflammation and other studies are prescribed for a correct search.
Purity grade IV. It characterizes the presence of obvious inflammation and the rich coccal or bacillary-coccal flora accompanying this process. After such results, they begin to search in order to prescribe the correct and effective treatment.

A smear on flora is a simple but indicative method of laboratory research with a quick result and great possibilities.

Conditionally pathogenic flora

Opportunistic pathogens are widely distributed in the environment. Many of them live in the intestines of healthy people as saprophytes, and are also natural inhabitants of the intestines of many animals. When the conditions of their existence change, these microorganisms become pathogenic and can cause a disease in humans - acute intestinal infection or food poisoning. This is also facilitated by the state of the macroorganism (reduced resistance, the presence of concomitant diseases, etc.).

Conditionally pathogenic organisms include: Proteus vulgaris, enterotoxic strains of staphylococcus aureus (St. aureus et albus), streptococcus (group A beta-hemolytic streptococci), spore anaerobes Clostridium perfringens and difficile, as well as the bacterium cereus, enterococci, Klebsiella, citrobacteria, Pseudomonas aeruginosa wand etc.

To date, there is a large amount of information about the role of opportunistic microflora and the exotoxins produced by it in the development of food poisoning.

These data allow us to consider that, unlike other infectious diseases, a prerequisite for its occurrence is not only the presence of microbial cells in food products, but also the accumulation in them of a sufficient dose of exotoxins produced by bacteria. Among the latter, enterotoxins (thermolabile and thermostable) are distinguished, which enhance the secretion of liquids and salts into the lumen of the stomach and intestines, and cytotoxin, which damages the membranes of epithelial cells and disrupts protein-synthetic processes in them.

The most common pathogens that produce enterotoxins are Clostridia perfringens, Proteus vulgaris, Cereus bacterium, Klebsiella, Enterobacteria, Citrobacteria, etc.

It should be noted that not every strain of the above bacteria is capable of producing exotoxins. Therefore, eating food containing a large number of microbes does not in itself lead to the development of the disease. It occurs only when food is infected with toxin-producing strains.

Opportunistic pathogens of food poisoning are widespread in nature and are found everywhere: in the feces of people and animals, in the water of open reservoirs (Proteus, Enterobacteria, Klebsiella), soil, air and on various objects.

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In the body there are many bacteria that are with a person in different relationships. Most of the microflora (microbiocenosis) are microorganisms that coexist with humans on the basis of symbiosis. In other words, the bulk of microbes benefit from humans (in the form of constant temperature and humidity, nutrients, UV protection, and so on). At the same time, these bacteria themselves benefit by synthesizing vitamins, breaking down proteins, competing with pathogens and surviving them from their territory. And at the same time with such beneficial bacteria, a person has “cohabitants”, which in small quantities do not cause significant harm, but under certain conditions become pathogenic. This group of microbes is called conditionally pathogenic microflora.

Opportunistic pathogens (OPM) of the gastrointestinal tract are fighting for their survival, so their generations develop resistance to competitive normal flora. Lacto - and bifidobacteria in the process of life produce substances similar to antibiotics in their action. In addition, the body itself, thanks to the immune system, inhibits the reproduction of pathogenic bacteria. Alcohol intake and smoking, not to mention drug addiction, nervous stress, physical overload, age-related changes, physiological imperfection of the lymphatic system (in young children), various diseases (primarily of viral origin) - all this disrupts the normal balance of microflora in the gastrointestinal tract. intestinal tract, leading to the death of beneficial microorganisms. Nature does not tolerate emptiness, and opportunistic pathogenic bacteria come to replace the dead beneficial bacteria. From this moment begins the development of dysbiosis and dysbacteriosis. If the former conditionally pathogenic, and now become pathogenic, bacteria leave their usual place of residence, penetrating through tissue barriers, then an opportunistic infection develops.

Composition of opportunistic microflora

The normoflora of each person is individual in its composition. The same applies to conditionally pathogenic microflora, as part of a normal biocenosis. Yes Yes! Despite their harmful activity, opportunistic microorganisms are needed by normal microflora. Bacteria live by the principle: "What doesn't kill us makes us stronger." That is, by constantly competing for space, our beneficial bacteria become more resilient., develop "skills" to combat UPM at the gene level. The same thing happens with the rest of the immune system. So, we can say that even opportunistic microbes are needed by our body as a kind of “trainer” of immunity.

Almost the entire Enterobacteriaceae family belongs to opportunistic pathogens of the gastrointestinal tract. This includes Klebsiella pneumonia, enterobacter (aerogenes and cloacea), citrobacter freundi, proteus. The maximum allowable norm for the family of enterobacteria in the gastrointestinal tract is an indicator of 1000 microbial units. From staphylococcus family non-hemolytic forms of staphylococcus live in the intestine on a permanent basis, the number of which can normally reach 10,000 microorganisms per 1 gcal. Hemolytic forms, that is, those that dissolve red blood cells, should not normally be in the intestine at all. From UPM, a very large number of bacteroids (fragilis, for example) can be found in the large intestine. These bacteria are involved in fat (lipid) metabolism. But their number should not go beyond 10 9 colony-forming units, that is, individual individuals, in 1 g of feces. Small amounts can also be found in the intestines. streptococci, which, in addition to antagonistic (hostile) properties, also carry a payload in our body - they stimulate the production of immunoglobulins, and also actively suppress pathogenic bacteria such as salmonella, shigella.

Among the representatives of the normoflora there are also microorganisms that can cause intestinal dysfunction. That is, in fact, these bacteria are classified as conditionally pathogenic, but nevertheless, their beneficial properties prevail over pathogenic ones. Such bacteria are enterococci fecalis and fecium.

Mushrooms of the genus Candida, which in large quantities inhabit the environment around us, naturally took root in the digestive tract. Here, up to 1000 CFU per 1 g of feces (colony-forming units) are allowed. Unfortunately, since these fungi are adapted not only to our internal, but also to the external environment, they have a great infecting potential, and, along with staphylococci, can cause significant harm to the child's body.

From representatives conditionally pathogenic microflora of the gastrointestinal tract, there are those that are very rare, but still can cause disease. These can include veillonella and fusobacteria. Their localization is mainly limited to the oral cavity. But when they enter the intestines, according to some scientists, they can cause all sorts of inflammation. Information about the role of these microbes in the occurrence of gastrointestinal diseases is very scattered and therefore doctors, in laboratory studies of the causes of dysbacteriosis, do not pay much attention to them.

Unlike veillonella and fusobacteria, helicobacter pylori pretty well studied. Much attention has been given to him lately due to the fact that he chose the stomach as his habitat. Gastritis, gastric ulcer of an infectious nature, is primarily associated with Helicobacter pylori. Treatment and bringing the concentration of this microbe back to normal is a rather complicated process. The main difficulty of therapy is the high resistance of Helicobacter to antimicrobial drugs. Still - after all, he lives in an environment with high acidity and all medicines pass through him. What defense mechanisms should a bacterium have in order not only to survive, but also to feel great in such conditions!

In order to contain the pathogenic properties of UPM, the body needs help. A person must understand that his health is in his own hands. No matter how wonderful antagonistic properties our Escherichia, bifidobacteria and lactobacilli have, they need our help, which consists in a reasonable approach to lifestyle, and first of all to nutrition.

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Study of the composition of microflora
1. The classical method of inoculation on nutrient media
The microflora that inhabits the human mucous membranes is divided strictly into pathogenic and conditionally pathogenic. Pathogenic microorganisms cause disease even in low concentrations; they should not be present at all in the body to any extent. Opportunistic or normal microflora normally inhabits the skin, various mucous membranes of a person and, with strong immunity, does not cause problems. Thousands of different types of microorganisms live in the human body with a total weight of up to 3 kg. They colonize our body in the first days after birth.
The norm of content of conditionally pathogenic microflora should not exceed 10^2/cm. sq.. mucosal, or 10 ^ 2 / gram of feces, or 10 ^ 2 / ml. urine or sputum. If the value is higher than 10^2, then this microorganism is considered pathogenic, it grows and causes inflammation. Accordingly, the higher the concentration of microbes, the worse. The standards of laboratories and the opinion of doctors may differ. In most cases, 10^4-10^5 degrees is the norm for them, but this is far from the case.
Why does normal microflora begin to grow? This may be a consequence of a viral infection, when the microbe joins the inflammation against the background of a decrease in immunity. But the main reason is the use of antibiotics. They reduce the number of neutrophils and their digestive capacity (phagocytosis), the content of immunoglobulin A, which protects the mucous membranes from the engraftment of microorganisms. Antibiotics themselves are a breeding ground for the growth of bacteria and fungi.
Where is the best place to plant? In order to correctly and successfully start treatment, it is necessary to do a seeding with the determination of the sensitivity of the pathogen to an antibiotic or antiseptic. It is impossible to be treated blindly with antibiotics, this is a senseless undertaking similar to suicide. Sowing on microflora is a very laborious and time-consuming task. To do this, you need to sow the discharge, for example, mucous on a nutrient medium, then transfer the microorganisms that have begun to grow to separate nutrient media specific to each type of bacteria. Identify the pathogen and calculate its concentration. Add antibiotics or antiseptics and see which ones stun the growth. In ordinary network laboratories such as Invitro, Hemotest, etc., no one will bother with crops manually. They use automatic computer analyzers and primitive nutrient media. And the result of the analysis actually depends on the nutrient medium for microbes, because most microorganisms will not grow on ordinary media.
For the delivery of crops, it is better to choose a research institute associated with microbiology, bacteriology, since in network laboratories the results are almost always negative, even with an obvious clinical picture and symptoms. Verified by more than one person. Personally, I didn’t have a living place in my mouth, everything was covered with a white coating, and in Invitro they gave me an empty piece of paper in my hands with the conclusion that no growth of microorganisms was detected. At the same time, a month before the delivery of the crop, I was in the clinic, where they found me candida and streptococcus viridans.
It is impossible to treat an infection with the same antiseptic for more than 14 days. Already on the first day, 5% of microorganisms will be insensitive to it, and after a week the number of resistant strains will increase to 30-60%.
The main disadvantage The classic bacteriological study is the inability to assess the role of non-culturable microorganisms in the infectious and inflammatory process, primarily anaerobes. At the same time, in most cases in clinical practice, one has to work with mixed aerobic-anaerobic microflora, which greatly complicates the diagnosis and requires a highly qualified specialist.
Representatives of normal microflora, which I usually find when sowing:
* Streptococcus viridans (green streptococcus) - normal inhabitants of the mouth, pharynx, nose.
* Staphylococcus saprophyticus (saprophytic staphylococcus) is the most peaceful of staphylococci, its main habitat is the wall of the bladder and the skin near the genitals, so it is easy to guess that it is the causative agent of cystitis, which women are more susceptible to.
*Staphylococcus epidermidis (epidermal staphylococcus) - lives in various areas of the mucous membranes and skin. The epidermis is the outermost layer of the skin, hence the name.
* Staphylococcus haemolyticus (hemolytic staphylococcus)
* Mushrooms of the genus Candida
*Non-pathogenic species of bacilli, corynebacteria, etc.
Representatives of pathogenic microflora. About the obvious bacteria that are the causative agents of plague, cholera, anthrax, syphilis and gonorrhea, there is no question. They are too symptomatic. Listed here are bacteria that can live on a person for years, causing low-level chronic inflammation.
*Staphylococcus aureus (Staphylococcus aureus)
* Streptococcus pyogenes (pyogenic streptococcus, also known as group A beta-hemolytic streptococcus) - gives complications in the form of rheumatism, affecting the kidneys, brain vessels, heart, joints.
* Streptococcus pneumoniae (pneumococcus) - the causative agent of pneumonia and meningitis
*Pseudomonas aeruginosa (Pseudomonas aeruginosa)
* Klebsiella pneumoniae, ozaenae, rhinoscleromatis
* Yersinia enterocolitica, pseudotuberculosis (Yersinia enterocolitis and pseudotuberculosis)
Classification of pathogenic microorganisms for humans
http://www.zakonprost.ru/content/base/part/66975
About the letters sp. and spp. in crops. In some laboratories and clinics, it is possible to find reductions in the results of microflora cultures. sp. and spp.
spp. is an abbreviation for the Latin "speciales" (species).
Written after the name of a family or genus of an organism (any, not necessarily a microorganism), used to designate species of a given family or genus. Usually, either different species of the indicated family/genus are implied, or when the exact species has not been established, but the genus is undoubted.
Possible usage options:
sp.(with one "p") - abbr. from "species", singular.
spp.(with two "p") - abbr. from "speciales", plural.
For example, Streptococcus sp.- refers to a certain (one) species of the genus Streptococcus.
Streptococcus spp.- refers to several different species of the genus Streptococcus.
And where several species have been identified at the same time, there may be green viridans (normal microflora) and pyogenic (absolute pathogen), but you will not know about it and will suffer.
The abbreviation is used to designate subspecies. ssp.(or subsp.); var.(varietas) - a variety of this species.
In the texts, the Latin names of organisms (genus, species) are usually written in italics with a capital letter, abbreviations (sp./spp./ssp.) - without italics.
2. Method of gas chromatography - mass spectrometry
The method belongs to a new direction in microbiological research - the diagnosis of infection, dysbiosis and inflammatory processes using specific microbial chemicals (markers). These substances are contained in the cell walls of microorganisms or are produced by them in the course of life. The idea of diagnostics by chemical markers is that they differ in chemical structure from the substance of human cells. In this case, we are talking about a variety of fatty acids, of which there are a little more than 20 species in humans, and more than 200 in microbes. Therefore, it is not difficult in principle to determine the presence of microbes in the human body if there is a sufficiently sensitive method of analysis. This method is chromato-mass spectrometry. It is a combination of an effective method for separating mixtures of chemicals - chromatography with mass spectrometry, which allows you to accurately determine the chemical nature of a substance from its mass spectrum. These methods have modern computer software, which, together with the developed methods, allows you to quickly and reliably determine small fractions of substances of microbial origin in any human biological fluids and in environmental objects. In a few hours, it is possible to qualitatively and quantitatively determine the composition of any microorganisms, if only they have markers or differ in the profile of chemical components, as people do in fingerprints. This method of microbiological research is fast and versatile, since it does not require growing individual microorganisms on special media and conducting special biochemical tests for each of them to determine the species. That is, there is no need to wait days or weeks for microbial cultures to grow and accumulate enough microbial cells to identify them.

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Analysis of feces for dysbacteriosis is a biological method for the quantitative assessment of beneficial and conditionally pathogenic intestinal microflora.

In different laboratories, the form of the test sheet may vary. Most often this refers to the order in which the bacteria are arranged.

The main representatives of the beneficial intestinal microflora:

bifidobacteria
lactobacilli
Escherichia coli (E. coli) with normal enzymatic activity.

These are the most numerous representatives of the normal flora of the large intestine.

Opportunistic pathogens intestines:

Klebsiella, Proteus, Citrobacter, Enterobacter, Pseudomonas aeruginosa, Hemolyzing Escherichia coli, Yersinia, Candida.
epidermal and saprophytic staphylococci, Staphylococcus aureus, streptococci.
clostridia.

The term “opportunistic” means that, while in the intestines, they usually do no harm. However, under certain conditions, they become pathogenic and cause intestinal disorders. This can happen in case of an increase in their absolute number or number in relation to the normal flora, as well as in violation of the function of the immune system.

Pathogenic microorganisms:

This group includes bacteria that cause acute intestinal infections: Salmonella, Shigella, Yersinia.

Analysis of feces for dysbacteriosis is normal

Name of bacteria	Description and role of bacteria in the intestine	Normal stool levels in adults	Normal content in feces in children
bifidobacteria	The main and most numerous representatives of the normal intestinal microflora. They inhibit the growth of pathogens, participate in the formation of vitamins B and K. Promote the absorption of vitamin D and calcium in the intestine.	10 8 - 10 10 CFU / g feces	10 10 - 10 11 CFU / g feces More in children on breastfeeding and less on artificial.
lactobacilli	The second largest representatives of the normal intestinal microflora. Suppress pathogenic microorganisms. Participate in the synthesis of immunoglobulins. Provide antiallergic protection. They produce lactase.	10 6 -10 8 CFU/g feces	10 6 -10 9 CFU / g feces More in children on breastfeeding and less on artificial.
Escherichia (E. coli with normal enzymatic properties)	The main competitor of opportunistic and pathogenic flora. Supports the vital activity of bifido- and lactobacilli. Synthesizes vitamins K and all B vitamins.	10 7 -10 8 CFU/g feces	10 7 -10 8 CFU/g feces (may vary in children up to a year depending on the type of feeding)
Escherichia (E. coli with reduced enzymatic activity)	Doesn't hurt, but doesn't do any good either. Its presence in the analysis is a sign of incipient dysbacteriosis, as well as a sign of the presence of worms or protozoa in the intestines.	10 6 -10 8 CFU/g feces	<10 6 КОЕ/г кала
Bacteroids	They belong to the normal intestinal microflora. Appear in the intestines in children after 6 months of life. They prevent the development of pathogenic bacteria, ferment carbohydrates, and participate in the utilization of proteins.	10 7 -10 9 CFU/g feces	In children up to 6 months. are not found; after 7-8 months 10 7 -10 8 CFU/g feces
Peptostreptococci	In small quantities, they belong to the normal intestinal microflora. They participate in the metabolism of carbohydrates, help maintain the normal acidity of the large intestine.	10 5 - 10 6 CFU / g feces	<10 5 КОЕ/г кала
Enterococci	Representatives of conditionally pathogenic flora. In small quantities, they belong to the normal intestinal microflora. They stimulate local immunity, have anti-allergic and antimycotic effects, participate in the metabolism of carbohydrates.	10 6 -10 7 CFU/g feces	10 6 -10 7 CFU/g feces
Peptococci	Representatives of conditionally pathogenic flora. They serve as a supplement and utilizer of the results of the work of beneficial microflora. They ferment peptones, amino acids, some carbohydrates, form ammonia, acetate, acetic and lactic acids in the process of growth. Prevent the growth of pathogenic bacteria.	10 5 -10 6 CFU/g feces	10 5 -10 6 CFU/g feces
Staphylococci	Staphylococci are of two types: pathogenic (golden, hemolytic, plasmacoagulating) and conditionally pathogenic saprophytic - not causing diseases (non-hemolytic, epidermal). Staphylococci are involved in the metabolism of itrates in the large intestine.	Pathogenic staphylococci: should not be. In some laboratories, up to 10 3 CFU / g of feces is allowed. Saprophytic staphylococci: 10 4 -10 5 CFU/g feces;	Pathogenic staphylococci - should not be Saprophytic staphylococci: 10 4 -10 5 CFU / g feces;
streptococci	They belong to the opportunistic intestinal flora (may be found in small quantities). They participate in the metabolism of carbohydrates, prevent the growth of pathogenic bacteria in the intestines.	<10 3 КОЕ/г кала	<10 3 КОЕ/г кала
Clostridia	Conditionally pathogenic. Clostridia are bacteria that are present in the intestines in small quantities. They show pathogenicity only in combination with other opportunistic flora, by themselves they rarely cause problems (thinning of the stool, diarrhea). Participate in the formation of acids and alcohols in the large intestine.	10 3 -10 5 CFU/g feces	<10 5 КОЕ/г кала (может варьировать у детей до года в зависимости от вида вскармливания)
Yeast-like fungi (Candida, etc.)	Refers to conditionally pathogenic flora, i.e. causes dysbacteriosis only under adverse conditions. Helps maintain an acidic environment.	<10 4 КОЕ/г кала	Up to 10 3 cfu/g feces
Proteus	Conditionally pathogenic.	<10 3	Must not be
Klebsiella, Citrobacter, Enterobacter	Conditionally pathogenic. Competitors of lactobacilli. Contribute to the development of allergies, constipation, and lactase deficiency.	<10 3	Must not be
Shigella, salmonella		Must not be	Must not be
Escherichia (Escherichia coli) hemolyzing	Representatives of the pathogenic flora	Must not be	Must not be

In the absence of any microorganism, the term "abs" or "not found" may be used.