Diagnostic technique of nonspecific aerobic vaginitis

FIELD: medicine.

SUBSTANCE: vaginal fluid is analysed. The vaginal secretion is collected by means of a common tampon placed in a vagina for 8-9 hours, further weighted; microbial metabolites are extracted in equiponderate amount of distilled water, and the extract is analysed by gas-liquid chromatography. If the vaginal discharge contain acetic acid more than 0.315 mg/g and total propionic and butyric acids ≤0.200 mg/g in an age group of 17 to 34 years, and acetic acid more than 0.210 mg/g with total propionic and butyric acids ≤0.120 mg/g in an age group of 35 to 48 years, nonspecific aerobic vaginitis is diagnosed.

EFFECT: more accurate diagnosis of nonspecific aerobic vaginitis.

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The invention relates to medicine, namely to gynecology and clinical Microbiology, may be used to diagnose non-specific aerobic vaginitis.

A known method for the diagnosis of vaginitis, based on study of vaginal washings obtained during examination of the patient by irrigation of the vagina 3 ml of distilled water with its subsequent study using gas-liquid chromatography Method for determination of microflora of the vagina and the method of treatment of diseases involving violation of the vaginal flora" - Patent of RF №2270447 07.09.2004 (Arbatskaya PPM; minushkin on.; Makarov O.; Hasukawa Z.Z.; Hasukawa AS).

Because the effectiveness of laboratory tests depends on the quality of receiving clinical sample, the disadvantages of the prototype should be considered the method of specimen collection for research and a significant number of indicators that characterize the microflora of the vagina.

Effect: simplified high accuracy of interpretation of the obtained results, ensuring timely correction of prescribed treatment.

This result is achieved by the fact that the sampling of the contents of the vagina carried out using standard hygienic tampon was in contact with the vagina for 8-9 hours. The sample then determine elaut qualitative and quantitative composition of short-chain fatty acids (acetic, propionic and butyric), which are metabolites of anaerobic and aerobic populations, and when the content in the vaginal discharge of acetic acid over 0,315 mg/g when the total content of propionic and butyric acids ≤0,200 mg/g in the age group from 17 to 34 years, when the content in the vaginal discharge of acetic acid over 0,210 mg/g when the total content of propionic and butyric acids ≤0,120 mg/g in the age group from 35 to 48 years old diagnosed with non-specific aerobic vaginitis.

The method is as follows: ambulatory patient at home before going to sleep places in the vagina standard tampon with a fixed weight, for example, 2,05, in the Morning, in the conditions of policlinic swab, which was in the vagina for 8-9 hours, remove, place in a pre-prepared sterile container and transported to the laboratory. In the laboratory, the swab is then weighed and the difference of the result before and after exposure to determine the weight of the collected clinical material, for example, 3,7-2,05=1,72 g, allowing to provide accurate quantitative estimates for the registration of the desired components in the vaginal secretion. The tampon, which is in close contact (including thermostable) with the subject mucosa for a long time, impregnated detachable containing microflora and met polity, is the source material chromatographic studies. For extraction of the desired soluble metabolites in the container with a tampon add sterile distilled water in an amount equal by weight collected vaginal discharge, for example, 1,72 g, incubated 5 minutes at room temperature, then vigorously shaken for 1 minute, press and extract examined by gas chromatography. The content in the vaginal discharge of acetic acid over 0,315 mg/g when the total content of propionic and butyric acids ≤0,200 mg/g in the age group from 17 to 34 years old; the content in the vaginal discharge of acetic acid over 0,210 mg/g when the total content of propionic and butyric acids ≤0,120 mg/g in the age group from 35 to 48 years allows to verify the non-specific aerobic vaginitis.

The advantages of the studies using the swab should also include the possibility of bringing to the procedure of sampling nurses, which allows the network to simultaneously examine a larger number of patients with a minimum expenditure of time and technical resources.

Examples of specific performance

Example 1. Patient S., 38 years. He complained of discomfort in the vagina, frequent urination. Previously exhibited the diagnosis of bacterial is th vaginosis, was prescribed a variety of antibiotic therapy, but the effect of the treatment was unstable. At home before going to sleep, the patient has entered the vagina standard tampon with a fixed weight 2,01 Morning, in the conditions of policlinic swab, which was in the vagina for 8-9 hours, removed, placed in a pre-prepared sterile container and transported to the laboratory. In the laboratory, the swab is then weighed and the difference of the result before and after exposure to determine the weight of the collected clinical material 3,8 - 2,01=1,79, For extraction of the desired soluble metabolites in the container with a tampon add sterile distilled water in an amount equal by weight collected vaginal discharge, 1,79 g, incubated 5 minutes at room temperature, then vigorously shaken for 1 minute, press and extract examined by gas chromatography. The result of the examination by the present method: the content of acetic acid - 0,604 mg/g; the total content of propionic and butyric acids 0,073 mg/g

Was diagnosed with non-specific aerobic vaginitis. In parallel had a control bacteriological examination of vaginal discharge, which found Klebsiella terrigena 106CFU/ml, Streptococcus acidophylus 105CFU/ml, S.epidermidis 104

Example 2. Patient, 32 years. He complained of liquid discharge from the genital tract, itching, burning, dyspareunia. Considers herself a patient in the course of 1.5-2 months. When the inspection of the mucous membrane of the vagina - bright diffuse hyperemia, discharge abundant milk. Quantitative contents of leucocytes in a smear 50-70 in the field of view, abundant flora mixed. At home before going to sleep, the patient has entered the vagina standard tampon with a fixed weight, 2,04, in the Morning, in the conditions of policlinic swab, which was in the vagina for 8-9 hours, removed, placed in a pre-prepared sterile container and transported to the laboratory. In the laboratory, the swab is then weighed and the difference of the result before and after exposure to determine the weight of the collected clinical material 3,5-2,04=1,46, For extraction of the desired soluble metabolites in the container with a tampon add sterile distilled water in an amount equal by weight collected vaginal discharge, 1,46 g, incubated 5 minutes at room temperature, then vigorously shaken for 1 minute, press and extract examined by gas chromatography. The result of the examination by the present method: the content of acetic acid - 0,370 mg/g; total content propionate and butyric acids 0,112 mg/year Was diagnosed with non-specific aerobic vaginitis. In parallel had a control bacteriological examination of vaginal discharge, which found Lactobacillus spp 102CFU/ml, Streptococcus agalactiae 105CFU/ml Enterococcus faecalis 105CFU/ml, Corynebacterium xerosis 106CFU/ml, which corresponds to the diagnosis.

Example 3. Sick Hours, 25 years. Appealed to the obstetrician-gynecologist with complaints of abnormal discharge from the genital tract discomfort in the vagina. These symptoms are disturbed in the course of one year. During the inspection were identified: focal hyperemia of the mucosa of the vulva and vagina; detachable homogeneous, gray-yellow color. The quantitative content of leukocytes in vaginal smear 5-15 in the field of view, clusters of squamous epithelium, abundant flora mixed. Was diagnosed with non-specific aerobic vaginitis? At home before going to sleep, the patient has entered the vagina standard tampon with a fixed weight, 2,04, in the Morning, in the conditions of policlinic swab, which was in the vagina for 8-9 hours, removed, placed in a pre-prepared sterile container and transported to the laboratory. In the laboratory, the swab is then weighed and the difference of the result before and after exposure to determine the weight of the collected clinical material 3,9-2,04=1,86 is. For extraction of the desired soluble metabolites in the container with a tampon add sterile distilled water in an amount equal by weight collected vaginal discharge, 1.86 g, incubated 5 minutes at room temperature, then vigorously shaken for 1 minute, press and extract examined by gas chromatography. The result of the examination by the present method: the content of acetic acid - 0,056 mg/g; the total content of propionic and butyric acids 0,314 mg/g

To confirm the proposed diagnostic method performed sowing on the microflora of the vaginal discharge, were sown Gardnerella vaginalis 109CFU/ml, Mycoplasma hominis, 107CFU/ml, which corresponds to the diagnosis of bacterial vaginosis.

Conclusion: non-specific aerobic vaginitis is not verified.

Example 4. Patient G., 36 years. Appealed to the obstetrician-gynecologist with complaints of abnormal discharge from the genital tract. Have repeatedly asked for medical assistance to the gynecologist for the place of residence of sexually transmitted infections (STIs), was not found. During the inspection were identified: focal hyperemia of the mucosa of the vulva and vagina; copious milk secretion. The quantitative content of leukocytes in vaginal smear to 20 in the field of view, clusters of squamous epithelium, rich flora with esanda. Was diagnosed with non-specific aerobic vaginitis? At home before going to sleep, the patient has entered the vagina standard tampon with a fixed weight 2,02 Morning, in the conditions of policlinic swab, which was in the vagina for 8-9 hours, removed, placed in a pre-prepared sterile container and transported to the laboratory. In the laboratory, the swab is then weighed and the difference of the result before and after exposure to determine the weight of the collected clinical material 3,95-2,02=1,93, For extraction of the desired soluble metabolites in the container with a tampon add sterile distilled water in an amount equal by weight collected vaginal discharge, 1,93 g, incubated 5 minutes at room temperature, then vigorously shaken for 1 minute, press and extract examined by gas chromatography. The result of the examination by the present method: the content of acetic acid - 0,062 mg/g; the total content of propionic and butyric acids 0,328 mg/g

To confirm the proposed diagnostic method performed sowing on the microflora of the vaginal discharge, were sown Gardnerella vaginalis 107CFU/ml, which corresponds to the diagnosis of bacterial vaginosis.

Conclusion: non-specific aerobic vaginitis is not verified.

The proposed method is iagnostic tested on 50 patients, applicants for examination to the obstetrician-gynecologist.

Method for the diagnosis of non-specific aerobic vaginitis by examining vaginal fluid, characterized in that the vaginal contents collected using a standard swab is placed into the vagina for 8-9 h, determine its weight, is extracted microbial metabolites in an equal weight quantity of distilled water, exploring the extract by gas chromatography, to determine in him acetic, propionic and butyric acid, and when the content in the vaginal discharge of acetic acid over 0,315 mg/g when the total content of propionic and butyric acids ≤0,200 mg/g in the age group from 17 to 34 years, when the content in the vaginal discharge acetic acid more 0,210 mg/g when the total content of propionic and butyric acids ≤0,120 mg/g in the age group from 35 to 48 years old diagnosed with non-specific aerobic vaginitis.



 

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