| Abstract [eng] |
As a diagnostic method the genital discharge smear test is widely used in gynaecological practice. The necesssity of this test is sometimes discussed nowadays, since agents of a disease can be determined by means of molecular diagnostics. The goal of this thesis is to analyse findings of the genital discharge smear test and the agents which were determined using other methods. 622 female and and 795 male patients from the Dermatological Centre of the Vilnius University Santariskes Clinic as well as 267 female patients from the Santariskes Clinic were examined. At the Dermatological Centre the genital discharge smear tests of female patients were obtained from vagina, cervic uteri and urethra, while those of male patients were taken from urethra and prepuce. The obtained samples were dyed by Gram stain to identify gram-positive and gram–negative bacteria (flora), especially looking for gram-negative diplococci (gonococci). At Santariškes Clinic two smear tests are made, both from the vagina; then one of them is dyed using methylene blue to search for trichomoniasis morphological picture and to the other a violet dye is applied (Gram stain). The results: 1. In all localizations of genital secretion smears of all investigated women of age groups gram-positive rods dominated 100%, gram-negative rods - 70-92%, gram-positive cocci– 49-83%, while in the investigated men of age groups mostly gram-positive cocci were identified (their quantity ranged from 86,4% to 94,4%, gram-positive rods – 74,8-78,7%, gram-negative rods – 52,7-77,8%. Together with a smear of vagina by other methods identified infection generators in women according to age groups dominated Mycoplasma hominis and/or Ureaplasma urealyticum (colorimetric half qualitative) - 26-31%, Chlamydia trachomatis (imunofermentic) – 9-14%, fungi (microbiological) – 2-3%; together with a smear of cervix uteri dominated germs (microbiologic) 7-14% and fungi - 2-3%. Whereas for men together with the genital smear of urethra, mainly germs were identified by other methods – 18,2%-27,4%, Chlamydia trachomatis – 5,3-7,4% and Mycoplasma hominis and/or Ureaplasma urealyticum – 6,3-7,4%. 2. Together with the genital secretion smear additional investigations are frequently assigned both to women and men: to identify Chlamydia trachomatis (women - 60%, men – 40,5%), Mycoplasma hominis and/or Urea plasma urealyticum (women - 62%, men – 33,3%), to identify fungi and germs by culture (women - 17%, men – 25,8%). 3. It was noticed that detection of gram-positive rods in all women/men patients did not depend on the number of leukocytes, while more gram-negative rods, gram-positive cocci, fungi, trichomones, have been identified in the case of the increased number of leukocytes. The number of generators investigated by other methods was greater in the case of leukocytosis. 4. Upon assessment of pathologic microflora in the smear it was established that in taken specimen both of women (investigated material of cervix uteri – 61) and of men (investigated material of urethra– 150) quantity of grown gram-positive cocci was the largest. 5. In the case of leukocytosis more positive cultures were found in the smear of genital secretion 6. Generators of bacterial vaginosis were not raised in cultures, pathologic flora has grown. 7. Not in a single smear of genital secretion of the investigated gram-intercell diplococcus was found, in smears of 6 patients diplococci were found and in only one investigated person‘s smear gonococci were found, it was also grown in culture and gonococcus infection was diagnosed. Conclusions. However possibilities of smear investigation are fairly limited and primary cause of infection of genital secretion does not reflect in it. Nevertheless in certain cases it provides an early opinion about the state of patient‘s health rather quickly and using this method it is possible to detect germs, fungus and parasitical (trichomoniasis) infections. |
