Mycoplasmosis. Causes, symptoms, modern diagnostics, effective treatment, disease prevention. Mycoplasma in men - causes, signs and treatment Can mycoplasma cause obstruction

Mycoplasmosis is an inflammatory infectious disease that develops when mycoplasmas, the smallest known bacteria, multiply.

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Mycoplasma is a family of small prokaryotic organisms of the class Mollicutes. They do not have their own cell wall, only a membrane, due to which they easily attach to the epithelial cells of the genitourinary, respiratory system and to spermatozoa.

Mycoplasmas occupy an intermediate position between viruses and bacteria - due to the absence of a cell membrane and microscopic size (100-300 nm), mycoplasma is not visible in a light microscope, and this brings these microorganisms closer to viruses. At the same time, mycoplasma cells contain DNA and RNA, can grow in a cell-free environment and reproduce autonomously (binary fission or budding), which brings mycoplasma closer to bacteria.

Mycoplasma infection affects the joints and mucous membranes of the eyes (conjunctivitis), can cause autoimmune reactions (allergy to the tissues of one's own body).

In total, more than 100 species of mycoplasmas are known, of which only five are dangerous to humans - representatives of two genera - Mycoplasma and Ureaplasma, from the Mycoplasmatacea family.

Pathogenic to humans are M. pneumoniae, M. hominis, M. genitalium, M. incognitus and Ureaplasma urealyticum.

The first of them - M. pneumonia is the causative agent of respiratory mycoplasmosis, M. incognitus causes a poorly understood generalized infection, the rest - M. hominis, M. genitalium and Ureaplasma urealyticum cause the development of urogenital mycoplasmosis.

Mycoplasmas are resistant to sulfonamides, penicillin, streptomycin, but sensitive to tetracycline antibiotics, macrolides and fluoroquinolones.

Mycoplasmas Hominis are considered opportunistic: they can cause diseases, but only if the body is weakened.

In healthy people, M. hominis does not manifest itself in any way, being commensal bacteria, that is, without bringing any benefit or harm. The asymptomatic presence of mycoplasmas (M. hominis) is detected, according to various studies, from 25% to 50% and 25% among all newborn girls. In men, carriage is practically not detected; self-healing is possible when infected.

Mycoplasmas are sensitive to high temperatures and humidity, die under the influence of ultraviolet and weak radiation, acidic and alkaline solutions, but are long-term resistant to cold. They can exist and multiply only inside the body.

Boiling and ultraviolet

Mycoplasmas quickly die when boiled, ultraviolet irradiation and exposure to disinfectants.

Transmission routes:

• The leading route of transmission of mycoplasma infection is sexual (unprotected genital, oral-genital contacts). The probability of transmission of mycoplasmas, ureaplasmas during a single sexual contact (genital, anal) varies from 4 to 80%, but is not predictable in each individual case;
• when kissing mouth-to-mouth, ureaplasmas and mycoplasmas are not transmitted if there was no prior oral contact with the partner's genitals and sperm. When kissing the skin of the cheeks, forehead, body, limbs (arms and legs), hair on the head, mycoplasma and ureaplasma are not transmitted;
• Concomitant often act other urogenital diseases - candidiasis, chlamydia, genital herpes, trichomoniasis, gonorrhea.
• Contact-household infection is possible, although very rare, it can be realized through the use of shared bed linen, towels and washcloths, toilet seats (including in public toilets), non-sterile gynecological and urological instruments.
• The possibility of non-sexual intrafamilial infection with mycoplasmosis is confirmed by the fact that 8-17% of schoolgirls who do not live sexually have M. hominis.
• vertical path. The probability of transmission of mycoplasmas and ureaplasmas from an infected mother to the fetus transplacentally (through the placenta) is quite high. A number of researchers consider it possible for mycoplasmas and ureaplasmas to penetrate through the amniotic (fetal) membrane into the amniotic fluid and infect the fetus when the amniotic fluid is swallowed. When passing through the birth canal, the risk of infection of the fetus with mycoplasmas and ureaplasmas reaches 50-80%;
• Pets are not a source of infection.

When it enters the mucous membranes, the pathogen, attaching to the cell epithelium, provokes the development of local inflammatory reactions, without showing a cytogenic effect. Mycopalzma interacts with the cellular apparatus, which leads to a change in its cytogenic structure and provokes the development of autoimmune processes.

Dangers and Consequences

Mycoplasmosis during pregnancy can cause:

• spontaneous abortions;
• intrauterine infection and fetal death;
• the development of congenital malformations in a child;
• postpartum sepsis in a newborn;
• the birth of children with low body weight;
• inflammation of the uterus after childbirth.

At the same time, some gynecologists completely disagree with the statement that mycoplasmas are dangerous to the health of pregnant women. They indicate that Mycoplasma hominis is found in 15-25% of pregnant women, and complications for the fetus develop in 5-20% of them. Therefore, it is believed that mycoplasmas can harm the health of mother and child only under certain conditions:

• in association with other pathogenic microorganisms, mainly with ureaplasmas;
• with a decrease in immunity;
• with massive lesions of the genital organs.

As a result, there is a frozen pregnancy and spontaneous abortion in the early stages. Danger - incomplete abortion, when parts of the fetus or membranes remain in the uterine cavity. Without intensive medical care, death is possible.

female infertility- can develop as a result of endometritis or inflammation of the fallopian tubes (adnexitis). With damage to the endometrium of the uterus, a fertilized egg cannot implant and develop in the inflamed uterine tissue. With inflammation of the fallopian tubes, lumen occlusion can occur, which leads to the fact that the egg is not able to reach the uterus, and the sperm cannot reach the egg. Therefore, the process of conception becomes unlikely.

male infertility- associated with damage to the prostate, and possible damage to the testicles. These damages lead to quantitative and qualitative violations of the sperm composition.

Impotence- primarily associated in men with damage to the prostate and testicles. In this case, sexual contact often becomes impossible due to the lack of an erection, and even if it occurs, the painful sensations do not allow it to be brought to its "logical conclusion".

preterm birth or spontaneous miscarriage in early pregnancy. This process is associated with infectious lesions of the endometrium of the uterus, which is a nutrient medium for the developing fetus.

Autoimmune diseases- can occur as a result of a malfunction in the immune system, which is caused by a chronic infectious and inflammatory process. In this condition, immune cells begin to fight the tissues of their own body, often causing irreparable damage.

Incubation period of mycoplasmosis

In the experiment, urethritis develops within three days after the introduction of pure culture. In practice, everything is more complicated:

The incubation period of mycoplasma respiratory infection ranges from 4 days to 1 month, and can last several months or never go into an acute stage at all. Then the person will remain an asymptomatic carrier of the infection.

Diagnosis of mycoplasmosis

There are no characteristic clinical symptoms for mycoplasmosis. Mycoplasmas may manifest themselves with inflammation and secretions, or they may not manifest themselves at all. It is impossible to make a diagnosis based on external signs alone. Therefore, the main criterion for infection are the results of a laboratory examination.

However, with all the perfection of laboratory research methods, a gynecological examination for women or a urological examination for men is still necessary. The thing is that mycoplasmosis can be combined with other sexually transmitted infections, as well as with a violation of the vaginal microflora. Therefore, in order to prescribe an adequate complex treatment, it is necessary to diagnose the entire spectrum of possible lesions.

The doctor will be interested in your complaints, chronic gynecological / urological diseases, the presence of sexually transmitted diseases in the past, the health status of your sexual partner / partner.

Gynecological examination - associated with the need to examine the mucous membrane of the vaginal cavity, the cervix, the external pharynx of the cervical canal. During this examination, as a rule, with mycoplasmosis, mucopurulent discharge, swelling of the vaginal mucosa and its inflammation are detected. Also, during this examination, the doctor will be able to take a biomaterial (smear from the mucous membranes).

Laboratory examinations

The most informative in the detection of mycoplasmosis are PCR examination of the biomaterial obtained with a smear, as well as bacteriological examination (to identify concomitant possible sexual infections).

More about each survey method:

PCR diagnostics - this method has high accuracy in detecting even a negligible population of microbes. With the help of this method, the reproduction of a specific pathogen "in vitro" and subsequent identification is carried out.

This examination is essential in making a diagnosis and in determining that the patient is cured.

Serological examinations (ELISA, PIF) are performed to detect antibodies to a specific pathogen. However, this examination does not provide accurate information about the dynamics of the process, the activity of the infection, and whether the prescribed treatment was effective.

Bacteriological and microscopic examination of the smear - allows you to identify concomitant diseases (bacterial or fungal vaginosis, gonorrhea, trichomoniasis). Thanks to this survey, it is possible to timely identify the entire “bouquet of infectious diseases”.

Symptoms in women

Urogenital mycoplasmosis in women manifests itself in the form of bacterial vaginosis (gardnerellosis), mycoplasmal urethritis, inflammation of the uterus, fallopian tubes and ovaries, pyelonephritis.

Often mycoplasmosis is combined with chlamydia and ureaplasmosis.

Bacterial vaginosis

Bacterial vaginosis is an imbalance in the microflora in the vagina. Normally, it is inhabited by lactobacilli, which produce lactic acid and a strong oxidizing agent - hydrogen peroxide, which prevent the development of pathogenic and opportunistic bacteria. If for some reason there are fewer lactobacilli, then the acidity of the vaginal walls decreases and the rapid reproduction of microorganisms begins. Mycoplasma hominis and Gardnerella vaginalis usually coexist with lactobacilli, and clinical manifestations of bacterial vaginosis are associated with the growth of their populations.

In bacterial vaginosis, pathogenic bacteria adhere to the cells of the vagina. Reasons for the development of vaginosis:

1. Frequent douching with antiseptics containing chlorine (miramistin, gibitan);
2. Condoms or contraceptive suppositories with 9-nonoxynol (panthenox oval, nonoxynol);
3. Uncontrolled use of oral antibiotics, suppositories or vaginal antibiotic tablets (terzhinan, betadine, polzhinaks);
4. Change of sexual partners.

Symptoms of vaginosis are vaginal discharge that is not abundant and thin, grayish-white in color, smelling like rotten fish. Women often associate the appearance of unpleasant amber with lack of personal hygiene and use douching. However, these actions only exacerbate inflammation and contribute to the spread of mycopalsmosis to the cervix and ascending infection up to the ovaries. Among the possible complications of gardnerellosis are endometritis, salpingo-oophoritis and infertility, as well as problems with miscarriage and premature birth.

Urethritis is an inflammation of the urethra associated with Mycoplasma genitalium.

In 30-49% of non-gonococcal urethritis, mycoplasmas are determined, and in women they are found more often and in higher titers than in men.

Symptoms are typical - burning during urination, mucous or purulent discharge from the urethra.

In an acute course, the temperature rises, general intoxication appears (headaches and muscle pain, chills, weakness).

An ascending urethral infection affects the bladder, then the ureters and kidneys, causing pyelonephritis.

Inflammation of the uterus and its appendages begins with pain in the lumbar region and lower abdomen, then mucous discharges from the cervix and vagina appear, bleeding joins during menstruation and between them.

Women complain of constant fatigue and lack of strength, lack of appetite and sleep disturbances.

This picture is typical for the chronic course of genital mycoplasmosis.

Symptoms in men

The main manifestations after infection with Mycoplasma genitalium in men are urethritis and prostatitis. Differences from female urogenital mycoplasmosis: characterized by an almost asymptomatic course; mono-infection rarely spreads to the kidneys, but often ends in infertility; among men there is no carriage of mycoplasmas.

Urethritis begins with a slight burning sensation when urinating, after a couple of days the symptoms disappear. Inflammation of the prostate gland is hidden, appears with mild dull pain in the lower back and gradually increasing problems with erection.

The symptoms of mycoplasmosis are more pronounced in the presence of a combined infection and in combination with urogenital ureaplasmosis and chlamydia. Ureaplasmas, together with mycoplasmas, are found in 30-45% of patients with prostatitis, chlamydia - in 40% of men with non-gonococcal urethritis. In such cases, signs of arthritis appear more often - joint pain, local swelling and redness of the skin; ascending infection with kidney damage; local inflammation of the genital organs - orchitis (testicles), epididymitis (epididymis), vesiculitis (inflamed seminal vesicles).

Male infertility in mycoplasmosis develops not only due to inflammation, but also in violation of spermatogenesis.

Where does mycoplasmosis come from in children?

In children, mycoplasmosis is observed after infection in utero, in normal childbirth, or after caesarean section. The upper respiratory tract is most often affected - rhinitis and pharyngitis, then tracheitis and bronchitis develop, and then pneumonia. The causative agent of respiratory mycoplasmosis - - with the help of flagella, attaches to the epithelial cells of the respiratory tract and destroys their walls.

As a result, interstitial pneumonia of newborns develops, which is characteristic of congenital mycoplasmosis.

In premature infants infected with mycoplasmas, respiratory disorders, development of scleroma of newborns (thickening of the skin and subcutaneous tissue), hemorrhages in the parietal and occipital regions (cephalohematomas), increased bilirubin and jaundice, development of inflammation of the brain and its membranes (meningoencephalitis) are possible.

In full-term children - pneumonia, subcutaneous hemorrhages, late symptoms of meningoencephalitis.

25% of pregnant women are asymptomatic carriers of mycoplasmas. In the vast majority of cases, the placenta and amniotic membranes protect the fetus during pregnancy. But if the amniotic bladder is damaged or during childbirth, mycoplasmas can enter the baby's body and cause infection.

Infection with mycoplasmosis in children can occur:

• with infection of amniotic fluid during pregnancy;
• with damage to the placenta;
• during the passage of the birth canal;
• when communicating with sick relatives or carriers of mycoplasmas.

Entrance gates for infection can serve as:

• conjunctiva of the eyes;
• mucous membranes of the oral cavity and respiratory tract;
• mucous membranes of the genital organs.

In healthy full-term infants, contact with mycoplasmas rarely leads to the development of the disease. But premature babies, who suffered from chronic placental insufficiency in utero, are very sensitive to mycoplasmas due to the immaturity of the immune system.

When infected with mycoplasmas, children may develop:

Conjunctivitis. Mycoplasmas infect the cells of the conjunctiva, a thin membrane that covers the outer surface of the eye and the inner surface of the eyelids. Symptoms:

• redness of the whites of the eyes;
• tearing;
• slight swelling of the eyelids;
• mucopurulent discharge.

• violation of nasal breathing;
• sore throat;
• hoarseness of voice.

Meningitis- inflammation of the soft and arachnoid membranes of the brain. Manifestations:

• heat;
• headache;
• stiffness of the neck muscles - increased tone of the occipital muscles, due to which the child cannot press his chin to his chest;
• increased sensitivity to light and sound;
• repeated vomiting;
• severe weakness.

Respiratory distress syndrome or non-cardiogenic pulmonary edema. Damage to lung tissue by mycoplasmas can lead to massive release of fluid into the lumen of the alveoli, and sometimes into the pleural cavity. Pulmonary edema leads to respiratory failure, and patients suffer from acute oxygen deficiency. Its manifestations:

• cyanosis of the skin;
• severe lethargy;
• disturbance of consciousness;
• coma.

neonatal sepsis- entry of mycoplasmas into the blood. "Blood poisoning" is associated with impaired immunity, namely the inability to phagocytize microorganisms. In this case, symptoms of a systemic inflammatory reaction appear:

• temperature above 38 or below 36°C;
• pulse over 90 beats per minute;
• increased breathing over 20 per minute;
• a large number of leukocytes (leukocytosis) in the blood test - above 12x10 per µl.

Carrying. Mycoplasmas settle on the membrane of mucosal cells, but there are no symptoms of the disease. Mycoplasmas often colonize the reproductive system of newborn girls - colonization was detected in 20-50% of them. Carriage in newborn boys does not occur.

Forms of mycoplasmosis

• Respiratory mycoplasmosis, which is an acute anthroponotic infectious and inflammatory disease of the respiratory system. Provoked by mycoplasma of the species M. pneumoniae (the influence of other types of mycoplasmas on the development of respiratory diseases has not yet been proven);
• , which refers to infectious inflammatory diseases of the urinary tract. Caused by mycoplasmas of M. Hominis and M. Genitalium species;
• Generalized mycoplasmosis, in which extra-respiratory lesions of mycoplasmas are detected. Mycoplasma infection can affect the cardiovascular and musculoskeletal systems, eyes, kidneys, liver, cause bronchial asthma, polyarthritis, pancreatitis and exanthema. Extra-respiratory organ damage usually occurs as a result of generalization of respiratory or urogenital mycoplasmosis.

Depending on the clinical course, mycoplasmosis is divided into:;

• spicy;
• subacute;
• sluggish;
• chronic.

Since the presence of mycoplasmas in the body is not always accompanied by symptoms of the disease, the carriage of mycoplasmas is also isolated (when there are no clinical signs of inflammation, mycoplasmas are present in a titer of less than 103 CFU / ml).

For the first time, mycoplasma was isolated in 1898 in France from the body of cows with pneumonia. A little later, in 1928, scientists turned their attention to a strange “virus” in sick bulls, and in 1937 Edzall and Dienes found out that mycoplasma also lives in the human body. They isolated it during the study of abscesses of the Bartholin glands. In the body of healthy women (in the region of the cervical canal), the pathogen was detected in 1942, and at the same time, mycoplasma was found in the urethra in men. And a few years later it was proved that mycoplasmosis is a sexually transmitted disease that can provoke quite serious consequences.

The causative agent of mycoplasmosis is separated from the environment by a cytoplasmic membrane (contains proteins that are located in the lipid layers).

Respiratory mycoplasmosis

The causative agent is Mycoplasma pneumoniae. Bacteria are isolated from the respiratory tract a week and a half after the onset of the disease, transmitted by airborne droplets or through objects. Respiratory mycoplasmosis has seasonal trends, more common in the autumn-winter period. 2-4 year rises in incidence are characteristic. Immunity persists for 5-10 years or more, the course of the disease depends on the immune status. In general, respiratory mycoplasmosis in humans is 5-6% of all acute respiratory infections and 6-22% of diagnosed pneumonia, during epidemic outbreaks - up to 50%.

Method of transmission of respiratory mycoplasmosis. The source of infection is sick people and asymptomatic carriers. The disease is transmitted by airborne dust. When coughing, mucus particles containing mycoplasmas fall on objects and settle on house dust, and subsequently on the mucous membranes of the respiratory tract. Young people under 30 are more often ill.

The consequence of respiratory mycoplasmosis is pneumonia.

Mycoplasma respiratory infection is more common in children and young adults. Children 5-14 years old become infected with M. pneumonia in 20-35% of cases of all acute respiratory infections, adolescents and people aged 19-23 years old - in 15-20% of cases. There is a combination of mycoplasmas with viral infections (influenza and parainfluenza, adenovirus, HIV). Complications - pneumonia, sepsis, meningoencephalitis, hemolytic anemia, inflammation of the joints.

The incubation period is up to 1 month, then symptoms of a common cold appear, turning into a painful dry cough. With a mild form of the disease, the temperature rises slightly, the patient complains of aching pain in the muscles and general malaise. On examination - dilated vessels of the sclera, pinpoint hemorrhages under the mucous membranes, "loose" throat. The cervical and submandibular lymph nodes are enlarged. Dry rales are heard in the lungs, the general condition of the patient is satisfactory. The disease lasts 1-2 weeks, ends without complications.

• The disease can occur in various forms:;
• nasopharyngitis;
• bronchitis;
• tracheitis;
• atypical mycoplasmal pneumonia (its share is about 10-20% of all pneumonia).

Mycoplasma pneumonia is characterized by:

• acute onset of the disease - chills, a significant increase in temperature;
• intoxication is expressed moderately, the condition worsens at the moments of temperature rise;
• weakness, weakness, muscle aches - the result of poisoning with a neurotoxin secreted by mycoplasmas;
• annoying dry cough with a slight release of mucopurulent sputum, less often with an admixture of blood;
• in the lungs, dry or moist fine bubbling rales, the lesion is usually focal unilateral;
• the face is pale, the sclera are reddened, vessels are sometimes visible;
• some patients experience nausea and vomiting.

Antibiotics are used to treat respiratory forms of mycoplasmosis.

Treatment

Therapeutic measures are not always justified, details:

Treatment is based on the use of antibiotics and antimicrobials. In acute uncomplicated urogenital mycoplasmosis, which:

• Caused by mycoplasma, metronidazole, clindamycin are used. Treatment may be local;
• Caused by mycoplasma, tetracycline drugs (doxycycline) or macrolides (azithromycin) are used.

Treatment of mycoplasmosis with antibiotics should be carried out under the supervision of a specialist physician. Self-treatment in this case can lead to a deterioration in the dynamics of the process and the development of resistance to antibacterial agents of mycoplasma.

Standard schemes for the use of antibiotics in the treatment of mycoplasmosis:

It is important to follow some rules when treating with antibiotics:

• Treatment should not be interrupted or stopped earlier than the period established by the attending physician.
• In the treatment of mycoplasmosis, even protected sex should be stopped for the period of treatment.
• Treatment is considered successful only after laboratory tests confirm this, and the disappearance of symptoms of mycoplasmosis is not a reliable criterion for cure.

An important component of effective therapy for mycoplasmosis is the need to undergo treatment together with a sexual partner. If this is not done, then chlamydia will circulate within the couple, causing re-infection.

The success of treatment is ensured by personal hygiene. It should be remembered that on sheets, towels and underwear, chlamydia survive for a week. And simply boiling the laundry for a minute is guaranteed to destroy them.

Probiotics in the treatment of mycoplasmosis

If antibiotics affect the entire body, then it is highly likely that they can also destroy beneficial microflora. In order to prevent its place from being taken by an aggressive microflora for the body (fungi, some types of opportunistic bacteria), live cultures of bifidus and lactobacilli are prescribed.

The most famous and commonly used drugs from the group of probiotics are: hilak forte, bifidumbacterin, linex.

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Mycoplasmosis and ureaplasmosis- this is an inflammatory process in the organs of the genitourinary system, caused respectively by mycoplasmas or ureaplasmas.

How does infection with mycoplasmas and ureaplasmas occur?

• Infection can occur through any type of unprotected sexual contact (vaginal, oral, anal) with a carrier of the infection. Depending on the state of the body (primarily the immune system), the probability of transmission of mycoplasmas and ureaplasmas during a single unprotected sex is 5-60%. Women are most often asymptomatic carriers of the infection, while men become infected sexually.
• It is also possible to transmit the pathogen in utero or during childbirth from an infected mother. The probability of infection in this case reaches 50-80%.
• The household route of infection (in the gym, swimming pool, through a towel, dishes, dirty hands, etc.) is practically impossible, because. mycoplasmas cannot live outside the body.
• Pets also cannot be a source and carrier of mycoplasmas and ureaplasmas.

What happens after infection with mycoplasmas and ureaplasmas?
The very fact of the transmission of the pathogen does not mean at all that it will necessarily lead to the disease.
Depending on whether mycoplasmas cause disease or peacefully coexist with humans, there are:

1. Carriage of mycoplasmas or ureaplasmas. In this case, mycoplasmas are representatives of the body's natural microflora and do not cause any changes in the urinary tract. It does not appear clinically.
2. The development of the disease - mycoplasmosis or ureaplasmosis. As a rule, this occurs with a decrease in local and general immunity. In this case, an inflammatory process develops in the organs of the genitourinary system.

What are the varieties of mycoplasmosis and ureaplasmosis?
If the transmission of the pathogen nevertheless led to the development of the disease, then, depending on the time of its course and the severity of the symptoms, they distinguish:

• Fresh, i.e. first-time mycoplasmosis or ureaplasmosis. Depending on the severity of the symptoms, it is acute or sluggish.
• Chronic, which is characterized by an asymptomatic course and duration of the disease over 2 months. Chronic infection under the influence of various factors can periodically worsen.

Symptoms of mycoplasmosis and ureaplasmosis.
Because Since mycoplasmas and ureaplasmas are related bacteria, the nature of the infection and the symptoms are very similar.
Incubation period can last from 2 to 5 weeks, after which the first signs of infection appear.
Mycoplasmosis and ureaplasmosis are characterized by the absence of a pronounced immune response of the body, the absence of symptoms of infection, a long chronic course, and the absence of stable immunity. All this is explained by the peculiarities of the pathogens themselves - mycoplasmas and ureaplasmas.

Mycoplasmosis and ureaplasmosis do not have any specific symptoms that would point specifically to them. All clinical manifestations are practically the same as in other urogenital infections.
However, acute manifestations in mycoplasmosis and ureaplasmosis are extremely rare.
Most often, erased or latent forms of the course of these infections are observed with a rapid chronization of the process.
In this case, usually no complaints or no complaints occur at all, or they are so insignificant and quickly disappear without any treatment that they simply do not pay attention. But under certain conditions of the body, for example, stressful loads, the old symptoms reappear.

Mycoplasmosis is characterized by the fact that, as a monoinfection, it occurs in only 10-15% of patients, in other cases - together with other microorganisms. Of these, in 25 - 30% of cases - together with chlamydia. Mycoplasmas can often be found in trichomoniasis, gonorrhea and chlamydia, so the so-called mixed infections are distinguished: mycoplasma-trichomonas, mycoplasma-chlamydia, mycoplasma-gonococcal.
And if at first mycoplasmosis and ureaplasmosis proceed as low-symptomatic urethritis or vulvovaginitis, then during the transition to the chronic form, the inflammatory process affects deeper sections - the fallopian tubes, ovaries, prostate, testicles.

Symptoms of mycoplasmosis and ureaplasmosis in women:
Manifestations of fresh mycoplasmosis and ureaplasmosis in women are rare. Most often they are asymptomatic carriers of mycoplasmas.
But if the disease occurs, the inflammatory process in the genitourinary organs with mycoplasma infection in women is mild and often almost does not bother. Fresh mycoplasmosis manifests itself as an inflammation of the urethra, vagina and cervix. However, pathological vaginal discharge in these diseases is not always the case. In addition, it is impossible to distinguish them from normal secretions without analysis.

However, if complaints still occur, they are more often like this:

• Slight clear discharge from the vagina, maybe a little more than usual.
• Slight pain and burning when urinating.
• Brownish spotting before or after menstruation.
• Soreness in the lower abdomen and during sexual intercourse.
• Slight itching of the external genitalia.
• Going to the doctor, as a rule, is already associated with complications of mycoplasmosis, such as infertility, miscarriage, menstrual irregularities, inflammation of the ovaries, etc.

Ureaplasmas, unlike mycoplasmas, do not have the ability to deeply invade, therefore, they damage only the surface epithelium of the external genital organs.

Symptoms of ureaplasmosis and mycoplasmosis in men
In men, carriage is much less common than in women, and fresh mycoplasmosis causes inflammation of the urethra and foreskin. These infections also do not cause particular concern to men, however, the signs of the disease appear more often and they are more pronounced than in women.

• Moderate soreness and burning in the penis, aggravated during urination or sexual intercourse.
• Redness and irritation of the lips of the urethra.
• Slight clear discharge from the urethra.
• Discomfort or pain in the testicles.
• Drawing pains and unpleasant sensations in the lower and deep abdomen, as well as in the perineal region.
• There may be some weakening of potency.

Complications of urogenital mycoplasmosis, ureaplasmosis.

• Miscarriage (spontaneous miscarriage or premature birth). Often associated with autoimmune processes. Infection with mycoplasma leads to termination of pregnancy in 70 - 80% of cases.
• Complicated pregnancy - late toxicosis, polyhydramnios, the threat of interruption, premature detachment of the placenta and its abnormal attachment. Often associated with autoimmune processes.
• Urethritis, cystitis, pyelonephritis, urolithiasis.
• Endometritis, salpingitis, salpingoophoritis, adnexitis, endocervicitis and cervical erosion.
• Conjunctivitis.
• Autoimmune diseases (most often arthritis of the knee, ankle and hip joints).
• Epididymitis with pulling pain in the groin, perineum, scrotum, enlargement of the epididymis and reddening of the skin of the scrotum.
• Prostatitis with frequent painful urination, pain in the lower abdomen and in the perineum, decreased erection and potency, painful, erased early orgasm. If more than 104 colony-forming units per 1 ml of mycoplasmas or ureaplasmas are found in the secret of the prostate gland, this indicates that these pathogens cause prostatitis.
• Infertility female and male. In women with a long course of the inflammatory process, changes occur in the fallopian tubes and the uterine mucosa. In men, spermatogenesis is disturbed: the number of spermatozoa and their mobility decrease, immature forms and morphological changes in them appear.
• Intrauterine infection of the fetus.
• Mycoplasmas and ureaplasmas are capable of causing chromosomal changes in cells, including sex cells (spermatozoa and eggs). This can cause spontaneous abortions, as well as chromosomal abnormalities in the fetus and congenital malformations.

At a gynecologist's appointment, even an absolutely healthy woman can get the results of tests in her hands, where mycoplasma is found. Conditionally pathogenic flora, which doctors take into account only under the condition of high titers, is quite common.

If the growth of the flora is very active and there are prerequisites for a decrease in the immune system, then a diagnosis is made - mycoplasmosis. Let's figure out what it is, and what methods of treatment can overcome these microorganisms.

Causes

Why does mycoplasma occur in women, and what is it? Mycoplasma is considered the smallest form of organisms belonging to the mycoplasmataceae family. It is classified as a cross between unicellular organisms and multicellular viruses and bacteria.

Despite this, scientists tend to think of them (mycoplasmas) as viruses more because they don't have a cell wall. In the mycoplasmataceae family, there are two genera of microorganisms, mycoplasma and ureaplasma, which can cause the development of a wide variety of diseases.

The source of infection is a person with a manifest or asymptomatic course of mycoplasmosis. The infection is transmitted by airborne droplets (with respiratory mycoplasmosis), sexual (with urogenital mycoplasmosis) and vertical (from mother to fetus - more often with urogenital mycoplasmosis) routes.

The incubation period of the disease is from 3 days to 5 weeks, on average 15-19 days.

Symptoms of mycoplasma in women

As a rule, the presence of mycoplasmas in the body is characterized by erased low-symptomatic forms. Approximately 10-20% of women do not feel any obvious symptoms of mycoplasma until a stressful situation, such as abortion or severe hypothermia, activates the infection, often leading to quite serious complications.

Urogenital mycoplasmosis in women it appears as:

• (gardnerellosis);
• mycoplasmal urethritis;
• inflammation of the uterus, fallopian tubes and ovaries;
• often mycoplasmosis is combined with and.

The insidiousness of mycoplasma in women is that the disease can be completely asymptomatic for many years. During this period, a woman is a carrier of the infection and can transmit it to her sexual partners.

Diagnostics

Diagnosis of urogenital mycoplasmosis is based on the PCR method (polymerase chain reaction), which determines the DNA of mycoplasmas. The classical cultural method is also used, with inoculation of the material on a liquid medium and subsequent transfer to a solid one.

Mycoplasmas are identified by colony fluorescence after the addition of specific anti-sera. Serological methods for the detection of mycoplasmas are the complement fixation reaction (CFR) and the indirect agglutination reaction (IRGA).

As a material for laboratory research, women take a smear from the cervix, the vestibule of the vagina, the urethra and anus, the first morning portion of urine.

Treatment of mycoplasma in women

When diagnosing mycoplasma in women, the attending physician prescribes a treatment regimen consisting of complex therapy, including:

1. Antibacterial drugs(due to the resistance of mycoplasma to penicillin, antibiotics for mycoplasmosis are used from the tetracycline group, and macrolides are also used; the course of this treatment is up to 2 weeks);
2. Local treatment (candles, douching);
3. Immunomodulators (these drugs enhance the effect of drugs, they are used in the treatment of cycloferon or licopid);
4. Compliance with the diet recommended by the doctor;
5. Physiotherapy.

Unfortunately, the human body is not able to develop immunity to this infection, and therefore both sexual partners need to be treated with drugs at the same time. On average, the course of treatment for mycoplasmosis is 10 days. Then, after 2 or 3 weeks, the patient is assigned bakposev, and after 30 days - PCR.

Chronic form

In the treatment of chronic forms, immuno-oriented and local therapy is of great importance. The goal of immuno-oriented therapy is the correction of the immunodeficiency state, which has become the cause of the chronic course of the disease and has intensified against its background. It is prescribed taking into account the parameters of the immunogram.

Local therapy is carried out simultaneously with systemic antibiotic therapy, for 5-7 days. Usually, ethmotropic, anti-inflammatory drugs and enzymes (trypsin, chymotrypsin, etc.) are prescribed in the form of installations or using cotton-gauze swabs to treat the vagina. Immediately after its completion, it is recommended to undergo a course of treatment with probiotics to restore the microflora.

Consequences

A long course of mycoplasmosis without symptoms leads to the development of endometritis - inflammation of the uterine mucosa. Women with mycoplasmal endometritis have frequent miscarriages and missed pregnancies.

From the uterus, M. hominis and M. genitalium can spread to its appendages with development. Then adhesions appear in the tubes, which can lead to an ectopic pregnancy.

Mycoplasmas and ureaplasmas are the causative agents of urogenital and respiratory infections in men and women. These microorganisms belong to the class of opportunistic pathogens and are constantly present on the mucous membranes of the reproductive organs, organs of the urinary system, and the oral cavity. In a healthy person, they do not cause symptoms of infection, but when immunity is weakened, increased growth of bacteria occurs and the disease progresses.

The transmission of mycoplasmosis, ureaplasmosis occurs in most cases during unprotected sexual contact from a sick partner to a healthy one. The incubation period is quite long, a person may not feel any signs of infection for several months. In some cases, there are no characteristic symptoms, and the infected person becomes a carrier and can pass the bacteria to his partner.

Mycoplasmosis and ureaplasmosis are spread vertically from a pregnant mother to a child, while intrauterine infection develops, which can affect the development of the fetus and cause congenital malformations and neonatal diseases. Infection also occurs when the baby passes through the birth canal.

Airborne bacteria are spread by coughing and sneezing. The infection is not transmitted by contact-household method, since pathogenic microorganisms die very quickly in the external environment.

Symptoms of a mixed type of disease

In women, ureamicoplasmosis is manifested by the following symptoms:

• burning, itching of the genitals;
• discomfort, pain during urination;
• mild mucous discharge from the vagina with an unpleasant odor;
• painful sexual contact;
• lower abdominal pain;
• spotting after sex;
• intermenstrual bleeding;
• miscarriage;
• violation of the menstrual cycle.

Ureaplasmosis, mycoplasmosis cause inflammation of the vagina, uterus, fallopian tubes, ovaries. At the same time, women have an increase in body temperature, nausea, chills, and acute pain in the abdomen, radiating to the lower back. Allocations can acquire a yellow-green hue, impurities of pus and blood appear. Running forms of adnexitis lead to the development of infertility, the formation of adhesions and obstruction of the tubes.

Mycoplasmosis and ureaplasmosis in men are not accompanied by any specific symptoms. Complaints appear when the organs of the urinary system are involved in the pathological process. Urethritis is often diagnosed, the disease causes acute pain during urination. Mucus interspersed with pus is separated from the opening of the urethra.

Men experience pain during erection and ejaculation, for this reason, erectile dysfunction develops. The infection can be complicated by prostatitis, orchitis, infertility, impotence. Mycoplasmosis, chronic ureaplasmosis provoke the development of autoimmune diseases:

• rheumatoid arthritis;
• chronic heart failure;
• kidney failure.

Respiratory form of ureaplasmosis and mycoplasmosis

Pathogenic microorganisms can infect the mucous membranes of the upper respiratory tract, causing:

• tracheitis;
• bronchitis;
• tonsillitis;
• nasopharyngitis;
• atypical pneumonia.

Usually this form of the disease is diagnosed in large groups, it spreads by airborne droplets. The incubation period is 3-5 days, but may occur after 21 days.

In mild forms of infection, the patient is worried about headache, a slight increase in body temperature, general malaise, cough, sore throat, rhinitis, swollen lymph nodes in the neck.

With the development of pneumonia, there is a strong ache in the muscles and joints, a wet cough, nausea, vomiting, diarrhea, the temperature rises to 39–40 ° C. The patient has pale skin, severe sweating, weakness, small bubbling rales are heard in the lungs, a rash appears in the joints. Children carry the disease more severely than adults. Atypical pneumonia caused by mycoplasmosis, ureaplasmosis, is complicated by pulmonary edema, bronchiectasis, pneumosclerosis, deforming bronchitis.

Diagnosis of ureamicoplasmosis

Since the infection proceeds for a long time without pronounced symptoms, treatment is usually prescribed already at advanced stages, when inflammation of the organs of the genitourinary and respiratory systems has begun. In women, a bimanual examination is performed, the gynecologist takes smears of the vaginal discharge, from the mucous membrane of the larynx (for bacteriological examination).

For men, the treatment of mycoplasmosis, ureaplasmosis is prescribed by a urologist. For analysis, a swab is taken from the urethra and from the surface of the glans penis. Both partners suffering from a urogenital infection should be examined by a doctor, since one of them may have a latent disease.

A general blood test reveals an elevated level of leukocytes, which is characteristic of an inflammatory process. Research on RV excludes the presence of venereal disease pathogens. Bacteriological smear analysis allows diagnosing the nature of the pathology, differentiating bacterial and fungal vaginitis, and detecting a mixed type of infection.

Serological diagnostic methods include ELISA - enzyme immunoassay for the presence of antibodies to ureaplasmas and mycoplasmas. Based on the results, you can determine the severity of the disease and how long ago the infection occurred. And also ELISA helps to evaluate the effectiveness of the treatment.

PCR diagnostics is necessary to determine the type of infectious agent. A class of bacteria is identified by DNA. This highly accurate method is not used in all laboratories, as expensive equipment is required.

Methods of treatment of an infectious disease

Whether it is necessary to be treated for ureaplasmosis, mycoplasmosis - the doctor determines in each individual case. If a high titer of antibodies is found in the blood, but there are no clinical manifestations of the disease, then antibiotic treatment is not prescribed. The patient is recommended to strengthen the immune system, lead a healthy lifestyle, use contraceptives during sexual intercourse.

When is therapy indicated:

• in the presence of an inflammatory process;
• at the planning stage and during pregnancy;
• before gynecological operations, instrumental procedures;
• with a high titer of ureaplasmas, mycoplasmas (10⁴ CFU / ml);
• with infertility in men and women.

Treatment of ureaplasmosis, mycoplasmosis is carried out with systemic antibiotics, immunomodulatory drugs and probiotics. If another type of bacteria is additionally detected, then agents that are active against pathogenic microorganisms are added to the therapy regimen.

The most commonly prescribed antibiotics for treatment are:

The course lasts from 3 to 14 days, depending on the severity of the disease. In chronic and sluggish forms of infection, treatment is increased to 28 days. In some cases, it is indicated to take several antibacterial drugs of different groups at the same time.

In addition to anti-inflammatory therapy, in patients with chronic forms of the disease, immunity is strengthened. Patients are prescribed Imudon, Viferon, Echinacea, Lavomax, multivitamins that have an antioxidant effect. Antibiotic treatment kills not only harmful bacteria, but also beneficial ones. To restore the microflora of the intestines and genitourinary organs, it is necessary to take preparations containing live bifidus and lactobacilli (Hilak Forte, Linex), eat more fermented milk products.

Local therapy

It is useful for women and men to take baths to relieve acute symptoms of the disease. For their preparation, take 50 ml of gelatin, 500 units of vitamin A, 200 units of insulin, 1 million units of tetracycline. The fairer sex can douche, use a solution for washing, make tampons, sitz baths for 10-15 minutes 2 times a day. Men perform urethral lavage.

Women with ureaplasmosis, mycoplasmosis are prescribed the use of vaginal suppositories and tablets (Hexicon, Neotrizol). Suppositories are inserted into the vagina daily at bedtime for 10-14 days.

Treatment should be taken by both sexual partners, during this period it is recommended to refrain from sexual intercourse. You need to drink pills strictly according to the doctor's prescription, you should not stop taking them ahead of time, even if the symptoms of the infection have passed. Otherwise, a relapse of the disease may occur, and bacteria develop resistance to the antibiotic.

During therapy, it is necessary to take tests several times to evaluate the effectiveness of the course. If the titer of ureaplasma, mycoplasma remains high, the antibacterial drug is replaced or the dosage is increased.

You can not self-medicate, this can lead to the development of serious complications, bacterial resistance to drugs. Prevention measures include a culture of sexual relations, timely treatment of diseases of the urogenital area, a healthy lifestyle.

How does infection manifest itself in children?

Infection of a child with mycoplasmas and ureaplasmas occurs from a sick mother during pregnancy and childbirth, through contact of infected people with a newborn baby. Healthy, full-term babies rarely get sick when exposed to bacteria. And crumbs born prematurely, with low weight, suffering from placental insufficiency, are very sensitive to ureaplasmas and mycoplasmas.

The disease can cause:

• conjunctivitis;
• neonatal pneumonia of bacterial etiology;
• prolonged healing of the umbilical wound;
• candidiasis of the skin, mucous membranes;
• meningitis;
• diaper rash in the area of ​​\u200b\u200bthe folds;
• bronchitis, pharyngitis;
• pulmonary edema;
• sepsis.

Bacteria can populate the mucous membranes of the genital organs (mainly in girls) and stay there asymptomatically for a long time, until puberty. Treatment of an infectious disease in children is carried out with antibiotics as prescribed by a doctor.

In pregnant women, infection with mycoplasmosis, ureaplasmosis can lead to premature birth, fetal hypoxia, pregnancy fading. Therapy is prescribed for severe symptoms of pathology, you can take medications starting from the 2nd trimester. Expectant mothers are prescribed antibiotics Erythromycin, Azithromycin, immunomodulators.

Ureamycoplasmosis infection is a mixed type of disease that affects the urogenital region and the upper respiratory tract. Pathology causes inflammation of the mucous membranes and soft tissues, the development of complications of varying severity. Treatment is prescribed by a gynecologist, urologist or pulmonologist.