Analysis of femoflor-16: norm, pathology, interpretation, self-assessment of the result

A smear on the flora of women is taken for diagnostic purposes; this analysis allows you to detect atypical cells, assess hormonal balance and identify signs of certain gynecological diseases.

Women are prescribed a smear test for preventive purposes, as well as in case of symptoms of diseases of the genitourinary system and in the presence of complaints: itching in the vaginal area, discharge not associated with menstruation, pain in the lower abdomen. Such an analysis is definitely indicated after long-term treatment with antibiotics and during pregnancy planning. The procedure is painless and does not cause harm.

What is included in the test

Detected indicators:

• KVM (control of material collection) – allows you to make sure that the material was taken of high quality and that human DNA is present in the sample (there is material from the vagina and cervix)
• TBM (total bacterial mass) - how many microorganisms are in the vaginal secretion.

Normal flora:

• Lactobacillus spp. -shows the total number of normal lactobacilli
• Opportunistic mycoplasmas:
• Mycoplasma (hominis);
• Ureaplasma (urialiticum+parvum);

Their detection does not always mean a disease; in small quantities they can be present in an absolutely healthy woman.

Candida spp. are yeast-like fungi; when they multiply, one of the most popular gynecological diseases develops, often called “thrush”.

Facultative anaerobic microorganisms:

• Enterobacterium spp.;
• Streptococcus spp.;
• Staphylococcus spp.;

They can grow in air and without the presence of oxygen. They are present both normally and in some diseases; quantitative assessment allows us to understand their role in each specific patient.

Anaerobes:

• Gardnerella vaginalis;
• Prevotella bivia;
• Porphyromonas spp.;
• Eubacterium spp.;
• Sneathia spp.;
• Leptotrichia spp.;
• Fusobacterium spp.;
• Megasphaera spp.;
• Veillonella spp.;
• Dialister spp.;
• Lachnobacterium spp.;
• Clostridium spp.;
• Mobiluncus spp.;
• Corinebacterium spp.;
• Peptostreptococcus spp.;
• Atopobium vaginae;

These microorganisms do not grow in the presence of oxygen; ordinary vaginal samples do not reveal them. Only the femoflora test allows not only to identify them, but also to determine their quantity. After all, a healthy woman can have them, the whole question is in quantity.

Pathogenic microorganisms:

Mycoplasma genitalium - unlike mycoplasma hominis, this is an absolute enemy, it should not exist.

VENEREAL INFECTIONS (chlamydia, gonorrhea, trichomonas) ARE NOT INCLUDED IN THE DIAGNOSTIC TEST FEMOFLOR-16; the femofolor-13 test, femoflor-screen, florocenosis and standard PCR tests, which are usually supplemented with the femoflor-16 test, are intended for their diagnosis.

Also, femoflor-16 does not detect herpes viruses, human papillomaviruses, or cytomegalovirus.

Femoflor 16 is a highly informative analysis of biological material from the cervical and vaginal canal. Laboratory monitoring allows you to assess the ratio of beneficial lactic acid bacteria, opportunistic and pathogenic microorganisms that live in cervical mucus and vaginal secretions. Microflora is examined using PCR diagnostics. Real-time polymerase chain reaction helps to reliably determine the bacterial mass, and then quantify all kinds of bacilli, cocci, fungi and viruses that live and multiply on the woman’s genital mucosa.

How to take a smear for flora

In order for the result of a smear on the flora to be reliable and informative, certain conditions must be met.

What does the preparation include (two days before the procedure):

• Refusal of sexual activity;
• Ban on suppositories and tablets for the vagina.
• Do not use detergents.
• Refrain from bathing.
• Douching is not allowed.
• The smear test is not taken during menstruation.

Also, gynecologists do not recommend their patients to urinate several hours before taking a test. A smear is taken with a special sterile spatula from the mucous membrane of the vagina, cervix and urethra during a gynecological examination.

Efficiency

Reputable clinicians rightly call Femoflor-16 a highly accurate method for diagnosing microflora disorders. During the research process, specialized specialists quickly and accurately determine the real state of the biocenosis of the organs of the woman’s genitourinary system. Laboratory assistants will provide the results to the doctor or patient within a few hours after collecting the biological material.

The polymerase chain reaction demonstrates high sensitivity and allows the detection of pathogenic microbes even with a minimal amount of test material. In this case, bacteriologists and virologists lay down DNA probes for 16 types of bacteria. During clinical monitoring, “probes” look for the DNA of relevant microbes. When detected, a polymerase chain reaction test is started. As a result, doctors receive reliable indicators of the quantitative and qualitative characteristics of the biocenosis. The specificity and purposefulness of this diagnosis make it relevant and irreplaceable.

Indications

1. Profuse leucorrhoea, itching, burning, discomfort in the vagina.
2. Inflammatory diseases of the genitals.
3. Before surgery.
4. Lack of expected results in the treatment of inflammatory diseases of the female genital area.
5. The use of oral contraceptives, intrauterine devices, frequent douching.
6. Sexual disorders or frequent change of sexual partners.
7. Menstrual irregularities, menopause.
8. Failure to comply with basic rules of intimate hygiene.
9. Planning pregnancy or preparing for in vitro fertilization.
10. Diseases of the vulva.

Preparation

The event does not require special preparation, but it is still necessary to follow simple rules and recommendations.

• Give up sex and alcohol within three days.
• Avoid douching and local antiseptics.
• Do not take antibiotics for two weeks,
• On the day of taking a smear, do not wash yourself.
• For half an hour, refrain from urinating.

Remember, a smear cannot be taken during menstruation, or immediately after a biopsy or ultrasound examination with a vaginal probe. Otherwise, the lady can lead her usual lifestyle. There are no restrictions on diet and physical activity.

Biological material from the mucous membranes of the urogenital tract

When taking material for cultural and microscopic examination, the patient should not take antibacterial drugs for the previous two weeks.

Microscopic studies.

To prepare a native preparation, a drop of warm sterile saline solution (37°C) is placed on a glass slide, the resulting material is mixed with saline solution, covered with a cover glass and examined immediately after receipt. To perform microscopy of a stained preparation, the material is dried in air at room temperature.

When preparing a smear for microscopic examination, it is recommended to roll the swab over the glass rather than “spread” the material. To obtain the material, cotton/Dacron swabs and bacteriological loops are used.

When taking material for cultural testing, the swab with the material is left in a test tube with the transport medium. To obtain the material, cotton/Dacron swabs and bacteriological loops are used.

When taking material to detect DNA/RNA, the working part of the probe is broken off and left in a test tube with transport medium. If it is impossible to break off the working part of the probe, you should rinse the biological material from the working part as completely as possible into a test tube with a transport medium, pressing it to the inside of the tube and rotating 5-10 times clockwise and counterclockwise. It is unacceptable to use reusable scissors to cut the working part of the probe - this can lead to cross-contamination of biological material and, as a result, false positive results. When taking samples, you must use only the equipment recommended by the manufacturer of the reagent kits (universal probes, cotton/Dacron swabs, cytobrushes).

Smears (scrapings) from the mucous membrane of the cervical canal.

Access to the cervical canal is provided using a disposable or reusable sterile gynecological speculum. Remove mucus and vaginal discharge from the surface of the cervix with a sterile gauze swab, insert the working part of the probe (tampon) into the cervical canal 1–2 cm and make two to three full turns clockwise. The probe (swab) is removed and its working part, containing the sampled material, is placed in a test tube with a transport medium or rolled over a glass slide.

Smears (scrapings) from the mucous membrane of the urethra of women.

If there is discharge from the urethra, it should be removed with a cotton swab before taking material. The probe (tampon) is inserted into the urethra 1–2 cm, rotated for several seconds, then removed and placed in a test tube with a transport medium or rolled on a glass slide.

Smears (scrapings) from the vaginal mucosa.

A sterile speculum is inserted into the vagina. If there is heavy discharge, remove it first with a cotton swab. The material for research is collected with a probe (tampon) from the posterior and lateral vaginal vaults. Then the probe (swab) is placed in a test tube with transport medium or rolled over a glass slide. Moderate presence of impurities in the form of mucus and blood is acceptable.

In virgins: A probe (tampon) is inserted into the vagina through the hymenal opening and material is collected from the posterior wall of the vagina. Then the probe (swab) is placed in a test tube with transport medium or rolled over a glass slide. Moderate presence of impurities in the form of mucus and blood is acceptable.

Smears (scrapings) from the mucous membrane of the male urethra.

Before taking a scraping from the urethra, the glans penis in the area of ​​the external opening of the urethra is treated with a swab moistened with sterile saline solution. The urethra is massaged. If there is discharge freely flowing from the urethra, remove it with a dry swab. A probe (tampon) is inserted into the urethra to a depth of 1–2 cm. Epithelial cells are scraped off with several rotational movements and the probe is transferred to a test tube with a transport medium or rolled on a glass slide.

Smears (scrapings) from the mucous membrane of the foreskin.

The foreskin is moved towards the base of the penis. A probe (swab) is used to scrape epithelial cells from the mucous membrane of the foreskin and transfer the probe into a test tube with a transport medium or roll it over a glass slide.

Sample storage.

Smears (scrapings)

• Microscopic examination:

If transportation is necessary, the native drug is placed in a Petri dish containing damp filter paper or a cotton ball; when delivered to the laboratory, it should not be allowed to cool, and examined immediately after delivery.

The colored preparation, previously dried in air, is stable for 24 hours. If longer storage is necessary, the preparation is fixed with 96% alcohol for 3 minutes.

• Cultural examination: to detect Chlamydia trachomas - at a temperature of 2–8°C for no more than 24 hours;
• to detect Neisseria gonorrhoeae - at a temperature of 18–25°C for no more than 48 hours, do not allow the material to cool below 18°C;
• to detect Trichomonas vaginalis - at a temperature of 18–25°C for no more than 12 hours, avoid temperature fluctuations during storage and transportation;
• to detect Herpes Simplex Virus – at a temperature of 18–25°C for no more than 24 hours;
• to identify fungi of the genus Candida - at a temperature of 18–25°C for no more than 2 hours, at a temperature of 2–8°C for no more than 24 hours.

The transport medium in which biomaterial samples are placed and the conditions for its storage are determined by the instructions for the reagent kit used.

Norm and pathology

The main indicators of the normal state of microflora are displayed in the table below.

Serious deviations from the norm are considered a pathology and require additional diagnostics and adequate therapy. The doctor develops a treatment regimen personally for each patient based on current clinical protocols and treatment recommendations. The use of alternative medicine without prior approval from a doctor is unacceptable.

How to interpret the analysis yourself:

It is not always possible to go to your doctor, but the results are in hand and you really want to understand what to do next. For the convenience of patients, there is a final transcript at the end of the study. So, if the word “NORMOCENOSIS” is the norm, everything is fine. If there is “DYSBIOSIS”, then depending on the symptoms and severity, correction will be required, you need to make an appointment with a doctor. Also, a visit to a doctor requires a conclusion “UREOPLASMOSIS”, “CANDIDIASIS”, “BACTERIAL VAGINOSIS”.

What can be seen as a result of the study

A smear on the flora, if carried out correctly and the woman followed the preparation recommendations, allows us to identify inflammatory processes that develop due to the presence of pathogenic microorganisms.

Common diseases identified during the study:

• Cervicitis – affects the cervical canal. The pathology is inflammatory in nature.
• Vaginitis is a disease that adversely affects the vaginal walls.
• Candidiasis – thrush occurs due to the excessive presence of Candida in a woman’s flora.
• Bacterial vaginosis develops when the composition of the vaginal microflora changes.

In addition, a smear analysis of the flora can identify a number of sexually transmitted diseases. If gonococcal pathogenic microorganisms were detected, this indicates the development of gonorrhea. During the study, chlamydia, trichomoniasis, mycoplasmosis and ureaplasmosis can be detected. Only a gynecologist can make an accurate diagnosis after studying the test results and a thorough examination of the patient.