Sexually Transmitted Diseases - I. I. Mavrov 2005

Other bacterial infections of the urogenital organs

Urogenital bacterial infections represent one of the most pressing issues in venereology, obstetrics, gynecology, urology, and other medical fields. Data on their prevalence remain contradictory due to several factors, such as variations depending on the examined cohort, the Location and timing of the study, and the level of Laboratory Diagnostics. Opinions regarding the etiological role of various Microorganisms in the development of inflammatory lesions of the Genitourinary system are likewise inconsistent.

According to modern concepts, primary bacterial Inflammatory Diseases of the urogenital Organs in men and women should be suspected upon the onset of relevant symptoms, provided that gonococcal, chlamydial, mycoplasmal, trichomonal, viral, or mycotic etiologies have been ruled out during examination.

Infectious processes in the genitourinary system can be caused by microorganisms normally residing in the microbial flora of the lower genital tract or introduced from external sources during sexual intercourse and other circumstances that alter the COMPOSITION OF THE vaginal or urethral microflora in favor of more virulent pathogens. These include anaerobes, facultative anaerobes, and certain aerobes, such as ß-streptococci, Gardnerella, Listeria, staphylococci, coliform Bacteria, Proteus, Pseudomonas aeruginosa, Bacteroides, Neisseria, and other microorganisms. All of the listed bacteria can contribute to the pathological processes underlying inflammatory lesions of the reproductive sphere, with multiple species actively involved in the process.

It is difficult, and sometimes entirely impossible, to precisely determine the degree of involvement of each microbial agent due to numerous differences in the immune responses they elicit, as well as in the Methods used for their analysis. These proportions also depend on geographical and temporal factors, since each region, season, and time of year features its own most characteristic infectious agents. In some cases, Laboratory studies cannot ensure 100% accuracy in etiological Diagnosis.

Streptococci, staphylococci, coliform bacteria, Mycoplasmas, and other surface-dwelling microorganisms can invade Tissues only when the mucous membrane or Skin is compromised (e.g., inflammatory processes, foreign bodies, mucosal trauma from instrumental examinations, local therapeutic manipulations, or sample collection for Laboratory tests). Frequently, they enter the urogenital organs concurrently with gonococci, chlamydias, or Viruses during sexual contact.

It should also be borne in mind that the perineal surface and genital skin are constantly contaminated with intestinal coliform bacteria. In the areas of the anus, Scrotum, and Perineum, many bacterial species (streptococci, staphylococci, Fungi) may begin to proliferate aggressively and penetrate the epidermis or spread along the Urethra under certain conditions (maceration, diabetes, etc.).

Direct contact between a man's Penis and a woman's anus poses a risk of infection for both partners. Anal and orogenital sexual practices (penio-oral, orovaginal) can also cause infection, as gonococci, chlamydias, mycoplasmas, Klebsiella, streptococci, staphylococci, Neisseria, Gardnerella, and certain Gram-negative bacteria (such as Proteus and Escherichia coli) are frequently detected in the Pharynx.

Nosocomial (hospital-acquired) transmission of infection also occurs. Microorganisms may be inadvertently introduced into the genital organs during various Procedures (urethroscopy, cystoscopy, instillations, smearing, uterine cavity manipulations, etc.). Pathogens may also be transferred to the genital organs by patients' own hands due to poor hygiene. Furthermore, hematogenous or urogenital spread of pathogens from latent infection foci (Kidneys, nasopharynx, etc.) to the genital organs has been documented. Trichomonas and spermatozoa can serve as a "vehicle" for microorganisms invading the upper genital tract and Abdominal cavity, as a close interaction takes place between microbes and these Cells.

It is quite evident that the cornerstone of managing any specific bacterial infection of the reproductive organs is the Selection of optimal therapy, while comprehensive information regarding the causative agents facilitates not only successful patient Treatment but also The Development of the most effective preventive measures.

Therapy for bacterial genital infections is based on the General Principles of etiological and Pathogenetic Treatment of inflammatory infectious lesions of the genitourinary system. Prevention of bacterial urogenital infections is carried out taking into account the principles of organizing the control of Sexually Transmitted Diseases. If a bacterial infection is diagnosed in one sexual partner, all sexual contacts must be thoroughly investigated. However, even in the absence of any pathological changes in close contacts, identical treatment is prescribed to them as well.

It is essential to strictly adhere to asepsis and antisepsis rules when performing local therapy, various genital manipulations, collecting samples for laboratory tests, and other procedures.