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Treatment for trichomoniasis, chlamydia and ureaplasma. Chlamydia, ureaplasma and mycoplasma - what are these bacteria and why are they dangerous? What is the difference between mycoplasma, ureaplasma, chlamydia and trichomoniasis

The most common genitourinary diseases include chlamydia, ureaplasmosis and mycoplasmosis infections. They give similar symptoms, but each has its own specific symptoms.

Causes and symptoms of chlamydia

The disease has insidiously minimal clinical manifestations and slow progression. WHO statistics show that about 90 million are infected every year, and in both sexes, chronic course and untimely treatment lead to irreversible infertility.

The causative agent of the disease is Chlamydia trachomatis, a negligible (about 250 nm) special microorganism that has a combination of bacterial and viral properties.

Chlamydia trachomatis has several features:

Like a bacterium, the pathogen has a lipid cell wall. This makes it possible to use antimicrobial drugs for therapy.

Chlamydia is inactive outside the host's body.
“Favorite” habitats are the cylindrical epithelial layer of the organs of the urogenital system. Chlamydia attaches, activates, blocks the normal functioning of cells and modifies their structure.
The growth of infection occurs in geometric progression: the life cycle of the microorganism is 48 hours.
Chlamydia infection is asymptomatic and mild in half of the cases. The patients have no clinical manifestations or complaints.

Chlamydia trachomatis infection occurs through sexual contact, and infection is possible through any type of unprotected sexual contact: oral, genital or anal. Household transmission is unlikely and is currently not clinically confirmed.

The infection process occurs in stages:

The latent stage, at which Chlamydia trachomatis penetrates, infects the mucous membranes of the genital organs and begins to multiply cyclically intracellularly.
Clinical stage with the first symptoms. The onset in women and men is manifested by acute urethritis, cervicitis, pharyngitis or proctitis.
The stage of development of chlamydial complications begins with concomitant autoimmune pathologies or are combined with other sexually transmitted infections: trichomoniasis, mycoplasmosis, ureaplasmosis and gonorrhea. Women and men develop secondary infertility.

The combined infection enhances the pathogenic activity of Chlamydia trachomatis, which complicates and lengthens the period of chlamydia therapy.

Causes and symptoms of ureaplasmosis

The disease is caused by the pathogen Ureaplasma urealyticum. This microorganism belongs to the group of sexually transmitted infections. Medicine knows 14 types of ureaplasma, and so far experts have not come to a consensus on the issue of their absolute harm to the body in the absence of symptoms. As with similar diseases - chlamydia and mycoplasmosis, signs of infection are mild.

Clinical manifestations depend on the condition of the organs affected by the pathogen. The latent (hidden) period of infection can last from one to several months. Ureaplasmosis does not have any unique characteristics characteristic of it. The disease occurs in the form of inflammation of the genitourinary tract: in men cystitis, urethritis, prostatitis. Women experience frequent and painful urination, itching of the mucous membranes of the genital organs, mucous-turbid discharge, and skin rashes.

Causes of infection and development of ureaplasmosis:

Promiscuous sexual contacts.
Early sexual activity in adolescents.
Failure to comply with hygiene rules.
Wearing tight synthetic underwear.
Reduced immune defense due to stress, colds, poor nutrition.
Other sexually transmitted infections (mycoplasmosis, chlamydia or trichomoniasis).
Long-term treatment with antibacterial and hormonal drugs.

A final diagnosis is made only if the patient has an inflammatory process and the presence of other pathogenic microorganisms (causative agents of chlamydia, mycoplasmosis, trichomoniasis) is laboratory confirmed. The question of the need for treatment in each specific case is decided by a qualified specialist.

Causes and symptoms of mycoplasmosis

Mycoplasmosis, like chlamydia and ureaplasmosis, is transmitted primarily through sexual contact. In women and girls, infection can occur directly through household items, underwear, and medical gynecological and urological instruments. There is also information about cases of intrauterine infection or infection from the mother of newborns during the passage of the birth canal.

There are two forms of the disease - asymptomatic (mycoplasma carriage) and with specific symptoms (acute and chronic).

Risk group for Mollicutes hominis genitalium infection:

Women of fertile period.
Patients with other concomitant urogenital pathologies.
Pregnant women.

Mycoplasma carriage is characterized by symptoms of variable cervicitis, vulvovaginitis in women and urethritis in men.

Latent infection is especially dangerous because during the period of activation against the background of weakened immunity it can cause diseases of the hematopoietic organs, peritonitis, postpartum and post-abortion sepsis, pyelonephritis.

The acute form of infection has specific symptoms:

Itching of the genitals.
Serous discharge from the urethra and vagina.

Chronic mycoplasma infection in men affects the prostate, urethral canal, epididymis, and seminal vesicles. In women, Mollicutes genitalium causes endometritis, menstrual irregularities, adnexitis, and anovulatory bleeding.

Advanced mycoplasmosis is complicated by secondary infertility or spontaneous miscarriages.

Almost 50% of Mollicutes hominis genitalium carriage is observed in women. The male body is able to heal itself from infection in 95% of cases.

Diagnostics

Chlamydia, ureaplasmosis, mycoplasmosis are combined into one name: mixed infection. Therefore, the basic methods of detection and treatment are common for them.

The following laboratory and diagnostic measures are prescribed:

Study involving the isolation of microorganisms from clinical material.
Immunofluorescence.
Enzyme-linked immunosorbent assay (ELISA) with determination of “antigen-antibody” indicators.
Polymerase chain reaction (PCR) study to identify the pathogen.
Bacteriological culture for the sensitivity of microorganisms to antibiotics.

Indications for mandatory initiation of a course of therapy:

An inflammatory process of the genitourinary system and an increased level of leukocytes were detected.
Infertility in women (provided that other tests are normal).

Features of the therapeutic program

Treatment of mixed infection is quite complex, with the mandatory prescription of effective medications, primarily antibiotics with a wide spectrum of action. For adequate and successful treatment while minimizing unwanted complications, the specialist chooses one antibacterial drug in combination with agents that reduce the severity of symptoms and stimulate their effectiveness directly in the inflammatory focus.

The following are prescribed as auxiliary drugs in the treatment of chlamydia and ureaplasmosis:

Immunomodulators-interferons (Pyrogenal, Immunal, Viferon, Polyoxidonium).
Enzymatic preparations (Enzistal, Creon, Pancitrate).
Means for improving blood circulation (Actovegin, Vazonit, Warfarin).
Vitamin complexes.
Physiotherapy course.

To treat mixed infections, highly effective antibiotics, fluoroquinolones or macrolides, are used. They act simultaneously on mycoplasma, chlamydia and ureaplasma.

From the group of macrolides for the treatment of sexually transmitted bacterial infections, erythromycin and its derivatives (spiramycin, josamycin, midecamycin, doxycycline, azithromycin, roxithromycin) deserve attention.

The drugs suppress protein synthesis in intracellular pathogens and are also harmful to gram-positive cocci and anaerobic bacteria. Macrolides are among the least toxic antibiotics, have high clinical efficacy (over 90%) and bioavailability, are well tolerated by the body and are safe to use (adverse reactions no more than 1%).

For acute uncomplicated forms, drugs are prescribed orally in the morning and evening for a course of 7 to 14 days.

The group of fluoroquinolones (Ciprofloxacin, Ofloxacin, Pefloxacin, Moxifloxacin, Gemifloxacin) are relatively new synthetic antibacterial drugs. Due to their good pharmacokinetic properties and high degree of tissue penetration, they are actively used in venereological, urological and gynecological practice for the treatment of infections of chlamdia and mycoplasma etiology. The action of the group’s drugs is based on the destruction of the bacterial DNA of the cell at all phases of its life cycle. Fluoroquinolones are also well tolerated, have a low percentage of side effects (about 2.5%) and do not have carcinogenic, mutagenic or teratogenic properties.

The duration of treatment for mixed infection, frequency of administration and dosage is determined by the observing specialist.

A month after the established course of therapy, repeated laboratory tests are carried out.

At the moment, microbiologists know 14 biovars of ureaplasma, but during serotyping, only 3 species are identified that can cause diseases: parvum, urealiticum and species. They lack a cell wall and DNA.

To accurately determine which types of ureaplasma are present in the body, typing is used. After this, it will be possible to prescribe more specific treatment that will give maximum results.

general information

All ureaplasmas belong to the mycoplasma family. These microorganisms are somewhat larger in size than viruses, but smaller than bacteria.

Ureaplasma parvum species

According to its classification, this type of pathogen belongs to mycoplasmas, like all others. Its main habitat is the vaginal mucosa in women.

This type of ureaplasma has the ability to break down urea in urine using an enzyme called urease. As a result, ammonia is formed.

With an increase in the amount of this microorganism and a decrease in immunity, an inflammatory process in the genital area may develop. There is also a chance of triggering urolithiasis, and stones will begin to form in different parts of the urinary tract.

Most often, this bacterium is activated when there are already other sexually transmitted infections, for example, chlamydia or gonorrhea. The duration of the incubation period is 3-4 weeks.

Ureaplasma species urealiticum

Their peculiarity is that they penetrate much more easily into the mucous membrane of the genital organs. In women, the risk of this type of ureaplasma is slightly higher.

In women, adhesions may form, resulting in tubal obstruction. This leads to an increased risk of ectopic pregnancy, and in severe cases, infertility is likely.

Ureaplasma species

Finding out exactly what type of ureaplasma is observed in each individual woman is an important point for choosing treatment for the disease. An accurate diagnosis is already half the way to a cure. Only after the cause has been correctly identified can the most effective treatment be prescribed, which will get rid of the infection in the shortest possible time.

The thing is that the urealiticum type causes disease only when its permissible amount is exceeded. For this reason, if the carriage is asymptomatic, therapy may not be prescribed at all.

A different tactic is used when ureaplasma such as spices or parvum is detected. In this case, treatment should be started immediately.

Determining the type of ureaplasma is mandatory in the following cases:

pregnancy planning. Testing for ureaplasma is mandatory for women who are registered at the consultation. It is also prescribed for spontaneous abortions in the early stages, since ureaplasmosis can be a provoking factor;
infertility. Identification of this microorganism is mandatory, since there is a possibility of sperm destruction, which affects their total number;
the appearance of symptoms of genital infection;
choice of drug and treatment tactics for the disease.

Determining the type of ureaplasma

The need to determine which subtype led to the development of the disease is dictated by the choice of the correct treatment tactics. The main analysis that is prescribed is a PCR study. At the moment, this is the most informative method available to the doctor. With its help, it is possible to detect even small amounts of the pathogen in the test material.

It is carried out in the following way:

Material is collected from the urethra. Sometimes blood can be used, but with small quantities of the pathogen, its determination will be difficult.
In the laboratory, the finished drugs are transferred to a special reactor.
Then special enzymes are added that bind to ureaplasma RNA and make it possible to determine the type that led to the development of the disease.

In addition to PCR diagnostics, culture seeding is sometimes used. With its help, you can clearly determine which type of pathogen is present in the microflora and its quantity. A special nutrient medium is created in a petri dish, onto which a microorganism is introduced using a microbiological loop. After a few days, the culture grows and is subjected to microscopy. The result will be the type of pathogen identified.

It is also quite common to perform a blood test for antibodies to ureaplasma. But it won't help determine the type. In this case, only the presence in the body can be determined.

Both sexual partners undergo all tests, since when one is cured, the pathogen may remain in the other.

Determining the type of ureaplasma is very important. The course of the disease will always depend on the species that was identified during research. As well as treatment tactics. Therefore, it is always necessary to type the pathogen immediately after its detection.

How to treat trichomoniasis and chlamydia?

The infectious diseases trichomoniasis and chlamydia are very similar, but at the same time, they have slightly different clinical manifestations and treatment features. This article will tell you what trichomoniasis and chlamydia are and how to treat them.

Characteristics of diseases

Trichomoniasis is a very common acute infectious disease. The main route of infection is unprotected sexual intercourse (traditional sex) with a carrier of the infection. As for the transmission of the disease through oral or anal sex, this is unlikely.

Important! Trichomoniasis is a sexually transmitted infection. For this reason, it cannot be transmitted through shaking hands, sharing utensils, or kissing.

Despite this, there is a small risk of transmitting the disease when using someone else's underwear, using a damp washcloth, towels, or visiting a bathhouse. This is justified by the fact that Trichomonas is able to actively live in a humid environment for several more hours.

In the event that infection with this disease occurs through domestic means, then, as a rule, a person does not even know about it and finds out during a routine diagnosis. In most cases, the infection then becomes chronic.

After Trichomonas penetrates the human body, the incubation period begins. It lasts for 2-3 weeks. At this time, pathogenic bacteria adapt to the new environment, after which they begin to actively make themselves felt.

During the incubation period of the bacteria, the patient does not feel any signs of illness.

As for chlamydia, it is also a sexually transmitted infectious pathology. It is characteristic that the causative agents of this infection - chlamydia - can affect not only the genital organs (vagina, cervix), but also the rectum, urethra in men and eyes.

Carefully! Chlamydia is considered an extremely common disease.

According to research, it is observed in 10% of people under thirty who are sexually active.

Those people who are most susceptible to this infection are those who often change sexual partners and practice sex without barrier contraception (condom).

You should know that most often infection with chlamydia occurs during intimate intercourse (traditional or anal, it does not make much difference, since the probability of transmission of infection is equally high in both cases).

In addition, chlamydia can also be transmitted from mother to newborn baby through sexual intercourse. In this condition, the baby has a high risk of developing pneumonia and eye diseases.

The domestic route of transmission of such an infection is not excluded, but it is unlikely. This is justified by the fact that these pathogenic bacteria die very quickly when they find themselves outside the human body.

Moreover, for a full infection to occur, a large number of active chlamydia must enter the body. Otherwise, infection will not occur.

After chlamydia enters the body, the incubation period begins. It may take one to three weeks for the first symptoms to develop.

Symptoms of trichomoniasis

The manifestations and general symptoms of trichomoniasis are not much different from traditional pathologies of the genitourinary system. Moreover, very often this infection is confused with gonorrhea, since the signs of these pathologies are also quite similar.

Reference! The form of its course plays a very important role in the characteristics of the manifestation of trichomoniasis. Thus, a person can have an acute infection, a chronic infection, or a condition such as carriage, when a man or woman does not get sick themselves, but can infect other people.

The acute type of infection is manifested by pronounced symptoms.

Women may experience the following symptoms:

In men, the acute form of this disease can provoke the following symptoms:

Weakness and pain when urinating.
Decreased sexual desire and prostate problems.
Burning during intimate intercourse.
The appearance of unpleasant discharge from the urethra, which most often occurs in the morning.
Fever and increased body temperature occur when the immune system is weakened, when infections are very easy to infect the body.

In the chronic form of trichomoniasis, it has the same symptoms as in the acute form, but they are mild and a person may not even pay attention to them.

As a rule, the chronic form of such a disease is detected only when it begins to cause dangerous complications. That is why infectious disease specialists strongly recommend regularly taking a preventive test for trichomoniasis, even if a person, at first glance, is not bothered by any signs of pathology.

In the event that a person is only a carrier of such a disease, then the least harm is caused to his body. Thanks to a strong immune system, he will not suffer from the consequences of trichomoniasis, however, in the event of a sharp decrease in immunity, the disease can again acquire an acute form.

Symptoms and signs of chlamydia

Chlamydia (trichomoniasis, its symptoms are very similar to this disease) is characterized by a sluggish course, so most patients find out that they are infected by accident.

This infection can occur in acute and chronic forms, each of which has its own symptoms.

During an acute course, men may develop the following signs of the disease:

Hyperemia of the urethra and its severe inflammation.
Swelling of the glans penis.
The appearance of unpleasant mucous or purulent discharge from the urethra.
Pain when urinating.
General deterioration in health and fever.
Weakness.

Attention! In its advanced form, chronic chlamydia in men will not cause acute symptoms, but it can provoke the development of prostatitis, proctitis and urethritis.

In women, acute chlamydia usually manifests itself with the following symptoms:

Discomfort during sexual intercourse and pain during urination.
Inflammation of the genital organs.
Drawing pain in the lower abdomen.
The appearance of vaginal discharge of a specific nature.

Carefully! Untreated chlamydia, in both men and women, can cause a very dangerous complication in the form of infertility.

That is why it is important to respond to its manifestations in a timely manner and treat this disease.

It should also be noted that sometimes such an infection may not manifest itself at all for a long time, that is, it may proceed without symptoms. For this reason, every six months both sexual partners need to undergo a preventive test.

Treatment of chlamydia

Treatment for detecting chlamydia largely depends on the form of the disease, its neglect, symptoms and the presence of concomitant pathologies in a person. Thus, therapy is selected for each patient individually.

Treatment of chlamydia is aimed at suppressing the activity of chlamydia and preventing the development of dangerous complications.

It is worth remembering that chlamydia itself is highly resistant to many drugs, so therapy must be monitored by a doctor and the drug replaced with another if it is not effective enough.

The following drugs can be used to eliminate chlamydia:

Medicines Doxycycline and Azithromycin. They are most often used for treatment of chlamydia. Usually, they are prescribed in combination and used for several weeks.
Macrolide antibiotics (Rifampicin) are considered very effective. The duration of their use for acute infection should be at least two weeks. In the case of a chronic disease, a person needs to take such drugs in courses.
For general support of the body, the patient must be prescribed immunomodulatory drugs.
Additional drugs that can be prescribed for chlamydia are: Claditz, Metacycline, Lomefloxacin. The dosage and method of administration are selected separately for each patient.

You cannot self-medicate the disease.

Treatment of trichomoniasis

The following drugs are commonly used to treat trichomoniasis:

The regimen for taking these drugs and the duration of treatment is selected individually for each patient.

Also, as a supplement, local and symptomatic therapy can be carried out.

Conclusion

Chlamydia and trichomoniasis, the treatment of which must be supervised by a doctor, requires maximum endurance and patience from the patient, since general therapy is often lengthy and complex.

A combined “bouquet” of sexually transmitted diseases is caused by several reasons: people’s reluctance to use barrier contraception, unreasonable trust in a partner, irresponsible attitude towards their own health, etc. As a result, some patients consult a doctor with several diseases at the same time, including gonorrhea, trichomoniasis , chlamydia.

Sexually transmitted infections are quite common, as is their combination. Typically, men discover that they have an STD and seek medical help earlier than women. Diseases can become chronic and subsequently affect reproductive function.

Gonorrhea

urinary disturbance;
the appearance of pain when trying to urinate;
frequent urge to go to the toilet;
the appearance of thick discharge that has a yellowish-brown color and an unpleasant odor;
the formation of edema around the external opening of the urinary canal.

In the last century, gonorrhea was called gonorrhea, under this name it is sometimes found in specialized literature today. A particular danger is that the disease can be asymptomatic for a long time, while contributing to the development of infertility.

Antibiotics are used to treat gonorrhea. Such therapy is most effective in the early stages of the disease: if the disease has become chronic, then it is more difficult to get rid of it.

The doctor develops a treatment method that includes two areas:

strengthening the immune system: taking vitamins, immunomodulators, special medications;
actually eliminating the infection with the help of potent antibiotics, which are selected individually for each patient.

Another problem associated with this disease is that there are different types of the pathogen, including those that are not affected by antibiotics. Then the doctor selects a separate, combination therapy, including several drugs. After completing the course, repeated diagnostics are required, which should confirm the effectiveness of the methods used.

Trichomoniasis

Trichomoniasis is caused by the protozoan Trichomonas vaginalis, which affects the vagina in women and the urethra along with the prostate gland in men. The most common method of infection is sexual, it is also possible in the home, but its probability is very low and pathology is recorded extremely rarely.

The incubation period of trichomoniasis is a little more than a week, then obvious signs of the disease appear:

pain during urination and during sexual intercourse;
In men, the head of the genital organ itches when urinating;
discharge appears from the vagina and urethra, which has a characteristic unpleasant odor;
streaks of blood may appear in the semen.

Without therapy, after a month the disease becomes chronic, which threatens the development of infertility, chronic vesiculitis and prostatitis.

Treatment of trichomoniasis is carried out comprehensively or individually. Antitrichomonas drugs are initially prescribed. This is metronidazole, which is taken 2 grams once or 500 mg twice a day. The course lasts about a week.

The product may be sold under other commercial names:

"Aquametro";
"Trichazol";
"Medazol";
"Metronidazole Nycomed";

"Klion";
"Trichopolus".

Local treatment in this case is ineffective.

When the chronic form develops, combined methods are used, including additional immunostimulating drugs, physiotherapy, antimicrobial therapy, restorative drugs, and others.

Chlamydia

This disease is caused by a group of organisms that occupy an intermediate position between the bacterial and viral forms - chlamydia. The pathogen affects the human genitourinary system and, developing over 1–3 weeks, manifests itself in the form of symptoms:

the appearance of unusual discharge from the urethra in the morning;
weakness;
slight increase in body temperature;
itching and pain during urination;
pain in the lower abdomen in women;
bleeding between periods.

Like the previous ones, it can develop without pronounced symptoms, which complicates its timely diagnosis and initiation of treatment. With prolonged development, chlamydia can spread further and lead to:

chronic inflammation of the urethra;
in women - inflammatory processes in the uterus and appendages and, as a result, infertility;
Reiter's syndrome, in which other body systems are affected, including joints, skin, eyes and internal organs, leading to the development of their pathologies.

Diagnosis of the disease is quite complex; the highest percentage of accuracy is provided by the polymerase chain reaction technique, which is used in medical institutions.

Drugs for the treatment of chlamydia depend on the severity of the disease. In acute, uncomplicated cases, oral or doxycycline 100 mg is prescribed twice a day for a week.

Azithromycin in pharmacies can be sold under the brand name:

"Azitrox";
"Zitrolide";
"Azivok";
"Azitral";
"Sumizid";
"Sumamed";
"Hemomycin."

In addition to doxycycline, chlamydia can be treated with analogue drugs:

Apo-Doxy,
Vibramycin;
Doxal;
Medomycin;
Unidox Solutab.

In case of chronic development of the disease, antibiotic therapy is supplemented with immunotherapy, physiotherapy and other methods.

Combination in a “bouquet”

This group of diseases rarely affects a person alone; most often STIs occur in combination: gonorrhea with trichomoniasis or gonorrhea with chlamydia. In this case, the symptoms can differ significantly, and accordingly, the treatment method also differs.

Gonorrhea and trichomoniasis represent an interesting form of existence in which trichomonas can ingest gonococci, but do not digest them. The latter retain the ability to reproduce and develop further, resulting in the formation of an asymptomatic but rather dangerous disease.

Medicines for the simultaneous treatment of both diseases are:

Ceftriaxone 250 mg administered intramuscularly in combination with 1000 mg Metronidazole, taken in two doses during the day for a week.
Instead of Metronidazole, Tinidazole 2 grams orally or Ornidazole in the same dose, divided into 4 parts during the day, can be used.
In the case of chronic development of both diseases, an intramuscular injection of Solcotrichovac, half a milliliter, is initially used after two weeks, and then Metronidazole with antigonorrhea drugs.
Metronidazole is used as a local remedy in the form of vaginal balls or vaginal pellets.

Therapy for gonorrheal-chlamydial infection includes the use of one of the combinations:

Ceftriaxone 250 mg intramuscularly once in combination with Doxycycline tablets 100 mg twice a day for a week.
Ceftriaxone 250 mg intramuscularly once together with Azithromycin orally 1 gram once.
Ceftriaxone 250 mg intramuscularly once along with Erythromycin 0.5 grams four times a day for 10 days.
Ciprofloxacin orally 0.5 grams per day for 10 days.
Ofloxacin orally 0.8 grams per day for 1 – 2 weeks.

If pain appears at the end of urination, it means that the infection has gradually spread higher up the urinary canals, causing complications. This situation requires separate treatment.

The combination is quite common, since these microorganisms are able to live in symbiosis. In such cases, doctors prescribe the parallel use of antibiotics that destroy Trichomonas and antiprotozoal drugs to eliminate chlamydia.

Prevention

Preventive measures for all three and chlamydia are the same. This is a series of procedures:

Using condoms during sexual intercourse.
Maintaining a relationship with one sexual partner.
In case of infection, both partners undergo treatment together.
Visit a gynecologist and urologist regularly.
Monitor the condition of the genitals, paying attention to unusual discharge.

By following these rules, the risk of infection is reduced to a minimum.

Here is my tragic story. In 1990, trichomoniasis was discovered, the discharge was strong and the smell was clearly different, different from normal discharge. Treated with antibiotics, cystitis and pyelonephritis (kidneys) began, which were treated again with antibiotics. P.F. didn’t live long. I changed my partner, and he got trichomoniasis several more times, then we were treated together. In 1999, my husband and I wanted a child, I got tested with a fool just like that (I didn’t worry about anything, I felt like a healthy woman) - PCR for all infections, they found ureaplasma, but they didn’t find it in my husband. She was treated alone with antibiotics. Result: decreased immunity, did not get out of throat diseases, flu, acute respiratory infections for six months, which did not go away on their own and the doctors again tried to treat it with antibiotics (well, they have no other methods!). For a year I took the PCR test for ureaplasma again 3 times, everything was fine, and a year later they found it again. I decided to get treatment with my husband (I thought that he was a carrier, but he was infecting me). Together we took another course of antibiotics, checked me right away, and she was still sitting there. A sharp deterioration in health began, terrible cystitis (you pee after 10 minutes), your kidneys, gallbladder, liver and generally the entire gastrointestinal tract began to hurt (dysbacteriosis). Restoring with probiotics (bifidum, lacto-dry, but they grow very slowly and take a long time in the body). Then, a year later, I firmly decided to finish off the ureaplasma (with American natural preparations Vita Line), because... I thought that antibiotics weren’t killing her. WELL AND I GOT IT... EVERYTHING! Now I’m all sick, I have no living space, dysbiosis of the vagina, gastrointestinal tract, allergies to medications, fungi on the nails, terrible pain, it hurts to have sex, I avoid it (and my husband feels it). I’ve been suffering for 4 years now, I’ve spent even more money on examinations and treatments for everything that now hurts, but I haven’t been able to restore the body’s flora in 4 years, always one bacteria comes out, then another, then fungi. And I also developed an allergy to probiotics, especially liquid ones, which supposedly restore flora faster and more effectively. You know, in addition to everything that hurts, when you add scabies all over your body, your nerves can’t stand it! NOW I DREAM OF TURNING TIME BACK AND I WOULD NOT TREAT ANYTHING! I'VE BEEN SO BAD FOR ALMOST 5 YEARS! Yes, now I hear from many doctors that ureaplasma is considered an opportunistic flora, i.e. Everyone has it (as well as many other bacteria, streptococci, staphylococci, etc.) and when the body weakens, that is, immunity decreases, the growth of some type of bacteria occurs, if at that moment I take a fence from you, then it can detect, if she is taken away in a healthy state, she will not be detected. In general, modern doctors now say that even if ureaplasma is detected, but it does not bother you, there is no discharge, itching, pain, etc., then there is no need to treat it, because it is your own flora. If you fight it, the result may turn out to be disastrous, for example, like mine, although some endure everything without consequences. PS. By the way, bacterial inoculation is considered the golden mean, in contrast to PCR for any type of bacteria. In English, research methods are inoculation on a nutrient medium, and the polychain PCR reaction is polychain reaction.

“A bouquet of sexually transmitted infections” - this expression appeared thanks to the observation of doctors: when a person is diagnosed with one sexually transmitted infection, there is a high probability that he will be diagnosed with several more diseases in this area. Such people first “collect” sexually transmitted infections from different partners, and then at once “gift” someone with the collected bouquet.

Very often, “in the same company” there may be chlamydia, mycoplasma, ureaplasma, gonococci, trichomonas, candida, herpes, human papilloma and even treponema - the causative agent of syphilis. Doctors call such cases mixed infections.

The problem is that together these diseases manifest themselves and behave differently than individually. Some “help” each other - they hide their accomplices from the human immune system and create more comfortable living conditions for them.

Chlamydia, mycoplasmosis and ureaplasmosis

Mycoplasma and ureplasma are intracellular microbes (Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum) that are sexually transmitted. Usually they live in the body of a healthy person, without causing disease, and are activated only when the immune system is weakened, including by other microorganisms.

Up to 90% of cases of ureaplasmosis occur as part of mixed infections. Chlamydia can become the trigger that will undermine the health of the genitourinary system and create a comfortable climate for the development of myco- and ureaplasmosis.

Let's see how these diseases manifest themselves together and how they are treated.

Manifestations of chlamydia in combination with myco- and ureaplasmosis

All 3 pathogens cause inflammation of the mucous membranes of the genitourinary tract. In men, the main manifestation of both chlamydia and myco/ureplasmosis is urethritis (inflammation of the urethra).

There are universal signs of urethritis, regardless of which bacterium caused the inflammation:

itching, burning and pain in the urethra during and outside urination;
pain in the perineum, which radiates to the rectum and intensifies during sex;
redness and swelling of the mucous membrane of the external opening of the urethra.

In women, these bacteria most often spread through the genital tract and lead to low-grade inflammation in the cervix (endocervicitis).

Inflammation of the female genital organs is manifested by nagging pain in the lower abdomen and unusual vaginal discharge (more abundant than always, of an unusual color or with an unpleasant odor).

All 3 types of microorganisms can spread through the genitourinary tract to other pelvic organs and lead to infertility in men and women. The most dangerous thing is that there may be no external signs of the disease at all.

All 3 pathogens can lead to infertility in men and women

What tests are needed?

Considering how similar the symptoms of these diseases are, you should always remember: if a person is found to have chlamydia, myco- and ureplasmosis cannot be ruled out.

To detect the causative agents of all three infections, the PCR (polymerase chain reaction) method is suitable. This is a rapid analysis, thanks to which you can accurately determine the presence of microorganisms even in a small amount of any biological fluid. Its only drawback is its high cost.

If the analysis reveals myco- or ureaplasma, but not chlamydia, then a bacteriological analysis (culture) will also have to be carried out.

To do this, one of the patient’s fluids, which may contain specific pathogenic bacteria (urine, mucus from the genital tract or fluid from the prostate), is dripped into a flat test tube with nutrients (Petri dish). After this, the test tube is placed in a warm place and what happens in it is observed for several days/weeks.

If there were bacteria in the liquid, then in warmth and satiety they will begin to multiply, and visible accumulations of microorganisms (colonies) will form in the cup.

This method helps to estimate the number of bacteria and understand how they affect the symptoms of a particular patient.

Treatment of chlamydia and ureaplasmosis

This version of the bouquet is treated with the same medications.

You can treat 3 infections at once with one of the following medications in tablet form:

Doxycycline (orally 100 mg 2 times a day, course of 7 days),
Josamycin (orally 500 mg 3 times a day for 7 days), or
Azithromycin (orally 1 g once).

Cure of chlamydia, ureaplasmosis and mycoplasmosis will cost from 70 to 1,500 rubles, depending on the antibiotic and the need for re-treatment - if the first course of medication did not help completely.
The likelihood that after treatment a person will get rid of myco- and ureplasma, but chlamydia will remain, is small, but still there. Therefore, after treatment, it is extremely important to re-take tests and check how effective it was.

Chlamydia and gonorrhea: who is in charge and who is in the wings?

The causative agent of gonorrhea - Neisseria gonorrhoeae, aka the microbe gonococcus. Under a microscope, gonococci look like coffee beans. Gonorrhea can affect the internal genital organs (uterus and appendages in women, prostate in men) and lead to dangerous complications - for example, causing peritonitis (an infection in the abdominal cavity) and sepsis (the entry of many bacteria into the blood).

How does this pair of diseases manifest?

Gonorrhea usually manifests itself brightly and violently:

pus or mucus mixed with pus is abundantly discharged from the genitourinary tract;
the genitals become red, itchy, or even painful;
Symptoms of general intoxication of the body may appear (fever, weakness, fatigue).

Gonorrhea can also affect the internal genital organs: the uterus and its appendages in women, and the prostate in men. Also, gonococcus can actively multiply directly in the abdominal cavity, causing peritonitis (inflammation of the lining of the abdominal cavity), and even enter the blood, which can cause sepsis (blood poisoning). These two complications are extremely dangerous and can lead to the death of the patient.

Gonorrhea can cause peritonitis and sepsis. These complications are very dangerous and can lead to the death of the patient.

In the case of peritonitis, the symptoms simply “scream” about the presence of infection and inflammation:

abdominal pain appears and then constantly intensifies;
abdominal muscles are tense;
general health worsens: headache and weakness are tormented, the temperature rises, there is a lot of chills, and cold sweat may appear periodically.

The onset of sepsis manifests itself as general intoxication - the patient loses appetite, his blood pressure decreases, chills, interruptions in heart function and shortness of breath appear.

At the same time, chlamydia itself, against the background of gonorrhea, is often asymptomatic, and even if it does manifest itself, it behaves much more modestly than the “neighbor.” Therefore, if a person is infected with both gonococcus and chlamydia at the same time, then there is a high risk that doctors will suspect gonorrhea and, based on the test results, will prescribe antibiotics only against gonococcus.

After treatment for gonorrhea, the symptoms of chlamydia will be mild, and a person may mistake them for “echoes” of previous gonorrhea. In such a situation, it is very easy to leave the symptoms of chlamydia without proper attention. As a result, the patient may waste time and later face a number of complications, including infertility.

Chlamydia against the background of gonorrhea is often asymptomatic

What tests are needed?

If you suspect gonorrhea, it is extremely important to test for chlamydia. The optimal diagnostic method in this case will be the same PCR - it will help identify the causative agents of both infections.

Treatment of gonorrhea and chlamydia

Will it be possible to get by with just one antibiotic for this couple? Unfortunately no. The thing is that these bacteria are very different in their structure: they have different weak points - therefore, they need drugs with different mechanisms of action.

To cure gonorrhea, you need:

Take one of the following tablets orally once:

Cefixime (400 mg),

Ciprofloxacin (500 mg),

Ofloxacin (400 mg);

or give a single intramuscular injection of Spectinomycin (2.0 g).

To cure chlamydia, you need (on the same day):

take Azithromycin (1.0 g) orally once;
or start a course of Doxycycline (100 mg 2 times a day for 7 days).

The cost of two-component treatment is 300-1500 rubles.

Chlamydia and trichomoniasis

Among women Trichomonas live mainly on the external genitalia and vagina, causing inflammation. From there, Trichomonas can penetrate the cervix and cause endocervicitis. Then the woman will be bothered by pain in the lower abdomen and bleeding outside of menstruation. Further spread of trichomonas to the uterus and its appendages threatens infertility.

In men Trichomonas most often colonize the urethra and prostate gland, causing urethritis and prostatitis. But sometimes they do not cause obvious inflammation. These diseases lead to problems with urination, impaired potency and infertility.

But how does the pair “trichomoniasis - chlamydia” behave?

Trichomonas vaginalis

Manifestations of chlamydia against the background of trichomoniasis

In the “single variant” trichomoniasis manifests itself:

yellow-green foamy discharge mixed with pus from the genital tract;
itching in the perineum;
unpleasant sensations when urinating;
pain during sex;
redness and a characteristic “strawberry” appearance of the mucous membranes (due to pinpoint hemorrhages).

Against this background, the symptoms of chlamydia may go unnoticed

Trichomonas is extremely harmful to the body, especially in the form of a mixed infection:

it secretes a substance with which it loosens the tissues of the genitourinary tract and penetrates deeper, and also helps other microbes, including chlamydia, penetrate there;

it is able to evade the protective forces of local immunity;

Trichomonas can harbor various microorganisms (gonococci, chlamydia, ureaplasma, mycoplasma, etc.). At the same time, Trichomonas protects them from the immune system and from antibiotics. Such “friendly relationships” between microbes can make treatment ineffective and lead to re-exacerbation of additional infections, in particular chlamydia.

What tests will be needed?

We have already described above how to identify chlamydia. To detect Trichomonas, several methods are used, the most accurate of which are: microscopy (examination of a smear from the genital tract under a microscope) - an accurate, fast method, but dependent on the skill of the laboratory technician, and PCR - an automated, but more expensive method.

To identify Trichomonas, a cultural method is also used - sowing biological material on a nutrient medium. This is a reliable method, but it takes a lot of time (about a week).

Treatment of trichomoniasis

For a mixed infection (trichomoniasis plus chlamydia) there are two ways to proceed:

or carry out simultaneous treatment of both diseases;
or first - trichomoniasis, and then - chlamydia.

For treatment it is enough:

take one of the antiprotozoal tablets orally once:

Metronidazole (2.0 g),

Ornidazole (1.5 g),

and one of the antibiotics for the treatment of chlamydia (see above or in the article “Treating Chlamydia”).

Such treatment will cost 200-1500 rubles.

The peculiarity of all the described infections is that it is impossible to accurately determine the pathogens based only on the symptoms, because the manifestations of the listed diseases are very similar to each other. Therefore, if you suspect one sexually transmitted infection, it is better to get tested for all others.

Tests for mixed infections differ greatly from each other and depend on the pathogens that are considered to be the cause of the disease.

The PCR method is the basis for the diagnosis of mixed sexual infection, including chlamydia. However, in some cases, culture (bacteriological examination) is necessary. It will allow us to determine how vulnerable the detected microbes are to different antibiotics.

Both tests are quite expensive: PCR - about 350-400 rubles (for each pathogen), and culture of mucus from the genital tract with determination of sensitivity to antimicrobial drugs - from 1000 to 2500 rubles.

When the entire composition of the bouquet is known, it is necessary to undergo complex treatment from a dermatovenerologist. You cannot engage in self-diagnosis and self-medication! All drugs have contraindications, and comparing information from the instructions and correctly applying it to a specific person is not easy; this requires professional medical training.

Some mixed infections can be cured with one drug, but most combinations will require a combination of several antibiotics. For example, when treating mixed infections, including trichomoniasis, drugs are added to destroy protozoan microorganisms (antiprotozoals).

Many tests and medications for these diseases cannot be called cheap. But it is important to understand that treating a venereal mixed infection in time is much cheaper than later treating the complications of an advanced disease.

Also remember that after a course of medication, you must repeat the tests - this is the only way to make sure that the treatment has completely helped.

Features of the manifestation of urogenital ureaplasmosis

The group of sexually transmitted infections includes urogenital ureaplasmosis. This is a disease characterized by damage to the urinary tract and genital organs in women and men. Ureaplasma infection occurs in a chronic form and often leads to complications such as impotence and infertility.

Ureaplasma infection in men and women

Urogenital ureaplasmosis is a widespread disease. This pathology is often combined with chlamydia, gonorrhea, trichomoniasis and syphilis. This is a type of mycoplasmosis.

Mostly young people aged 14–29 years are affected. The reason is an active sex life. The disease occurs in acute and chronic forms.

Many people are asymptomatic carriers of the infection. There are no clinical signs, but the sick person is dangerous to his partners. In women, symptoms are less pronounced. Ureaplasmosis is diagnosed in almost every 4 pregnant women. The presence of this infection can cause the following pathology:

Most often, the disease lasts a long time.

Main etiological factors

The causative agent is ureaplasma urealyticum. These microorganisms have the following characteristics:

Ureaplasmosis is transmitted from one person to another through contact. The main routes of transmission of infection are sexual, household contact and vertical. With unprotected sexual relations, the risk of infection is highest. Between 20 and 40% of those infected become carriers. People with weakened immune systems develop acute ureaplasmosis.

Transmission of the pathogen occurs through oral, vaginal and anal contact. The contact and household method of infection cannot be ruled out. Donation items can include towels, someone else's underwear and washcloths. Ureaplasma can get on the genitals when swimming in pools, visiting bathhouses, and through contact with a toilet lid contaminated with the urine of a sick person.

Sometimes the disease is diagnosed in children. The reason is infection of the child from a sick mother during childbirth. Risk factors for the development of ureaplasmosis in women and men are:

lack of personal hygiene;
using someone else's towels;
wearing someone else's underwear;
onset of sexual activity in adolescence;
unprotected sex;
previous STIs;
indiscriminate choice of sexual partners;
decreased immunity.

The risk group includes teenagers and young adults, drug addicts, alcoholics, girls of easy virtue and sex workers.

How does ureaplasmosis occur?

The disease often develops asymptomatically. Ureaplasmosis in women can occur as urethritis. Inflammation of the urethral mucosa occurs. The following symptoms are observed:

The pain intensifies with urine excretion. Chronic colpitis often develops. The vagina becomes inflamed. This manifests itself as mucous, mucopurulent or bloody discharge from the genital tract, hyperemia and swelling of the mucous membrane and pain in the lower abdomen. The discharge is scanty. They may smell unpleasant.

In the chronic course of ureaplasmosis, complaints are mild. General health does not suffer. Some sick women experience discomfort during sexual intercourse. In the absence of proper treatment, the infection penetrates the uterus and appendages. Adnexitis and endometritis develop. Damage to the uterus can result in infertility.

Chronic adnexitis against the background of ureaplasmosis during the period of exacerbation is manifested by low-grade fever, pain in the lower abdomen, weakness and menstrual irregularities. Men develop cystitis. It is manifested by frequent mictions and pain in the pubic area. Urethritis in men is more severe due to the fact that their urethra is longer and narrower than that of women.

Burning, stinging and pain are observed. There may be mucous discharge. In severe cases, ureaplasmosis leads to orchitis (inflammation of the testicles). Appendages are involved in the process. Orchiepididymitis develops. It manifests itself as heaviness and pain in the scrotum. Penetration of microbes leads to the development of prostatitis.

Inflammation of the prostate gland is characterized by soreness in the perineum, pain while sitting, decreased libido and discomfort during sexual intercourse. This condition is called dyspareunia. Erectile dysfunction may develop against the background of prostatitis. Chronic prostatitis and orchiepididymitis, if left untreated, can cause infertility.

Patient examination plan

Before treatment, the following studies are carried out:

microscopy of smears from the urethra, vagina and cervix;
general clinical tests;
biochemical blood test;
gynecological examination;
bacteriological examination;
sowing the material on a nutrient medium;
polymerase chain reaction;
serological study.

Before taking a smear, the patient must prepare. You cannot urinate for at least 2 hours, abstain from sexual intercourse for a while, and refuse douching, suppositories and gels. There is no need to wash yourself before taking the material. If a ureaplasma infection is suspected, a PCR test is required. It reveals the genome of the pathogen. Additionally, serodiagnosis is carried out. Its goal is to detect specific antibodies.

Treatment tactics

The view of modern doctors on the treatment of this disease is the same. The main aspects of therapy are:

For ureaplasma infection, macrolides, fluoroquinolones and tetracyclines are effective. Drugs such as Doxycycline-Akos, Doxal, Ecomed, Azithromycin Forte, Sumamed, Hemomycin and Vilprafen are used. These medicines have received the best reviews from doctors and patients. When ureaplasmosis is combined with trichomoniasis, 5-nitroimidazole drugs are additionally prescribed.

These include Naxogin, Klion, Metrogyl, Trichopolum, Metronidazole Nycomed, Tinidazole-Acri, Tiniba and Tiberal. Additionally, immunostimulants are included in the treatment regimen. These include Immunal and Pyrogenal. Lidaza is often prescribed. Treatment is carried out in relation to the sick person or his sexual partner.

Additionally, it is recommended to take vitamins and eat a healthy diet. It is necessary to enrich the diet with animal proteins, fruits and vegetables. It is necessary to limit the consumption of spicy foods, sweets and alcohol. Along with antibiotics, you can drink herbs (lungwort, yarrow). Physiotherapy (magnetic therapy) is indicated.

A month after the end of treatment, control laboratory tests are carried out. With timely treatment, the prognosis is favorable. Prevention of the disease consists of excluding casual relationships, using a condom, refusing to wear other people's underwear and use other people's towels, as well as using antiseptics. Thus, ureaplasmosis is diagnosed very often and can cause male and female infertility.

What is the difference between mycoplasma, ureaplasma, chlamydia and trichomoniasis?

Ureaplasmosis, mycoplasmosis, chlamydia, trichomoniasis are sexually transmitted diseases, the prevalence of which is so widespread among the world's population that some doctors equate it to a flu epidemic. “Why does this happen, and how to prevent it?” - questions that are increasingly heard at health symposiums and forums.

One of the reasons for the global prevalence of chlamydia, mycoplasma, and ureaplasma is considered to be its latent, asymptomatic course. Quite often, a person simply does not suspect that he is a carrier of the infection, infecting his sexual partners and spreading ureaplasmosis, mycoplasmosis, chlamydia and trichomoniasis into society.

Doctors call the second good reason the lack of basic knowledge of many people about infections such as chlamydia, mycoplasma, ureaplasma, trichomonas, which are sexually transmitted and can cause serious diseases leading to severe complications.

As modern medical practice shows, when examining patients for carrier infections, a single type of parasite is rarely detected. Most often, there are several identified infections. For example, often detecting chlamydia, ureaplasma, mycoplasma are also detected.

Chlamydia. Symptoms and treatment of chlamydia

Clinical picture

Chlamydia is diagnosed in several ways. But PCR is recognized as the most reliable method. Treatment of chlamydia must begin immediately after the infection is detected, otherwise it is fraught with severe complications

For the treatment of chlamydia, a complex of medications is used, which are selected and prescribed by a doctor. The healing process takes a long time, because chlamydia living inside the host cells is reliably protected from the chemical attack of antibiotics. Both sexual partners are treated. Re-infection cannot be ruled out, since the body does not develop stable immunity to infection.

If chlamydia is not treated or if you do it yourself (which rarely leads to a positive result), then serious complications are possible over time:

Epididymitis (inflammation of the epididymis in men);
Inflammation of the appendages and uterus - in women;
Reiter's syndrome (inflammation of the cervix, urethra, joints and eyes) and many others;

Mycoplasma and ureaplasma. How are mycoplasmosis and ureaplasmosis treated?

Despite the diversity of mycoplasma species, only some of them pose a danger to human health. Possessing opportunistic mycoplasma flora M. pneumonia, M. hominis, M. genitalium, with decreased immunity they can cause urogenital or pulmonary mycoplasmosis. The infection is transmitted sexually, by airborne droplets and vertically.

If an infected patient does not have an inflammatory process, then treatment of an opportunistic infection is most often not prescribed. This feature of ureaplasmosis and mycoplasmosis distinguishes them from diseases such as chlamydia and trichomoniasis, which require immediate treatment.

If painful symptoms appear in the form of scanty discharge from the vagina or urethra, burning during urination, itching, you should consult a doctor for examination and treatment. Therapy for mycoplasmosis and ureplasmosis is carried out with antibiotics. Complications of these diseases can include infertility, kidney stones and many other infectious and inflammatory processes.

Treatment and symptoms of chlamydia, ureaplasmosis and mycoplasmosis