Gardnerellosis: causes of the disease, diagnosis, consequences and treatment

Gardnerellosis is a disease caused by an excess of the bacterium Gardnerella vaginalis in the vaginal microflora. The disease is not venereal and in most cases is caused by failures in the internal processes of the body, or by external factors that provoke dysbiosis of the microflora.

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The disease is typical for women, since gardnerella is a bacterium that lives in the microflora of the vaginal mucous tissues. However, the bacteria can also be transmitted to men through sexual contact. If a man is completely healthy, exposure to bacteria in most cases does not pose significant risks.

The gardnerella bacterium was identified only in 1955; at the moment, effective drugs have been developed to help destroy it and stabilize the state of the microflora. But no one is immune from the appearance of gardnerellosis, and the disease itself can cause both significant discomfort and significant harm to health if the necessary measures are not taken in time.

What is the bacterium Gardnerella vaginalis

The content of the article

Gardnerella vaginalis is a coccobacilli from the family of opportunistic microorganisms. It is always present in minimal quantities among other bacteria that make up the vaginal microflora. When creating acceptable conditions for reproduction, it begins aggressive division, simultaneously destroying beneficial bacteria that form the basis of healthy microflora. Capable of maintaining vital activity in secretions for up to 6 hours, in the form of spores it is viable for up to 1 year.

Despite the aggressive nature of the bacillus, its presence in the flora at acceptable levels does not pose any risks and, on the contrary, helps to normalize acidity levels and other environmental parameters. But if the indicators are exceeded, immediate treatment is required.

Features of the bacterium

Gardnerella are bacteria that are constantly present in the female body. Microorganisms of the species Gardnerella vaginalis are present directly in the vagina. These microorganisms can maintain their activity in both anaerobic and aerobic environments, but the preferred condition is the absence of oxygen. Normally, the number of Gardenella is limited by the activity of lactobacilli, the content of which in the microflora reaches 95%, however, under certain pathological conditions, conditionally pathogenic bacteria begin to multiply. At the same time, gardenella creates optimal conditions for the spread of other infectious agents into the vagina.

Risks and manifestations of Gardnerellosis

When Gardnerella is contained in quantities comparable to the permissible norm, no negative symptoms, pain or other deficiencies are detected. However, with a significant increase in the number of microorganisms, the following symptoms may appear:

• An unpleasant smell of discharge appears, similar to the smell of rotten fish;
• In acute stages, cloudiness and discoloration of vaginal discharge are observed;
• Deterioration of the immune system, frequent colds, inflammatory diseases;
• Disturbance of the intestinal mucosal flora, accompanied by unpleasant sensations and changes in stool (acute form of the disease).

The destructive effect of the bacterium Gardnerella vaginalis is that the bacilli damage the epithelial tissues of the mucous membrane and provoke the dissolution of phagocytes, which act as a barrier to pathogenic microorganisms in the body.

Vaginal dysbiosis caused by gardnerella can develop into an infection of the genitourinary system if timely measures are not taken. Gardnerellosis can also cause inflammatory vaginitis, which causes discomfort, pain and burning during urination. If these symptoms appear, you should immediately contact a specialist.

Diagnostics

To undergo the examination, you must make an appointment with a gynecologist. During the appointment, the doctor will ask the patient about her complaints, collect anamnestic data and conduct an instrumental examination of the genital organs. During the examination, the specialist also collects vaginal secretions for laboratory tests. It is important to understand that one symptom of vaginosis does not allow a diagnosis, since many genitourinary infections have similar manifestations.

Required laboratory tests:

• Staining and microscopic examination of the smear. This test allows doctors to determine the approximate proportion of bacteria in the vaginal microflora.
• Assessment of the acid-base balance of vaginal discharge. With bacterial vaginosis, this indicator shifts to the alkaline side.
• Amine test to detect chemicals produced by anaerobic bacteria.
• Determination of the sensitivity of pathological microflora to antibiotics.
• Test for sexually transmitted infections.

Diagnostic procedures performed in different clinics may differ, but it is important to understand that confirmation of the presence of gardnerella in a smear does not indicate the presence of vaginosis. These bacteria are often present in the female microbiome and begin to actively multiply only in the presence of unfavorable factors. In this regard, it is important to determine the ratio of bacteria in the microflora and look for indirect signs of dysbiosis.

Gardnerellosis during pregnancy

The greatest danger is a sharp exacerbation of gardnerellosis during pregnancy. Statistics show that pathology occurs in approximately 20% of women during pregnancy. Thanks to the body's natural defense mechanisms, actively stimulated during pregnancy, infectious processes are often suppressed at the initial stages by the body's immune system. However, if the immune system is weakened, the disease may develop, which in the future may have the following negative consequences:

• Complicated pregnancy;
• Increase or decrease in uterine tone;
• Damage to amniotic fluid by Gardnerella bacteria;
• Premature birth.

Considering all the risks, when planning a pregnancy, as well as during the period of bearing a child, it is worth regularly taking tests for gardnerellosis and other pathogenic microorganisms that can cause vaginal dysbiosis and other complications.

Also, it is worth remembering that gardnerellosis can be transmitted from mother to child (girl) during childbirth. Therefore, you should monitor your own health extremely carefully and take the necessary measures in a timely manner.

Gardnerella in women

Probiotics for gardnerella in women

After antibiotic treatment, medications are prescribed to restore vaginal flora.
Medicines are prescribed for oral administration and local use, containing beneficial bifidobacteria and lactobacilli.

Before starting to take probiotics, a control smear is performed on the flora in women to identify the amount of gardnerella and confirm its reduction to normal levels.

Preparations for restoring microflora in case of dysbiosis of the vagina and intestines after treatment with antibiotics:

• Linex capsules - prescribed to adolescents over 12 years of age and adult patients, 2 capsules three times a day, immediately after meals. The duration of treatment is up to several weeks; if necessary, the doctor extends the medication.
• Bifidumbacterin in powder form for oral administration - 2 sachets up to 3-4 times a day, at regular intervals. Before use, the sachet is dissolved in 50 ml of distilled water at room temperature or in fermented milk products (kefir, sourdough, yogurt). The duration of therapy is up to three weeks.
• Enterol - the medicine in powder form is diluted in 30 ml of warm water (hot water is not used, as beneficial bacteria die), capsules are consumed orally with water. Dosage – 1 capsule or 1 sachet of powder several times during the day. The course of therapy is up to 10 days.

For local treatment, vaginal suppositories are used:

1. I. Acylact - 1 piece is inserted into the vagina several times a day. The duration of treatment is from 7-14 to 20 days.
2. II. Lactonorm - vaginal tablets are administered 1 piece in the morning and evening for 7 days. If necessary, the duration of treatment is adjusted.
3. III. Lactobacterin - suppositories are prescribed 1 piece twice a day, up to 10 days.

The use of immunomodulatory drugs for gardnerellosis

Standards for the treatment of bacterial vaginosis also involve the use of agents to increase local and general immunity.

As a rule, interferon-based drugs are prescribed:

• Interferon suppositories (administered rectally, 1 suppository up to 2 times a day, for one to two weeks);
• Viferon suppositories (at a dosage of 500,000 IU, 1 suppository once a day; 1,000,000, 1 suppository once a day; duration up to 5 days, after a break of 5 days, treatment is repeated).

Diet for gardnerella in women

Adjusting your diet plays a big role.

Since the exclusion of harmful products and the increase in healthy ones, in particular fermented milk, can speed up the healing process and improve the disturbed microflora.

A woman should completely avoid alcoholic drinks, salted foods, smoked foods, spices, fatty foods, spicy, fried, and fast foods for the duration of treatment.

As well as baked goods and chocolate products.

The daily diet should be dominated by fermented milk products, such as sourdough, freshly prepared natural yoghurts, and cottage cheese.

You should also include vegetables and fruits in your food.

It is recommended to bake or boil vegetables, and prepare fruit juices.

In this way, it is possible to significantly increase the body's defenses and its resistance to infection.

All dishes should be cooked in a steamer or oven.

Important recommendations for the period of treatment of Gardnerella

It is very important to avoid sex before starting treatment.

Also, during the course, after therapy, it is necessary to use barrier contraceptives.

After completing antibiotic therapy, follow-up tests should be taken to monitor the condition.

Repeated diagnosis is required one to one and a half months after the end of Gardnerella therapy.

How is gardnerella treated in pregnant patients?

When diagnosing gardnerellosis during pregnancy, the treatment regimen is slightly different.

Taking antibacterial drugs during the first trimester is strictly contraindicated.

Since the influence of medications negatively affects the developing fetus.

As a rule, even during the second and third trimesters, antibiotics are used in extremely severe and advanced cases.

The dosage is prescribed on a strictly individual basis.

More often, the gynecologist prescribes Metronidazole vaginal tablets, which are administered 1 piece in the morning and evening.

Duration of treatment is from 7 to 10 days.

If mild symptoms occur, probiotics are prescribed for oral and vaginal administration.

The products allow you to normalize the disturbed microflora.

The drugs and dosage are used according to the same scheme as for non-pregnant women.

Suppositories containing interferon are used, but only after the 14th week of pregnancy.

To monitor the dynamics of the condition during pregnancy, the patient is prescribed a monthly examination during which a smear is taken for analysis.

The study makes it possible to control the growth of Gardnerella.

Treatment of gardnerellosis in girls

The development of vaginal dysbiosis in girls is associated with the use of antibacterial drugs.

Against this background, a disruption of the normal flora of the vagina and intestines occurs.

In girls, treatment consists mainly of the use of medications containing bifidum and lactobacilli.

In some cases, the use of local antiprotozoal drugs, such as Metronidazole ointment, is required.

Vitamin complexes are prescribed and fermented milk products are introduced.

Gardnerella in women: traditional medicine methods

For complex treatment, it is recommended to use traditional medicine methods.

If they involve the use of herbal remedies for instillation.

Before starting traditional therapy, you should consult with your gynecologist to ensure the necessity and benefit of this activity.

Most often, solutions are prepared from lavender, celandine, chamomile inflorescences, string, and oak bark.

These plants are medicinal.

They cope well with inflammatory processes and reduce itching.

Have a detrimental effect on pathogenic microorganisms.

At home, you can prepare a special phyto-tampon - a cotton swab should be thoroughly soaked in fresh aloe juice.

The product is inserted into the vagina every day before bed and left overnight.

The course of therapy is up to 7 days.

Local treatment by douching is carried out using the following solutions:

• douching with hydrogen peroxide 1% - restores acidity in the treatment of gardnerella, carried out twice a day, lasting 7-10 days;
• installations with chlorhexidine - several times a day for 5-7 days;
• rinsing the vagina with herbal mixtures (St. John's wort, chamomile flowers and sage are prepared together - the dried herbs are mixed, take 1 tablespoon of the raw material and pour in 1 tablespoon of boiled water, leave for 30-40 minutes).

Possible complications of tank vaginosis in women

Very often, a negligent attitude towards your health and postponing a trip to the gynecologist lead to serious consequences.

So, with a high content of gardnerella, the development of chronic bacterial vaginosis and other dangerous conditions is possible.

Their treatment will take longer and can cause infertility.

Complications of gardnerella in women:

• inflammatory damage to the renal tubular system;
• cystitis;
• endometritis, adnexitis;
• during the period of gestation, the risks of developing uterine bleeding increase, premature delivery or spontaneous miscarriage is possible;
• in women of reproductive age, gardnerella can cause infertility;
• diagnosing gardnerellosis in pregnant women can lead to the birth of a baby with low birth weight or its infection during passage through the birth canal.

You can avoid the serious consequences of vaginal dysbiosis by promptly seeking help from a qualified specialist.

The doctor will prescribe examinations and a subsequent treatment regimen.

For the purpose of prevention, it is recommended to take probiotics during antibiotic therapy and maintain genital hygiene.

You should avoid casual sex and sex without using a condom.

If you suspect gardnerella, contact the author of this article, a venereologist in Moscow with many years of experience.

How is gardnerellosis detected and diagnosed?

The disease is identified through the process of examining the patient’s biomaterials taken for analysis. In particular, when examined by a gynecologist or attending physician, you may need to undergo the following tests:

• A smear from the mucous membranes of the walls of the vagina and cervix;
• Urinalysis for suspected infection of the genitourinary system and ducts.

When receiving an analysis, pay attention to the following indicators

To increase the accuracy of diagnosis, it is recommended to do a smear and urine test simultaneously. If the bacterial content is within normal limits, but symptoms of gardnerellosis are observed, it is recommended to perform a second analysis a week after the first one to give the bacteria a period to develop and increase in number.

Causes of gardnerellosis

Gardnerellosis in most cases is provoked by external factors or is activated during the course of any diseases that can affect the balance of vaginal flora. Among the reasons that can provoke the development of the disease, experts name the following factors:

• Infectious sexual diseases - with sexually transmitted diseases, a concomitant complication is dysbiosis of the vaginal flora, as a result of which a sharp increase in the number of Gardnerella bacteria can be observed;
• Failure to comply with the rules of intimate hygiene - regular use of panty liners can affect the condition of the microflora. Untimely replacement of personal hygiene products during menstruation can also lead to dysbacteriosis;
• Hormonal disorders - hormonal imbalance provokes changes in the flora of mucous tissues, disturbing the balance of microorganisms. Hormonal imbalances can be caused by various diseases or the targeted use of hormone-containing drugs during treatment;
• Taking medications - various antibiotics used to treat infectious diseases can act on the vaginal flora, reducing the number of beneficial bacteria and causing dysbiosis. The same applies to various means of contraception, birth control pills, oral condoms;
• Intestinal dysbiosis – disturbances of the intestinal flora can become a catalyst for vaginal dysbiosis;
• Promiscuity in intimate relationships , frequent change of partners;
• Decreased immunity due to various diseases or general weakening of the body in winter, vitamin deficiency, etc.;
• Carrying out operations and invasive cosmetic procedures that can affect the balance of microorganisms.

Planning pregnancy with gardnerella

Despite the fact that with bacterial vaginosis it is allowed to have sex with a condom, it is not advisable to plan a pregnancy until the vaginal flora is restored. This is important because any immune malfunction in the female reproductive system can affect health. Untreated gardnerella develops candidiasis, inflammation of the genitourinary tract and kidneys in pregnant women, which is dangerous during pregnancy and can also cause miscarriage.

Therefore, it is best to postpone pregnancy planning until the end of immunomodulatory therapy, complete recovery and receipt of good tests after control diagnostics.

With gardnerella, a pregnant woman can and should be treated in the last month before giving birth to prevent infection of the newborn. During pregnancy, the vaginal microflora is very poorly restored. In this case, Gardnerella can infect the baby in utero.

Gynecologists at our center will help solve this problem. Patients will be prescribed medicinal douching. In this case, the course will be individual and will prepare the birth canal well.

Gardnerellosis in men

Gardnerella is a bacterium that cannot appear in a man’s body on its own, but it can be acquired during unprotected sexual intercourse with an infected woman. For men, infection with Gardnerella is not so scary, since if the body is healthy and there are no viral diseases or severe weakening of the immune system, most likely the bacteria will die and be eliminated naturally.

If the body is weakened, the bacterium can cause urethritis and cause significant discomfort. The disease is manifested by discomfort, burning and pain during urination. However, if you consult a doctor, the disease can be treated quickly and without consequences. It is worth remembering that a man can act as a carrier of gardnerella, and if a woman experiences frequent relapses after treatment for gardnerellosis, then the man should also be checked for the presence of microorganisms in the genitourinary system. This can be done by contacting a urologist; you will need to undergo a smear and urine test.

Which specialist should I contact for the treatment of gardnerellosis?

Gardnerellosis is not a sexually transmitted disease. This means that if symptoms appear, you should contact a gynecologist who will conduct an initial examination and take a smear for analysis. If the course of the disease is accompanied by an intestinal disorder, it is worth contacting a gastroenterologist, since gardnerellosis can be the cause of intestinal dysbiosis. Men with gardnerellosis should see a urologist.

If there is a suspicion that a sexual partner is also a carrier of Gardnellera bacteria, then the man should be examined by a urologist and also undergo the necessary tests to identify pathogenic bacteria.

Treatment of gardnerellosis

Granderellosis is quite treatable and the microflora can be normalized within 1.5-2 weeks, depending on the severity of the case and individual characteristics. Treatment takes place in two main stages:

1. Taking antibiotics to kill gardnerella bacteria . Antibiotics are selected by a specialist. When choosing, individual contraindications, the effectiveness of a particular drug, as well as general health are taken into account. You should not take any medications on your own; be sure to consult a doctor. A specialist can prescribe various types of antibiotic drugs. To increase effectiveness, topical antibiotics are used in the form of vaginal suppositories. Depending on the severity of the case, tablets may also be prescribed. An important point is the fact that when taking antibiotics, thrush may develop and a specialist, taking this into account, will prescribe suppositories to prevent it;
2. At the second stage, the microflora is restored. To do this, colonies of lactobacilli are colonized in the vagina, normalizing the environment and restoring the condition of the mucous membranes. Suppositories or douching are prescribed, which can also be prescribed by a specialist. The second stage begins only after the gardenerelles have been successfully destroyed; after a course of antibiotics, you will need to take the necessary tests.

During the treatment process, the specialist will prescribe a diet that will help stabilize the flora. In particular, it is recommended to consume lactic acid products, kefir, biokefir, yoghurts, etc.

It is strictly recommended to limit the use of:

• Spicy food;
• Fried food;
• Alcohol and tobacco.

The doctor may also prescribe medications to boost immunity. After all, a weakened immune system is unable to fight infections and inflammation.

During the entire treatment period, you should refrain from intimacy and ask your partner to also take tests and be checked for the presence of bacteria. A man can act as a carrier and after treatment it is quite possible to become infected again.

At the end of the course of treatment, repeated tests are taken, a control smear is done after 2 months. In most cases, drug treatment allows you to completely get rid of the problem. To prevent the disease in the future, you should be attentive to personal intimate hygiene, give preference to underwear made from natural materials, and be tested annually for pathogenic microflora. At the first signs of illness, discomfort, change in color or smell of discharge, you should immediately contact a gynecologist.

Treatment regimen for the disease

When determining the necessary course of treatment, the clinic doctor is guided by the data of diagnostic studies, allergy history, individual intolerance to drugs, and the presence of chronic pathologies. And here it is important to collect a thorough medical history, which the doctors at Polyclinic +1 successfully cope with. But for all patients with Gardnerella, the only common requirement will be for a treatment regimen in which they use:

1. Antibacterial drugs (Metronidazole, Clindamycin) in the form of tablets and ointments.
2. Hormonal agents.
3. Antiseptics for local treatment (Chlorhexidine).
4. Medicines containing lactic acid.
5. Symptomatic remedies.

Women can be prescribed Viferon, Vagitsin, Fluomizin, Banbakt, Neo-Penotran, Acylact suppositories, as well as daily visits to the treatment room for douching and baths with products that normalize the vaginal flora. Men may be offered rinses with furatsilin, chamomile decoction, a weak solution of manganese and disinfectants (Miramistin, Chlorhexidine) prescribed by a urologist.

For symptoms of gardnerella in women, the treatment regimen may be different for each patient. Treatment recommendations apply to two regular partners.

Features of bacteria in relation to antibiotics

Gardnerella is resistant to macrolides and tetracyclines, so before taking antibiotics it is necessary to test for resistance and sensitivity to specific drugs. Tablets and suppositories Metronidazole and Ornidazole are considered the best for treatment. Clindamycin is prescribed as an addition to the main antibiotic. This is how the best result is achieved.

What vaginal tablets can be prescribed?

How else can you treat gardnerella in women? In addition to suppositories, your doctor may suggest tablets for the vagina:

• Terzhinan (a mixture of antibiotic, antifungal agent and hormones);
• Klion-D (a combination of an antibiotic and an antifungal drug).

The course of therapy with the dosage of all medications is prescribed and fully supervised by a gynecologist.

ethnoscience

Drugs of this group are used as additional to the main therapy. A doctor's permission will be required here. Patients are recommended to use restorative teas, decoctions and infusions of medicinal herbs, douching, rinsing and baths.

For gardnerellosis, the following herbs are recommended: St. John's wort, chamomile, birch leaves, thyme, marshmallow, sweet clover, leuzea and mint. To boost immunity, you can brew rose hips, eat cranberries or viburnum. Inserting a tampon with tea tree oil at night helps a lot.