5301. Bacterial culture. Urogenital complex (Lactobacillus spp., Gardnerella vaginalis, Enterococcus spp., Staphylococcus spp., Streptococcus spp., Enterobacterales, Non-fermenters, Candida spp., and others). Automatic identification. Antimicrobial resistance pr

Urogenital culture. Complex – is a bacteriological test that makes it possible to detect pathogens of genital and urinary tract infections, determine the quantitative composition of the microflora, and assess its sensitivity to antibiotics or antifungal drugs (antimycotics).

The study helps identify the cause of inflammatory processes in the urogenital tract, evaluate the balance of microflora, and select effective therapy.

Automated identification of microorganisms is performed using MALDI-TOF mass spectrometry on the MALDI Biotyper sirius IVD System analyzer (Bruker, Germany).

Urogenital culture – complex allows for the detection of bacteria, yeasts, and other microorganisms that may cause infections of the genitourinary system, including: Lactobacillus spp., Gardnerella vaginalis, Enterococcus spp., Staphylococcus spp., Streptococcus spp., representatives of the order Enterobacterales, non-fermenting Gram-negative bacteria, and yeasts of the genus Candida.

In women of reproductive age, normal vaginal microflora is characterized by high density. The basis of normal vaginal flora (obligate microorganisms) consists of bacteria that are permanent residents performing protective, metabolic, and immunomodulatory functions, maintaining physiological balance: Lactobacillus spp., Bifidobacterium spp., Peptostreptococcus spp., Corynebacterium spp., Propionibacterium spp. They prevent colonization by pathogens. Anaerobes such as Prevotella spp., Porphyromonas spp., and Bacteroides spp. predominate in the deeper layers of the vaginal biofilm.

The composition of the microflora in women is dynamic and depends on the phase of the menstrual cycle, pregnancy, and age.

In men, the normal urethral microflora includes: Staphylococcus epidermidis, Corynebacterium spp., Streptococcus spp., Mycobacterium smegmatis, Enterobacterales, Candida spp. (in low quantities).

Microorganisms that may temporarily appear in both women and men, but are not always associated with pathology (facultative, conditionally pathogenic microflora), include: Gardnerella vaginalis, Staphylococcus spp., Streptococcus spp., Enterococcus spp., Candida spp., Enterobacterales, Mycoplasma hominis, Ureaplasma urealyticum.

The composition of the microflora is influenced by medication use (especially broad-spectrum antibiotics and hormonal drugs), hygiene habits, sexual activity, and age.

The determining factors in infection development are the state of the patient’s immune system, the infectious load, and the pathogen’s virulence.

In the presence of signs of an inflammatory process associated with sexually transmitted infections (STIs), bacterial culture testing may be recommended in accordance with international guidelines for urinary tract infections (UTIs). The analysis is performed using biological material collected depending on the patient’s sex and clinical symptoms – from the urethra, vagina, or cervical canal – strictly under sterile conditions to avoid contamination that could distort the results. Sampling is carried out before antibiotic therapy, as even a single dose of an antibiotic can suppress bacterial growth and make the result unreliable.

Conditionally pathogenic microorganisms are considered etiologically significant at concentrations ≥10⁵ CFU/ml, especially in the presence of symptoms such as burning, pathological discharge, itching, pain, dysuria, or signs of vaginitis, cervicitis, urethritis, prostatitis.

Antibiotic susceptibility testing in accordance with EUCAST and CLSI standards is performed for any concentration of an identified pathogenic microorganism and/or in cases when the concentration of conditionally pathogenic bacteria exceeds the clinically significant threshold (≥10⁴–10⁵ CFU/ml). The antibiogram allows for the selection of an effective drug, even if the pathogen is formally included in standard protocols but shows resistance.

Interpretation considering the MIC ensures an evidence-based, personalized approach to treatment.

If pathogenic or conditionally pathogenic microorganisms are detected in a clinically significant quantity, self-medication is not recommended. It is necessary to consult a doctor for a comprehensive clinical evaluation and an evidence-based choice of therapy.

• Various types of biological material depending on the test