5334. Bacterial culture. Urogenital. Streptococcus pyogenes (group A Streptococcus). Antimicrobial resistance profile with MIC (if Streptococcus pyogenes is detected)

Urogenital culture for Streptococcus pyogenes (Group A β-hemolytic Streptococcus) is a microbiological test that allows detection of the pathogen, determination of its quantity, and assessment of antibiotic susceptibility.

If the result is positive, an antibiotic susceptibility test with MIC (minimal inhibitory concentration) is performed to help the physician select the most effective antibacterial therapy.

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

Although St. pyogenes is most commonly associated with infections of the upper respiratory tract, skin, and soft tissues, its detection in the urogenital tract has clinical significance, especially in the presence of symptoms or in patients with risk factors.

St. pyogenes is a Gram-positive β-hemolytic streptococcus that produces a wide range of toxins and enzymes capable of causing necrotizing lesions, streptococcal toxic shock, endometritis, vaginitis, urethritis, cervicitis, as well as postpartum infections. In women, St. pyogenes may cause acute inflammatory diseases of the pelvic organs, and in men – urethritis or prostatitis.

The material for the study is collected with a sterile swab from the vagina, cervical canal, or urethra (in women), and from the urethra or prostatic secretion (in men). In case St. pyogenes is detected, an antibiotic susceptibility test with determination of the minimal inhibitory concentration (MIC) is performed according to international EUCAST and CLSI standards, allowing the selection of effective antibacterial therapy.

Clinical interpretation of the results depends on the quantitative growth indicator, the presence of symptoms (pain, discharge, itching, fever), the patient’s history, and comorbidities. A high St. pyogenes titer combined with clinical manifestations indicates active infectious inflammation requiring immediate treatment. A low titer or asymptomatic carriage requires risk assessment, especially in pregnant women, immunocompromised patients, or before surgical interventions.

In the case of a positive result, self-medication is not recommended. The final decision regarding therapy is made by the physician, taking into account the patient’s clinical condition, laboratory findings, and epidemiological situation.

• Women with symptoms of vaginitis, cervicitis, endometritis, or postpartum complications, especially in the presence of purulent discharge, pain, fever, or signs of toxic shock.
  
• Men with urethritis, prostatitis, or other inflammatory processes unresponsive to standard therapy.
  
• Patients after pelvic or urogenital surgery – to rule out streptococcal etiology of postoperative complications.
  
• Immunocompromised individuals – in the presence of any infection signs, since S. pyogenes can cause rapid systemic infection.
  
• Patients with recurrent or atypical urogenital infections where previous cultures were negative or revealed nonspecific microflora.
  

• Various types of biological material depending on the test

Women