Contents
The genus Streptococcus includes over 20 species of bacteria. Some of these microorganisms are representatives of the normal human microflora, some cause diseases (streptococcal infection), pathogenic for the body. The bacteria themselves are very small, have a spherical shape, remain in dust for a rather long time, on objects, tolerate low temperatures, and die at 56 ° C within half an hour.
Types of streptococci, causes of streptococcal infection
Streptococcus mitis, a representative of the viridescent streptococci, normally inhabits the anterior urethral part of men with a detection rate of about 25%. In the same area can be detected • epidermal staphylococcus aureus (50-100%); • saprophytic staphylococcus (25%); • Enterobacteriaceae (E. coli) – 25%; • Pseudomonas aeruginosa (Pseudomonas aeruginosa) – up to 5%; • fecal enterococcus – 25%; • proteas (Proteus sp.) – 25%; • Corynebacteria (Corynebacteria) – 25%; • Neisseria (Neisseria sp.) – 25%; • Bacteroides (Bacteroides sp.) – 25%.
The urethral microflora of men does not depend on age, but changes under the influence of other factors. Some microorganisms “inhabit” the urethra permanently, some – for a short time. Unlike the female, the male urethral microflora does not have any specific functions.
Separately, the so-called transient microflora (otherwise called conditionally pathogenic) is distinguished. It includes microorganisms, for which it is not typical for a constant presence in a person to be normal and which provoke inflammation under favorable circumstances, can be transmitted through sexual contact. As a rule, such bacteria do not live long in the urogenital tract, being eliminated by the body’s defense mechanisms. In women, it is an acidic vaginal environment, the microflora is lactobacillary.
The following types of protection for men are distinguished: • mechanical – the Guerin damper separating the entrance to the urethra from the anterior part prevents the penetration of microbes, which secrete urethral mucus and a special substance during ejaculation of the gland contribute to the “washing out” of bacteria from the urethra; • neutral/slightly alkaline urethral environment – prevents the growth of certain bacteria in the urethra; • local immunological – implemented through special cells and substances produced by the prostate and urethral mucosa; • prostate antimicrobial factor – is a zinc-peptide complex with antimicrobial properties, produced by the prostate gland (in the prostatic secretion, the zinc content exceeds its amount in other organs by a hundred times).
Transient microflora in case of disruption of the work of such mechanisms leads to the development of an infectious process – streptococcal infection. In the case of genital-oral contact, infection of the organs of the genitourinary tract with respiratory microorganisms (inhabitants of the upper respiratory tract, pharynx, mouth), for example, such as group A beta-hemolytic streptococcus, is possible.
Another species – group B streptococcus (Streptococcus agalactiae) is not normally found in men, but is often detected in women (while it can cause infectious processes, especially dangerous for newborns). It should also be borne in mind that this type of microorganism in men can develop in the presence of another infection of the genital tract, so the presence of group B streptococcus requires a more thorough examination for other pathogens.
The main ways of transmission of transient, including streptococcal, infections: • sexual contact (including oral and anal-genital); • from mother to child, intrauterine, through the blood, during the passage of the birth canal; • in organ transplantation. Streptococcus in men can cause problems such as: • urethritis (an inflammation of the urethra); • balanitis, balanoposthitis (head, foreskin); • prostatitis (prostate); • epididymitis (epididymis); • deterioration of sperm quality, etc.
The infection develops as a result of the activation of transient microflora: • against the background of a decrease in immunity (with HIV, after serious illnesses); • the presence of chronic pathologies of various nature (for example, diabetes); • with chronic prostatitis, presumably due to a decrease in the zinc content in the prostatic secretion; • when transferring genital infections earlier, leading to scarring of the mucous membrane of the urogenital tract and violation of local immunity as a result; • with a burn of the urethra due to the abuse of antiseptics, etc. Treatment of streptococcus in men is determined by the type of microorganism and the presence of clinical manifestations of the disease.
Symptoms of a streptococcal infection
Most often, streptococci, representatives of transient infections, getting into the organs of the urogenital system, are present in them for only a few hours / weeks and are destroyed by the body’s defenses (the so-called temporary carriage). The detection of streptococcus during this period in the absence of clinical manifestations is not an indication for therapy. However, it should be borne in mind that with temporary carriage, infection of the sexual partner is very likely.
Persistent carriage is characterized by the fact that the microorganism is constantly present in a small amount in the urogenital system (no symptoms are noted), and in the event of a “failure” in the body, it manifests itself as a violent inflammatory reaction. Infection of the sexual partner in such a situation is also possible. The detection of streptococcus, confirming the persistent carriage of the latter, with moderately pronounced changes in the prostate, is a reason for more thorough diagnosis and treatment. If the body ceases to restrain the growth of streptococci, inflammation processes occur, the symptoms of which depend on the location. Typical signs of urethritis: • discomfort, irritation, redness in the urethra; • frequent and painful urination; • discharge from the urethra.
If the prostate is damaged, swelling, pain in the testicles, problems with urine output, pulling pains in the groin area, etc. can be noted. There are no characteristic manifestations of streptococcal lesions, which requires diagnosis of the nature of the pathology.
Diagnostic methods
Diagnosis of streptococcus in the organs of the genitourinary system in men includes: • general urine and blood tests; • study of smears, prostate secretion by polymerase chain reaction (with temporary carriage, only PCR can identify the pathogen); • cultural seeding (excretions, prostate secretions, etc.); • other laboratory methods (ELISA, RIF, etc.) and instrumental methods (ultrasound, MRI, CT) to exclude other causes of observed symptoms – non-streptococcal infections, tumor formations, etc.
Ways to treat streptococcus
The need for treatment of streptococcus is determined by the severity of the symptoms. In the absence of the latter (the detection of streptococcus occurred by chance during a routine examination), expectant tactics are used; with temporary carriage, spontaneous disappearance of the microorganism often occurs. If streptococcus, which does not belong to the representatives of the normal microflora, was found against the background of complaints about problems on the part of the urogenital tract, specific antibiotic therapy is carried out. It is first necessary to determine the sensitivity of the detected pathogenic microorganisms to certain antibacterial drugs. Most often, representatives of the penicillin (for example, ampicillin), macrolide series, and fluoroquinolones are used. In patients with streptococcal infection of the urogenital tract and allergic to penicillins, drugs such as clindamycin, cefazolin may be prescribed. Unfortunately, in recent years, cases of drug resistance to streptococcal infections are often observed. If the prescribed antibiotic is ineffective, a new drug is prescribed, taking into account sensitivity.
It is important to take into account the high likelihood of mixed infection, especially when men are diagnosed with Streptococcus agalactiae. In this case, treatment with several drugs may be required.
The doctor may recommend in addition to the main therapeutic course: • physiotherapy; • massage – with inflammation of the prostate gland; • immunomodulating agents; • enzymes; • local treatment (infusion into the urethra of solutions of various drugs); • traditional medicine (baths based on decoctions of medicinal herbs, such as chamomile, cranberry juice, etc.), etc.
Complications with streptococcus
The lack of adequate therapy for streptococcal urogenital infection in men can cause: • the transition of the disease to a chronic form; • the spread of the inflammatory process to other organs and tissues (damage to the testicles, seminal vesicles, appendages); • infertility and impotence, etc. Infection of women during pregnancy can cause serious pathologies in newborns, such as the development of sepsis – blood poisoning.
Prevention
Prevention of streptococcal infection consists in: • practicing safe sex using barrier methods of protection; • normalization of lifestyle – work and rest regime, provision of healthy nutrition and moderate physical activity, exclusion of stress factors; • hardening; • timely detection and adequate treatment of genital infections; • prevention of the development of chronic diseases or their correction with medications, etc.