Abstract | Fiziološka flora čovjeka je vrlo složena. Čovjeku su potrebni mikroorganizmi na koži i sluznicama da bi bio zdrav. Ti mikroorganizmi s ljudskim domaćinom imaju mutualistički odnos. Odnosno i jedni i drugi imaju koristi. Mikroorganizmi neprestano dobivaju nutrijente potrebne za život dok čovječja flora dobiva zaštitu i nutrijente. Ukoliko dođe do narušavanja imuniteta ili kontakta sa patogenim mikroorganizmima normalna flora se narušava te dolazi do infekcije. Ukoliko se infekcija razvije nakon spolnog odnosa sa zaraženom osobom tada je riječ o spolno prenosivim bolestima.
Spolno prenosive bolesti su u populaciji oduvijek prisutne i biti će prisutne i u budućnosti s obzirom na širenje spolnim kontaktom. Ulazna vrata mikroorganizama spolno prenosivih bolesti su sluznice, najčešće sluznice spolnih organa.
Gonoreja je spolno prenosiva bolest koja u većini slučajeva prolazi asimptomatski, a ukoliko se pojave simptomi to su gnojni iscjedak iz rodnice, bol u donjem djelu abdomena, bol prilikom odnosa, krvarenje nakon odnosa, spotting, neplodnost,...
N. gonorrhoeae su gram negativni diplokoki koji ne stvaraju spore i teško preživljavaju u okolišu što znači da je za prijenos potreban direktni put. Bakterija je primarno patogena za čovjeka jer nije dio fiziološke flore. Prenosi se spolnim odnosom ili s majke na dijete prolaskom kroz zaraženi porođajni kanal.
Gonoreja se dijagnosticira iz brisa cerviksa koji se nasijava na čokoladni agar te nakon 48 sati izrastu prozirne sitne kolonije nalik kapima rose. Na predmetnom stakalcu, mikroskopskom preparatu bojanom po gramu uočavamo gram negativne diplokoke unutar leukocita koji nalikuju zrnu kave.
Za liječenje se prvo izrađuje antibiogram da bi se odredio antibiotik najbolje učinkovitosti. Potrebno je liječiti oba partnera jer ako se ne liječe oba partnera istovremeno dolazi do ponovne aktivacije bolesti.Primalja ima veliku važnost u prevenciji, dijagnostici i liječenju gonoreje. Primalja prvenstveno treba žene prosvjećivati i uputiti na važnost redovitih ginekoloških pregleda. Također primalja je i potpora ženama koje imaju gonoreju te im treba pružati empatiju jer su kod nas spolno prenosive bolest još uvijek tabu tema i žene zbog srama nekada ne žele otići na pregled iako imaju simptome spolno prenosivih bolesti. Primalja upućuje na pravilan način uzimanja lijekova za liječenje bolesti, ali i sudjeluje u prevenciji prijenosa bolesti s majke na dijete tako što nakon rođenja djeteta provodi Credeovu profilaksu srebrovom otopinom koja se kapa novorođenčetu u oči. |
Abstract (english) | Human physiological flora is very complex. Human needs microorganisms on his skin and mucous membranes to be healthy. These microorganisms have a relationship with the human host. That is, both benefit. Microorganisms are constantly getting the nutrients they need to live while the human flora is getting protection and nutrients. If you get a violation of immunity or contact with pathogenic microorganisms, the normal flora is disturbed and an infection occurs. If the infection develops after sexual intercourse with earned persons, then it is a sexually transmitted disease.
Sexually transmitted diseases have always been present in the population and will be present in the future with wider sexual contact, which is the most common and natural human contact. The entrance door of the microorganism sexually transmits diseases in the mucosa, and the smallest mucosa of the genitals.
Gonorrhea is a sexually transmitted disease that usualy passes asymptomatically, and symptoms appear to be purulent discharge from the vagina, pain in the abdomen, better situation, bleeding after intercourse, spotting, infertility,...
N. gonorrhoeae are gram-negative diplococci that do not produce spores and are difficult to survive in the environment which means they should transmit the necessary direct, capillary pathway. The bacterium is a primary pathogen for humans because it is not part of the physiological flora. Sexual intercourse is transmitted either from mother to child by passing through an infected birth canal.
Gonorrhea is diagnosed from a swab of the cervix that is seeded on chocolate agar and after 48 hours expresses transparent tiny colonies resembling rose drops. On the slide, a gram-stained microscopic specimen, we observe a gram of negative diplococci inside leukocytes resembling coffee beans.
For treatment, an antibiogram is first made to determine which antibiotic is best. A doctor with both partners is needed if there is no re-execution of the partner and he will re-activate the disease.
Midwives has great importance in the treatment, diagnosis and prevention of gonorrhea. The midwife can primarily protest the women and teach them on the importance of regular gynecological examinations. Also a midwife is the support of women who have gonorrhea and they need to be given empathy because in our country sexually transmitted diseases are still a taboo topic and women sometimes do not want to go for checkup out of shame even though they have symptoms of sexually transmitted diseases. The midwife was instructed in the proper way of taking medication to treat the disease, but also participated in the prevention of disease transmission from mother to child in order to carry out Crede's prophylaxis with a silver solution after the birth of a child. |