5.1. Epidemiology. Etiology and pathways of infection. Risk factors
Inflammatory diseases of the female genitals take the 1st place in the structure of gynecological morbidity (60-65%) and are the most frequent cause of patients' visits to a women's health clinic. This is explained by the relatively high prevalence of these diseases among the population (especially at the age of 15-25 years), the difficulties in treatment due to chronicity of the process caused by inadequate or untimely etiotropic therapy, the resistance of the pathological microflora to antibacterial drugs, etc.
Etiology. The cause of inflammatory diseases of the reproductive system is an infectious factor. Absolutely pathogenic and conditionally pathogenic microorganisms are distinguished.
Absolute pathogens are Gonococci, Chlamydia, Trichomonas, β-hemolytic streptococci, Staphylococcus aureus, etc. As for such microorganisms as Urea-plasma and Mycoplasma (Mycoplasma hominis), they have an etiological significance in the development of female pelvic inflammatory diseases when detected in a high titer in the absence of other pathogens.
If immunocompetence of woman's body is impaired, microorganisms constituting the normal lower genital tract microflora (conditionally pathogenic) can become etiologically significant: gram-negative bacteria of genera Bacteroides, Prevotella, Fusobacterium; aerobic gram-negative bacteria of genera Klebsiella, Proteus, Enterobacter; gram-positive anaerobic microorganisms such as Peptostreptococcus, Clostridium, etc.
Mechanisms of infection of pelvic organs:
► the ascending (intracanalicular) route of infection is the most common (active, with sperm and Trichomonas, and passive involving contractions