CHARACTERISTICS OF THE AMINO TEST AS AN EXPRESS METHOD FOR DETECTING CAUSATIVE AGENTS OF BACTERIAL VAGINOSIS IN ORAL CAVITY

At present, the issue of cross-contamination and cross-infection between the oral cavity and other body sites has not sufficiently studied yet and requires the elaboration of clinical protocols for diagnosis infectious diseases, which the dentists can rely on in their practice. We consider it necessary to highlight the issue of cross-infection between the oral cavity and vagina in women with bacterial vaginosis. This gynaecologic diagnosis draws much attention of healthcare professionals due to its prevalence, the frequency of relapses and the specificity of the microflora causing pathology. The purpose of the work was to characterize the diagnostic value of the amino test of oral fluid as an express method for detecting bacterial vaginosis in the oral cavity. Materials and methods. 106 women of child-bearing age without marked somatic and orthodontic pathologies were examined. Patients were divided into 3 groups depending on their gynaecological status. I group included 25 women with the 1st and 2nd degree of vaginal purity; II group involved 27 individuals – carriers of Gardnerella vaginalis; the third group included 54 women with a confirmed diagnosis of bacterial vaginosis, who were divided into 2 subgroups depending on the prescribed treatment. 26 women who received standard treatment and supportive therapy made up III-A subgroup; 28 patients who received the treatment and preventive therapy aimed at eliminating atypical microflora in the oral cavity and preventing relapse, constituted III-B subgroup. The examination was carried out before starting therapy and in 6 and 12 months following the therapy. The amino-test of oral fluid that we patented is designed for express diagnosis of mixed saliva for the presence of volatile amine of isonitrile produced by bacteria Gardnerella vaginalis and Atopobium vaginae associated with bacterial vaginosis. To confirm the results of the amino test of the oral fluid, a PCR-diagnosis for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was performed. Results. In women with bacterial vaginosis (group III), chronic catarrhal gingivitis was diagnosed in 12.96%, chronic generalized periodontitis of initial severity was found in 25.93% of the patients studied, chronic generalized periodontitis I severity degree was diagnosed in 61.11% of the patients; clinically intact periodontitis was not registered. Comparing the results of the amino test of oral fluid at all stages of the observation with the results of PCR-diagnosis of Gardnerella vaginalis and Atopobium vaginae, we have found out that the patients of groups I demonstrated complete conformity to the results obtained in the group II: the absence of these microorganisms in the oral cavity was confirmed by negative results of amino test. In the group III-A examined, the percentage of the positive amine test was directly proportional to the changes in the detection of Atopobium vaginae in the oral cavity: before the treatment, this microorganism was detected in 84.6% of the amino test, at the beginning of the survey it was 76.9%; in 6 months following the therapy, the PCR decreased by 26.9%, while the result of the amino test dropped by 34.6%; in a year the detection of Atopobium vaginae increased by 42.3% and the percentage of positive test increased by 34.6%. In groups III-B, direct correlation of the changes in the results of the Gardnerella vaginalis PCR and the amino-test of oral fluid were noted. The primary findings of Gardnerella vaginalis and the positive amine test of women in this group made up 67.9% and 75% respectively. In 6 months, the percentage of Gardnerella vaginalis detection was reduced by 39.3% and by 53.6%, the positive oral test in the oral cavity decreased; in one year, Gardnerella vaginalis was found to be 14.3% less frequent in the patients of group III-B, and the registration of the positive amino test decreased by 7.1%. The obtained data make it possible to suggest the informativeness of the amino test of oral fluid as an express method for detecting bacterial vaginosis agents in the oral cavity, such as Gardnerella vaginalis and Atopobium vaginae, to use this method in the diagnosis of concomitant diseases of periodontal tissues and to prescribe treatment, taking into account the presence of oral microbes from atypical representatives who are resistant to traditional treatment regimens.