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Semenov D.M.
D-lactate as a marker of dysbiotic and inflammatory diseases of the lower genital tract in women
Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus

Vestnik VGMU. 2016;15(4):40-45.

Objectives. To evaluate the possibility of D-lactate investigation in the diagnosing and assessment of treatment efficacy in case of inflammatory and dysbiotic states of the lower genital tract.
Material and methods. D-lactate concentration has been studied in the material taken from the vagina in 26 women with bacterial vaginosis, 21 women with nonspecific vaginitis, 23 women with normal vaginal biocenosis.
Results. The etiologic component of the lower genital tract inflammation (vaginitis) in women of the reproductive age in the majority of cases is represented by a nonspecific bacterial flora: Ent. faecalis (38% of the total number of cases of positive cultures), St. epidermidis (31,7%), Str. haemalyticus (19%), U. Urealyticum (11,3%). The median of D-lactate concentration in the material obtained from the posterior vaginal vault in women without any signs of inflammation and with normal microbiocenosis is 24,8 (22,6; 31,2) imol / (l×g). The median of D-lactate concentration in female patients with the diagnosed vaginal inflammation and bacterial vaginosis, regardless of the bacterial agent causing the inflammatory process, is statistically significantly lower (p=0,0001) and makes up 14,1 (11,6; 14,7) imol / (l×g). The value of D-lactate amounting to 18,14 gmol / (l×g) is the point of the diagnostic division of the pathological process and normal microbiocenosis, sensitivity and specificity being 98,4% and 98,1%, respectively. High sensitivity and specificity of the test for determining the level of D-lactate in the material obtained from the vaginal vaults enable its usage as a universal criterion of the presence of an inflammation of the bacterial etiology and the state of the vaginal ecosystem.
Key words: bacterial vaginosis, vaginitis, D-lactate.


1. Prilepskaya VN, red. Klinicheskaia ginekologiia [Clinical gynecology]: izbran lektsii. Moscow, RF: MEDpress-inform; 2007. 480 р.
2. Kira EF. Bakterial'nyi vaginoz [Bacterial vaginosi ]. Saint-Petersburg RF: Neva-Liuks; 2001. 364 s.
3. Kokhanevich EV, red. Aktual’nye voprosy ginekologii [Topical issues of gynecology]. Kiev, Ukraine: Kniga-plius; 2007. 421 р.
4. Radzinskiy VE, Buyanova SN, Manukhin IB, Kondrikov NI, Krasnopol'skiy VI, red. Patologiia vlagalishcha i sheiki matki [Pathology of a vagina and neck of uterus]. Moscow, RF: Meditsina; 1997. 272 р.
5. Prilepskaya VN, red. Patologiia sheiki matki i genital'nye infektsii [Pathology of a neck of uterus and genital infections]. Moscow, RF: MEDpress-inform; 2008. 384 р.
6. Savelyeva GM, Sukhikh GT, Manukhin IB, red. Ginekologiia. Natsional’noe rukovodstvo. Kratkoe izdanie [Gynecology. National leadership. Short edition]. Moscow, RF: GEOTAR-media; 2013. 704 р.
7. Savicheva AM, Sokolovskiy EV, Marius D. Kratkoe rukovodstvo po mikroskopicheskoi diagnostike infektsii, peredavaemykh polovym putem [Short guide to microscopical diagnostics of infections, sexually transmitted]. Sankt-Peterburg, RF: Foliant; 2004. 128 р.
8. Poeze M, Froon AH, Greve JW, Ramsay G. D-lactate as an early marker of intestinal ischaemia after ruptured abdominal aortic aneurysm repair. Br J Surg. 1998 Sep;85(9):1221-4.
9. Martí R, Varela E, Segura RM, Alegre J, Suriñach JM, Pascual C. Determination of D-lactate by enzymatic methods in biological fluids: study of interferences. Clin Chem. 1997 Jun;43(6 Pt 1):1010-5.
10. Garg KB, Ganguli I, Kriplani A, Lohiya NK, Thulkar J, Talwar GP. Metabolic properties of lactobacilli in women experiencing recurring episodes of bacterial vaginosis with vaginal pH ≥ 5. Eur J Clin Microbiol Infect Dis. 2010 Jan;29:123-5.
11. Zenkova SK; Viteb Gos Med Un-t. Bakterial'nye meningity: kliniko-epidemiologicheskie i patogeneticheskie osobennosti, lechenie [Bacterial meningitis: kliniko-epidemiological and pathogenetic features, treatment]: dis … kand med nauk: 14.00.10. Vitebsk, RB; 2009. 158 р.
12. Smith SM, Eng RH, Buccini F. Use of D-lactic acid measurements in the diagnosis of bacterial infections. J Infect Dis. 1986 Oct;154(4):658-64.
13. Vlasov VV. Vvedenie v dokazatel'nuiu meditsinu [Introduction to evidential medicine]: ili kak ispol'zovat' biomed lit dlia usovershenstvovaniia svoei praktiki i issledovanii. Moscow, RF: MediaSfera; 2001. 392 р.

Information about authors:
Semenov D.M. – Doctor of Medical Sciences, associate professor of the Chair of Obstetrics & Gynecology, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University».

Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Chair of Obstetrics & Gynecology. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Semenov Dmitry M.

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