[Fungi in patients with diabetes mellitus type 2: prevalence, species of isolated strains].
In 77 diabetic patients the detection of fungi was carried out in the oral cavity, digestive tract, genital organs and skin lesions. Patient age ranged from 39 to 82 years, with the Body Mass Index (BMI) from 22 to the highest values of 46.5. Diabetes control was assessed by determination of the glucose level in serum after overnight fasting and after lunch, as well as by determination of the HbA(1c) level. Fungi were diagnosed in 61 patients (79.6%). The total of 111 fungal strains were isolated in 319 cultures evaluated from 12 biological materials. Fungal strains were detected in the highest percentage in oral cavity (77.9%), in the lower percentage in anus (33.8%), vagina discharge (11.6%) and the region of vulva (14.3%). Fungi were observed in one focus--exclusively in the oral cavity--in 28 (36.4%) patients, whereas they occurred in multifocal infections in 33 (42.9%) patients. The isolated fungal strains were classified into 4 genera (Candida, Saccharomyces, Trichosporon, Aspergillus) and 12 species. The most frequently detected fungi were C. albicans (55.2%), followed by C. glabrata (12.4%), C parapsilosis (10.5%) and C. tropicalis (9.5%). Relatively low percentage of fungi identified in vagina was associated, among others, with the fact that most of the female patients with diabetes were at the postmenopausal period. In all the patients in whom fungi were isolated from the vagina contents, these fungi were also found in other ontocenoses. The increase in percentage of fungal strains from genera other than Candida in patients with a higher risk is of clinical importance, as some of them are resistant in vitro to azole derivatives e.g. fluconazole. The digestive tract is thought to be the most frequent fungal habitat. A considerable prevalence of fungi, multifocal infections, particularly related to oral cavity and anus, and occurrence of high percentage of strains different from C. albicans species of Candida genus in female patients with type 2 diabetes indicate the necessity of the special mode of diagnostic and therapeutic management.
Maciejewska
Alina
A
Wojewódzki Ośrodek Diabetologii i Chorób Metabolicznych Wojewódzkiego Specjalistycznego Szpitala im. M. Pirogowa, ul. Nowa 30/32, 90-030 Lódź. katbiol@poczta.onet
Jaskółowska
Agnieszka
A
Kwaśniewska
Jolanta
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D048909:Diabetes Complications / Q000382:microbiology; D003924:Diabetes Mellitus, Type 2 / Q000382:microbiology*; D005260:Female; D005658:Fungi / Q000145:classification* / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology*; D012440:Saccharomyces / Q000145:classification / Q000302:isolation & purification; D013045:Species Specificity; D014250:Trichosporon / Q000145:classification / Q000302:isolation & purification