| Objective: vulvovaginal candidiasis (VVC) is a common complication of diabetes, Epidemiological survey found that the prevalence rate of diabetes was higher than that of non-diabetic about four times, And the incidence may be higher in diabetes with poor glycemic control.we aimed to investigate the strains of diabetes with vulvovaginal candida, and to detection invito fluconazole susceptibility of Candida strains.Methods: This prospective study was performed in 58 diabetes with vaginitis, vaginal secretions smear and fungal smear examination Candida was positive as a case group who visited the obstetrics and gynecology out-patient of the first hospital of Jilin University from August 2006 to October 2007, all patients had complied with the 1997 American Diabetes Association diagnostic criteria for diabetes. Among them, five were type I diabetes, Type II diabetes 53, aged 26 to 50years old, average (39.28±5.01years), who suffered from diabetes 6 month to 10 years, average (3.11±2.59) years. At the same time, take 60 patients as a control group who had VVC signs and symptoms, vaginal secretions smear and fungal smear examination Candida was positive, aged 26 to 53 years old, with an average age of 38.31±6.01. The cultures were taken for special fungal examination, strains were confirmed, and test their sensitivity to fluconazole with slip methed. Results: In the control group, C. albicans were islated in 47 of 60, accounting for 78.3 percent; Non-Candida albicans 13, accounting for 21.7 percent. In the case group C. albicans were the most common isolates, islated 31 from 58, accounting for 53.4 percent. Non-Candida albicans islated 27, accounting for 46.6 percent, among them, C.glabrata and C.tropicalis were 17, 7, accounting for 29.3% and 12.1%respectively. The case group of non-Candida albicans was significantly higher percentage than the control group, the difference between the two groups was statistically significant (X2=8.15, P<0.05).In the control group, 44 strains of C. albicans were sensitive to fluconazole, accounting for 93.6%; 4 strains of C. tropicalis all sensitive to fluconazole; 3 strains of 5 C.glabrata were sensitive to fluconazole, 1 resistance, the resistance rates was 20%; In the case group 28 strains of C. albicans were sensitive to fluconazole, accounting for 90.3%; 6 strains of C. tropicalis were sensitive to fluconazole, accounting for 85.7%; 10 strains of 17 C.glabrata were sensitive to fluconazole, 4 resistance, the resistance rates of 23.5%.Both the control group and the case group, the sensitivity of C. albicans and C.tropicalis were higher to fluconazole; While C.glabrata had higher resistance rate, P<0.05, the difference was statistically significant. In the control group and the case group, the sensitivity of the same pathogen strains to fluconazole had no statistically significant (P>0.05). Conclusion: 1. The difference of pathogens strains between diabetic VVC and non-diabetic VVC were significant, non-Candida albicans percentage increase, in which C.tropicalis and C.glabrata were mainly strains. 2. The sensitivity of C. albicans and C.tropicalis were higher to fluconazole; While C.glabrata had higher resistance rate. 3. In the control group and the case group, the sensitivity of the same pathogen strains to fluconazole had no statistically significant.Therefor, VVC with diabetes stubbornly intractable may be related to the high prevalence of Non-Candida albicans, To the treatment to VVC with diabetes, in addition to actively control of blood glucose, the fungal cultures and sensitivity to antifungal drug is very important and necessary. |
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