Epidemiological Analysis And Investigation On Balanic Candida Colonization In Diabetic

Balanic candidiasis is also called candidal balanoposthitis, it is a common fungal infection of the skin and mucous disease, which infects foreskin and the glans penis and is caused by Monilia. Damage often occurred in the glans and atrioventricular furrow. Clinical manifestations is diffuse aestus in inner foreskin and the glans,some are small red papules of needle cap size , and is more obvious when erection, it has ivory patching to rely on, with desquamating and abnormal flavour, Some have microerosin, and can affect scrotum produce erythema,desquamating and so on, with or without symptoms of itching.Most of balanic candidiasis cases are caused by Candia albicans; while others can also be due to other non- Candia albicans, such as: Candida tropicalis, Candida glabrata, Candida krusei, Candida parapsilosis, Candida pseudotropicalis, Brewer's yeast et al). Candida is round or oval and it reproduces spore and hypha, it is growing well on Sabouraud's dexteose agar medium and Gram-positive. Candida is biphase. In the external environment or messmateism its major existing pattern is spore. Pathogenic phase is hypha.Targets of the study are Diabetic Patients, who visit our hospital during October 2006 and October 2007, total 162 cases, all the patients' were tested in patients with the diabetic diagnostic code which was enacted by American Diabetes Association in 1997. the control group are 160 people who Participant in the health examination. All the diabetic did the experiment of Candida pathogens being culture with Sabouraud's chloromycn medium, to learn the germ-carrying rate and the strain constituent ratio of the diabetic, and take healthy people as cross-check analysis group, and assess the high risk of takeing candidal balanitis and the dependablity of dependablity type and pathogenic bacterium, to conduce to depressing the disease incidence and to guide the rational administration in clinical.The experimental results showed that: Monilia isolating rate of the diabetic is 41.4%, and the isolating rate of people who did health examination is 15.6%. Candida albicans account 74.6% in the strain constituent ratio of the diabetes group, Candida glabrata account 11.9%, Candida tropicalis account 3.0%, Candida krusei account 4.5%, the else account 6.0%. The detection rate of diabetes group is obviously exceed the health group (P<0.01), it is thus clear that the hyperglycaemia condition of the diabetic is the main cause to lead to the accrescence of diabetic Monilia field planting, when the blood sugar steps up, the content of glucogen in partly tela increases, cellular immune function of partly membrana mucosa degrades, to Provide conditions for the Monilia intrusion and permanent planting. Candida albicans is the main pathogenic bacteria in Candidiasis of the genitals. The investigation at home and abroad show that the constituent ratio of Candida albicans of diabetes group is 74.6%, is obviously higher than non- Candida albicans. The reasons maybe Candida albicans have more virulence and invasive power than non- Candida albicans. In recent years, the strain of Candida albicans begin to tide, the same strain changes tinyly("subclone drift")and the strain vicariousness and so on, alter the plasticity of the cell, and it increases the power of resistance to oppose the eumycete and to escape immunity the organism, gene vicariousness to lead to the generation of the drug resistant strain. Therefore, Candida albicans hold the absolute preponderance in the strain constituent ratio of Candidiasis of the genitals. But non-Candida albicans hold not- low-grade rratio cline, coincident with the update of the tendency of Candidiasis of the genitals disease incidence caused by non- Candida.In this study, 68 cases with symptom and 94 cases without symptom in diabetes group did the cultivation of the balanus dandruff, Monilia detection rate of the patients with symptom is 66.2%, Monilia detection rate of the patients without symptom is 23.4%, Monilia detection rate of with- symptom group is obviously higher than the rate of the without- symptom (P<0.01) ; Candida albicans hold 86.7% in the with- symptom group, Candida albicans hold 50.0% in the without- symptom group, Candida albicans detection rate of with- symptom group is obviously higher than the rate of the without- symptom (P<0.01) .Monilia in balanus' detection rate of Type 1 diabetic is 57.9%, Monilia in balanus' detection rate of Type 2 diabetic is 36.3%. Monilia detection rate of Type 1 diabetic is obviously higher than the rate of Type 2 diabetic (P<0.05 ); Candida albicans detection rate is 54.5% in Type 1 diabetic, Candida albicans detection rate is 80.0% in Type 2 diabetic, Candida albicans constituent ratio in Type 2 diabetic is obviously higher than the constituent ratio in Type 1 diabetic (P<0.05); Candida glabrata detection rate is 22.7% in Type 1 diabetic, Candida glabrata detection rate is 8.9% in Type 2 diabetic, Candida glabrata constituent ratio in Type 1 diabetic is slightly higher than the constituent ratio in Type 2 diabetic. Because of the small sample size, and investigation were to aim directly at Jilin region, and have invariably local, it is not clear that whether it was affected by the type of the diabetes or the age distribution of the target, it needs to be investigated further.This study did the fractional cultivation of the balanus dandruff; of 82 cases who were diabetic with redundant prepuce and 80 cases who were diabetic without redundant prepuce. The result shows that Monilia detection rate of patients with redundant prepuce is 51.2%, Monilia detection rate of patients without redundant prepuce is 31.3%, Monilia constituent ratio in patients with redundant prepuce is obviously higher than the constituent ratio in patients without redundant prepuce (P<0.01) . although redundant prepuce is not the direct causative agent, but one motivation, the high ratio in the patients illustrate that it is one of the risk factor.In short, diabetes can increase the symptomless field planting of Monilia and risk of pathopoiesis, and the type of the diabetes have important dependablity with Monilia strain constituent ratio.