Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Both diabetes and fungal infections contribute significantly to the global disease burden, with increasing trends seen in most developed and developing countries during recent decades. This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients, particularly those that present with unsatisfactory glycemic control. In addition, a relatively new group of anti-hyperglycemic drugs, known as sodium glucose cotransporter 2 inhibitors, has been linked with an increased risk for colonization of the urogenital region with Candida spp., which can subsequently lead to an infectious process. In this review paper, we have highlighted notable virulence factors of Candida species (with an emphasis on Candida albicans) and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis, potentially complicated with recurrences and dire pregnancy outcomes. We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes, further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in (primarily uncircumcised) males. With a steadily increasing global burden of diabetes, urogenital mycotic infections will undoubtedly become more prevalent in the future; hence, there is a need for an evidence-based approach from both clinical and public health perspectives.     

包皮龟头炎患者超高倍镜下病原体分析研究

目的:研究包皮龟头炎患者生殖器分泌物超高倍镜下病原体分布规律。方法:包皮龟头炎患者200例,对其生殖器分泌物进行超高倍镜下检测,研究病原体分布规律,并观察该组患者年龄、病程分布情况。结果:经超高倍镜检测,200例包皮龟头炎患者中,G+球菌感染占42%,真菌感染占30%,支原体感染占18%,未见致病菌占2%,混合感染占8%。年龄分布中,25岁以下占18%,25~45岁占69%,45岁以上占13%。病程分布中,1周以下占52%,1~8周占39%,8周以上占9%。结论:包皮龟头炎患者生殖器分泌物超高倍镜下检测,G+球菌感染所占比例最大,真菌感染次之。发病年龄,中青年居多。病程1周以下者居多。     

念珠菌性包皮龟头炎分离菌种鉴定及药敏测定

目的 了解2009年至2011年念珠菌包皮龟头炎念珠菌种类及其对抗真菌药物的敏感性,以便指导临床用药.方法 用沾有无菌生理盐水的无菌拭子反复转动擦拭包皮和龟头的炎症部位,所得拭子立即接种于沙保罗氏琼脂培养基,待培养基上长出酵母菌菌落后,挑取该菌落于科玛嘉念珠菌显色培养基培养.对分离的念珠菌用ROSCO纸片扩散法进行药物敏感性试验.结果 2009年至2011年共分离出507株念珠菌,其中白色念珠菌439株(86.59％),光滑念珠菌33株(6.51％),热带念珠菌28( 5.52％),克柔氏念珠菌3株(0.59％),其他念珠菌4株(0.79％);白色念珠菌对两性霉素B、克霉唑、5-氟尿嘧啶、氟康唑、伊曲康唑的敏感率分别为100％、87.1％、88.9％、86.7％、69.9％,耐药率分别为0％、1.3％、3.8％、6.4％、6.7％.结论 白色念珠菌是念珠菌性包皮龟头炎的主要分离菌株,其次是光滑念珠菌;白色念珠菌体外药敏显示,其对两性霉素B、克霉唑、5-氟尿嘧啶、氟康唑有很高的敏感性,对伊曲康唑敏感性较低,同时也显示其对氟康唑、伊曲康唑有相对较高的耐药率.     

458例包皮龟头炎真菌感染检测及药敏试验

目的 了解本地区包皮龟头炎患者中真菌感染情况及对抗生素的敏感性.方法 分别采用科玛嘉念珠菌显色培养基、法国梅里埃公司的ATB ID32C酵母菌鉴定卡和Rosco纸片扩散法对包皮龟头分泌物进行念珠菌培养、菌种鉴定及药敏试验.结果 458例患者中共培养出157株酵母样真菌,阳性率为34.3％;其中,白色念珠菌116株（73.9％）,光滑念珠菌14株（8.9％）,热带念珠菌12株（7.6％）,近平滑念珠菌8株（5.1％）,克柔念珠菌5株（3.2％）,季也蒙念珠菌2株（1.3％）.分离菌株对制霉菌素和酮康唑的敏感率均＞90.0％,分别为97.5％和93.0％,对氟康唑敏感率为79.6％,而对特比奈酚敏感性最低,为33.8％.结论 念珠菌感染是本地区包皮龟头炎发病的重要因素,感染的致病菌种以白色念珠菌为主,分离的念珠菌对多烯类药物敏感率较高,对唑类抗真菌药有不同程度的交叉耐药,不同菌型其药敏谱存在差异.     

双子参洗液治疗浅表性包皮龟头炎的疗效观察

目的观察双子参洗液治疗浅表性包皮龟头炎的临床疗效。方法用双子参洗液治疗87例浅表性包皮龟头炎患者,疗程14d。结果治疗7d痊愈54例（62.1%）,显效18例（20.7%）,有效率89.7%;治疗14d痊愈81例（93.1%）,显效4例（4.6%）,有效率98.9%。患者耐受性好。结论双子参洗液治疗浅表性包皮龟头炎有疗效确切。     

糖尿病性包皮龟头炎的诊断与治疗

目的:探讨糖尿病性包皮龟头炎的临床特点和规范治疗方案.方法:对门诊1年内以包皮龟头炎症状就诊的43例病例进行临床分析.结果:糖尿病性包皮龟头炎有其自身特点,诊断和治疗有其特殊性.结论:包皮龟头炎应警惕糖尿病,血糖检测应作为包皮龟头炎的必查项目.     

念珠菌性包皮龟头炎的致病菌种及其药敏试验分析

目的了解念珠菌性包皮龟头炎的致病菌种及其对常见抗真菌药物的敏感性。方法分别采用科玛嘉念珠菌显色培养基、YBC鉴定卡和ROSCO纸片扩散法进行念珠菌培养、菌种鉴定及药敏试验。结果380例患者共培养出93株阳性标本(24.47%),分离出白念珠菌81株(87.10%),非白念珠菌12株(12.90%)。93株念珠菌对制霉菌素、酮康唑、氟康唑、伊曲康唑、咪康唑和特比萘芬的敏感率分别为100%,95.70%,92.47%,67.74%,56.99%,45.16%。结论白念珠菌是念珠菌性龟头包皮炎的主要致病菌种,分离菌株对制霉菌素敏感性最高,其次是酮康唑和氟康唑,特比萘芬最低。     

包皮环切后包皮龟头炎、包皮垢及人乳头瘤病毒感染的年龄分布调查

目的：探讨不同年龄包皮环切后人群包皮中包皮龟头炎、包皮垢及人乳头瘤病毒（ Ｈ Ｐ Ｖ）感染的发生率。　方法：对 ２１９ 例包皮环切后通过问诊和体检，了解包皮龟头炎和包皮垢的情况，采用 Ｐ Ｃ Ｒ 扩增的方法检测包皮中 Ｈ Ｐ Ｖ ６、１１、１６、１８ 及 ３３ 型 Ｄ Ｎ Ａ 保守片段。　结果：包皮龟头炎、包皮垢及 Ｈ Ｐ Ｖ 感染的发生率分别为 ２１．０％（４６／２１９）、４３．３％ （９５／２１９）和４１．１％ （９０／２１９）。　结论：包皮环切后包皮中包皮龟头炎、包皮垢及 Ｈ Ｐ Ｖ 感染的发生率较高，对于包茎或包皮过长者，应尽早行包皮环切术。