摘要
目的分析2型糖尿病患者罹患口腔假丝酵母菌感染相关危险因素,为疾病防治提供指导。方法收集本院157例2型糖尿病患者,根据诊断标准确定口腔感染假丝酵母菌的患者数。采集患者未刺激全唾液进行病原学检查,经全自动细菌鉴定仪确定其感染假丝酵母菌类型。采用流行病学调查表调查患者资料,并采用SPSS软件分析影响2型糖尿病患者罹患口腔假丝酵母菌感染相关危险因素。结果本院157例2型糖尿病患者中,确诊为罹患口腔假丝酵母菌感染的患者55例(35.03%)。共分离67株假丝酵母菌,其中包括白色假丝酵母菌48株(71.64%),热带假丝酵母菌9株(13.43%),光滑假丝酵母菌6株(8.96%)以及其他假丝酵母菌4株(5.97%)。48株白色假丝酵母菌对氟康唑、伊曲康唑、伏立康唑、两性霉素B、氟胞嘧啶的耐药率分别为18.75%、16.67%、4.17%、2.08%和2.08%;9株热带假丝酵母菌对氟康唑、伊曲康唑、伏立康唑的耐药率分别为33.33%、11.11%和11.11%,而未检出对两性霉素B和氟胞嘧啶耐药菌株;6株光滑假丝酵母菌对氟康唑、伊曲康唑、伏立康唑的耐药率均为16.67%,且未检出对两性霉素B和氟胞嘧啶耐药菌株。患者的年龄、空腹血糖是否升高、是否使用碳酸氢钠漱口以及有无牙石等对口腔感染假丝酵母菌有显著影响。Logistic多变量分析显示,有牙石、使用碳酸氢钠漱口以及空腹血糖升高等因素对患者口腔假丝酵母菌感染有显著影响。结论 2型糖尿病患者罹患口腔感染假丝酵母菌主要为白色假丝酵母菌,且耐药程度较高。有牙石、使用碳酸氢钠漱口以及空腹血糖升高等因素是口腔感染的高危因素。
Objective To analyze the risk factors for development of an oral infection with a Candida sp.in patients with type 2diabetes mellitus in order to guide the prevention and treatment of disease. Methods One hundred and fiftyseven patients with type 2diabetes mellitus were identified,and the number of patients with an oral infection due to a Candidasp.was determined according to diagnostic criteria.Unstimulated saliva samples were collected from patients for etiological study,and the types of Candidaspp.were determined using an automated microbial identification system.Patient data were obtained from an epidemiologic survey,and the risk factors for patients with type 2diabetes mellitus developing an oral infection with a Candidasp.were analyzed using the software SPSS. Results Of the 157 patients with type 2diabetes mellitus seen at this Hospital,55 were diagnosed with an oral infection due to a Candidasp.,for a rate of infection of 35.03%.An etiological examination identified 67 strains of Candidaspp.,including 48 strains of Candida albicans（71.64%）,9strains of Candida tropicalis（13.43%）,6strains of Candida glabrata（8.96%）,and 4strains of other Candidasp.（5.97%）.Drug susceptibility testing indicated that the 48 strains of Candidaalbicanswere resistant to fluconazole at a rate of 18.75%,to itraconazole at a rate of 16.67%,to voriconazole at a rate of 4.17%,to amphotericin B at a rate of 2.08%,and to flucytosine at a rate of 2.08%.The 9strains of Candida tropicalis were resistant to fluconazole at a rate of 33.33%,to itraconazole at a rate of 11.11%,and to voriconazole at a rate of 11.11%,but the strains were not resistant to amphotericin B or flucytosine.The 6strains of Candida glabrata were resistant to fluconazole at a rate of 16.67%,to itraconazole at a rate of 16.67%,and to voriconazole at a rate of 16.67%,but the strains were not resistant to amphotericin B or flucytosine.A univariate analysis of factors causing the development of an oral infection indicated that gender and whether or not the patient was administered antimicrobials did not significantly affect the incidence of infection but patient age,whether or not fasting glucose was elevated,whether or not the patient gargled with baking soda,and whether plaque was present or not significantly affected the development of an oral infection due to a Candidasp.Multivariate logistic regression analysis indicated that the presence of plaque,whether or not the patient gargled with sodium bicarbonate,and whether or not fasting glucose was elevated significantly affected the development of an oral infection with a Candidasp.,（P0.05,OR1,95% CI）. Conclusion The main Candidasp.causing an oral infection in patients with type 2diabetes was Candida albicans,and it was more resistant to common drugs than other bacteria,which might be related to its epidemiology.The presence of plaque,gargling with sodium bicarbonate,and elevated fasting blood glucose significantly affected the development of an oral infection with Candidasp.Thus,drug use should be based on a real-time determination of etiology when clinically treating patients,and more attention should be given to relevant factors to effectively prevent infection.
出处
《中国病原生物学杂志》
CSCD
北大核心
2016年第5期468-471,475,共5页
Journal of Pathogen Biology
关键词
2型糖尿病
口腔感染
假丝酵母菌
影响因素
Type 2 diabetes mellitus
oral infection
Candida sp
influence factors
