Bouguerra R, Essaïs O, Sebaï N, Ben Salem L, Amari H, Kammoun M R, Chaker E, Zidi B, Ben Slama C
Service d'endocrinologie-diabétologie, institut national de nutrition, Bab-Saadoun, Tunisie.
Med Mal Infect. 2004 May;34(5):201-5. doi: 10.1016/j.medmal.2004.03.004.
The prevalence of mycotic infection seems to be higher among diabetic patients than in the non-diabetic population. The aims of this study were to determine the frequency of mycosis and to compare clinical and fungal results.
This transversal study included 307 type 1 and 2 diabetic patients admitted between January 1998 and January 2000. A dermatologist examined all patients. The mean age was 44 +/- 17 years and the duration of diabetes 8 +/- 6 years. Patients with suspected lesions underwent mycological examination.
Clinical signs of presumed fungal infection were found in 61% of patients, but mycosis was confirmed only in 30%. Fungal foot infection accounted 38% of the patients, mostly due to dermatophytes (94%). The commonest localizations of dermatophytes were interdigital (60%) followed by onychomycosis (30%). The main fungal agent was Trichophyton rubrum. The main risk factors for fungal infections were the age of patients (P = 0.0003) and duration of diabetes (P < 0.05). Interdigital foot localization of dermatophytes was correlated to age (P < 0.0001) and to the male gender (P < 0.01). The frequency of dermatophytes in nails was higher in type 2 diabetic patients (P < 0.01). Vulvovaginal candidosis and interdigital dermatophytes were more frequent in obese than in non-obese patients. The accuracy and specificity of direct examination were respectively 85% and 79%.
The high frequency of mycosis in diabetic patients at hospital is demonstrated. The main risk factors were age, male gender and obesity.
糖尿病患者中真菌感染的患病率似乎高于非糖尿病人群。本研究的目的是确定真菌病的发生率，并比较临床和真菌学结果。
这项横断面研究纳入了1998年1月至2000年1月期间收治的307例1型和2型糖尿病患者。由皮肤科医生对所有患者进行检查。平均年龄为44±17岁，糖尿病病程为8±6年。对疑似有病变的患者进行真菌学检查。
61%的患者发现有疑似真菌感染的临床体征，但仅30%的患者确诊为真菌病。足部真菌感染占患者的38%，主要由皮肤癣菌引起（94%）。皮肤癣菌最常见的感染部位是指间（60%），其次是甲癣（30%）。主要真菌病原体是红色毛癣菌。真菌感染的主要危险因素是患者年龄（P = 0.0003）和糖尿病病程（P < 0.05）。皮肤癣菌在足部指间的感染与年龄（P < 0.0001）和男性性别（P < 0.01）相关。2型糖尿病患者指甲中皮肤癣菌的感染率更高（P < 0.01）。外阴阴道念珠菌病和指间皮肤癣菌在肥胖患者中比非肥胖患者更常见。直接检查的准确性和特异性分别为85%和79%。
已证实住院糖尿病患者中真菌病的发生率较高。主要危险因素是年龄、男性性别和肥胖。
