Buchta V, Matula V, Kestřánek J, Vejsová M, Křivčíková L, Spaček J
Ceska Gynekol. 2013 Dec;78(6):537-44.
To analyze experimental and clinical data on diabetes mellitus (DM) related to infections with focus on vaginal mycosis. To evaluate a role of DM in the epidemiology of vulvovaginal candidiasis.
Review.
Department of Clinical Microbiology, Department of Biological and Medical Sciences, Faculty of Pharmacy, Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove.
Review of literature data.
DM is a risk factor for fungal infections caused by yeasts (Candida albicans), members of Mucorales fungi, some dimorphic fungi (Coccidioides) and agents of onychomycosis. DM is usually associated only with increased colonization of the anatomical sites (oral cavity, vagina), and/ or with an intensified symptomatology of infection (onychomycosis, mucormycosis). Diabetic patients with oropharyngeal and vulvovaginal candidiasis have frequently changed etiology spectrum. The patients with VVC and DM, especially of older age or with prone to relapses, have tendency to shift of the spectrum to non-albicans species, mainly C. glabrata. Treatment of VVC in diabetic patients can be complicated owing to unfavourable antifungal susceptibility profile (C. glabrata) and/ or adverse interactions between some azole antifungals and sulfonylurea-based antidiabetics.
Diabetes mellitus is often cited as a risk factor, although in many cases there is a lack of reliable and clinically relevant information. This does not mean that this disease can be underestimated. On the contrary, it is necessary to get the DM as soon as possible under control and thus prevent complications when infection develops. Individual approach should be applied to the diabetic patients at risk of an infection. Yeast colonization and development of vaginal infection is complex process primarily dependent on sexual hormones, indigenous microbiota and finely tuned mechanisms of local immunity. Role of DM consists in the fact that it is one of the important co-factors that can change the setup of the vaginal environment in favour of yeasts and thus promote or facilitate the development of VVC.
分析与感染相关的糖尿病（DM）的实验和临床数据，重点关注阴道真菌病。评估DM在外阴阴道念珠菌病流行病学中的作用。
综述。
布拉格查理大学医学院和赫拉德茨克拉洛韦大学医院临床微生物学系、生物与医学科学系、药学院、妇产科。
文献数据综述。
DM是由酵母菌（白色念珠菌）、毛霉目真菌成员、一些双相真菌（球孢子菌）和甲癣病原体引起的真菌感染的危险因素。DM通常仅与解剖部位（口腔、阴道）的定植增加和/或感染症状加重（甲癣、毛霉病）相关。患有口咽和外阴阴道念珠菌病的糖尿病患者的病因谱经常发生变化。患有VVC和DM的患者，尤其是年龄较大或容易复发的患者，其谱型有向非白色念珠菌物种（主要是光滑念珠菌）转变的趋势。糖尿病患者VVC的治疗可能会因抗真菌药敏谱不利（光滑念珠菌）和/或某些唑类抗真菌药与磺脲类降糖药之间的不良相互作用而变得复杂。
糖尿病常被认为是一个危险因素，尽管在许多情况下缺乏可靠且与临床相关的信息。但这并不意味着这种疾病可以被低估。相反，有必要尽快控制DM，从而预防感染发生时的并发症。对于有感染风险的糖尿病患者应采取个体化方法。酵母菌定植和阴道感染的发展是一个复杂的过程，主要取决于性激素、本地微生物群和局部免疫的精细调节机制。DM的作用在于它是重要的协同因素之一，可改变阴道环境，有利于酵母菌生长，从而促进或便利VVC的发展。
