Kohut Ihor, Galnykina Svitlana, Kushynska Mariia, Krynytska Inna, Marushchak Mariya, Kamyshnyi Aleksandr
Department of Infectious Diseases with Epidemiology, Dermatology and Venereology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Department of Medical Biology, Parasitology and Genetics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Pol Merkur Lekarski. 2020 Apr 22;48(284):77-81.
Candida albicans is the most prevalent human fungal commensal organism and is reported to be the most frequent aetiological factor responsible for infection associated with incontinence-associated dermatitis (IAD).
The aim of the study was to investigate the Candida spp. colonisation and efficacy of camphorated oil in the skin care of the patients with incontinence-associated dermatitis.
In patients of the study group (n=104), a local application of camphorated oil was used to clean and protect their skin from urine and/or faeces. In 30 patients of the control group routine wet wipes 3 in 1 or a combination of cleansing foam with protective cream were used. Pre-treatment (day 1) and post-treatment (day 30±1) study evaluations included detailed description of eruption, assessment by evaluation tools, and mycological culture for Candida spp. from sites with fungal-appearing rash.
Fungal-appearing rash was found in almost a half (51.0%) of patients at pre-treatment examination and in less than one-third (31.7%) of the patients after the course of application of camphorated oil. Candida spp. was cultivated in 39 (37.5%) patients. Fungal-appearing rash was approved by mycological culture in 56.6%. In patients with urine incontinence, Candida spp. negative cases (43.3%) were significantly prevalent over Candida spp. positive (22.1%). At post-treatment, this prevalence become more noticeable, accordingly obtaining 62.5% of negative and 2.9% of positive results. In patients with double incontinence, Candida spp. negative cases (19.2%) were almost equal to the number of Candida spp. positive (15.4%). After a course of study treatment, Candida spp. negative cases (26.0%) significantly overpassed Candida spp. positive level (8.7%). At an early and moderate grade of IAD Candida spp. negative cases were prevalent, but at severe grade did not differ from the number of positive mycology cultures.
The topical use of camphorated oil in skin care of the incontinence-associated dermatitis significantly decreases the severity of disease, reduces fungal appearing rash and Candida spp. colonisation. Camphorated oil was superior to routine products in the controlling of yeast colonisation of the skin in incontinence-associated dermatitis, especially in cases with double incontinence.
白色念珠菌是人类最常见的真菌共生生物体，据报道是与失禁相关性皮炎（IAD）相关感染的最常见病因。
本研究旨在调查念珠菌属在失禁相关性皮炎患者皮肤护理中的定植情况以及樟脑油的疗效。
在研究组患者（n = 104）中，局部应用樟脑油来清洁皮肤并保护其免受尿液和/或粪便的侵害。在30名对照组患者中，使用三合一常规湿纸巾或清洁泡沫与防护霜的组合。治疗前（第1天）和治疗后（第30±1天）的研究评估包括皮疹的详细描述、通过评估工具进行评估以及对出现真菌样皮疹部位进行念珠菌属的真菌培养。
在治疗前检查中，近一半（51.0%）的患者出现真菌样皮疹，在应用樟脑油疗程后，不到三分之一（31.7%）的患者出现此类皮疹。39名（37.5%）患者培养出念珠菌属。真菌样皮疹经真菌培养证实的占56.6%。在尿失禁患者中，念珠菌属阴性病例（43.3%）明显多于念珠菌属阳性病例（22.1%）。治疗后，这种差异更加明显，阴性结果占62.5%，阳性结果占2.9%。在大小便失禁患者中，念珠菌属阴性病例（19.2%）与念珠菌属阳性病例数（15.4%）几乎相等。经过一个疗程的研究治疗后，念珠菌属阴性病例（26.0%）显著超过念珠菌属阳性水平（8.7%）。在IAD的早期和中度阶段，念珠菌属阴性病例占多数，但在重度阶段，与真菌培养阳性病例数无差异。
在失禁相关性皮炎的皮肤护理中局部使用樟脑油可显著降低疾病严重程度，减少真菌样皮疹和念珠菌属定植。在控制失禁相关性皮炎皮肤酵母菌定植方面，樟脑油优于常规产品，尤其是在大小便失禁的情况下。
