Superficial candidosis course in patients with carbohydrate metabolism disorder and diabetes mellitus

OBJECTIVE

Introduction: One of the pressing issues of modern dermatology is the prevalence of diseases of skin and mucous membranes caused by yeast-like fungi. The aim: To study specific features of the course of skin and mucous membranes superficial candidosis against the background of initial carbohydrate metabolism disorders or diabetes mellitus.

PATIENTS AND METHODS

Materials and methods: We have examined 93 patients aged 18-75 suffering from superficial candidosis. Candidosis was diagnosed based on anamnesis data, results of clinical tests and laboratory studies. The study of carbohydrate metabolism included determining of the glucose level under fasting conditions to establish possible diabetes mellitus and glucose tolerance test (75 g glucose load), glycosylated hemoglobin (HbA1c) and fructosamine (FR).

RESULTS

Results: In patients with mild and moderate candidosis we have detected an increased rates of НbA1с and fructosamine, as compared with the like indicators received in the control group, by 1.54 and 1.21 times respectively. In patients with severe candidosis and relapses the concentrations of НbA1с increased by 2.59 times, FR - by 2.26 times against the indicators received in the control group. Thus, increased levels of blood glycosylated protein indicate the pathogenetic importance of these processes in the development of candidosis.

CONCLUSION

Conclusions: Consequently, increased levels of blood glycosylated protein indicates the pathogenetic importance of these processes in the development of candidal lesions. Tests for НbA1с and FR proved to be sensitive and allow reliable detection of individuals with diabetes mellitus and glucose intolerance among candidosis patients.

Comparative study of Streptococcus mutans laboratory strains and fresh isolates from carious and caries-free tooth surfaces and from subjects with hereditary fructose intolerance

This study was undertaken to investigate and compare some biochemical and physiological properties related to sugar metabolism of 4 laboratory strains and 13 freshly isolated strains of Streptococcus mutans from carious and caries-free tooth surfaces and from subjects with hereditary fructose intolerance. Growth in Trypticase (BBL Microbiology Systems)-yeast extract in the presence of various sugars was almost the same for all of the fresh isolates, which grew generally better than the laboratory strains. This was especially noticeable on sucrose where the fresh isolates (including those isolated from hereditary-fructose-intolerant patients) grew two to four times more rapidly than the laboratory strains. The rate of acid production by the fresh isolates, measured with resting cells in the presence of glucose, was quite comparable to the rate of the laboratory strains. The glucose analog, 2-deoxyglucose, inhibited the acid production from glucose by two laboratory strains (6715 and ATCC 27352), but none of the fresh isolates was affected by its presence. The antibiotic, gramicidin D, which allows free diffusion of H(+) across the cell membrane, inhibited the acid production of all of the strains. Phosphoenolpyruvate phosphotransferase activity toward alpha-methylglucoside was found in all of the laboratory and freshly isolated strains. 2-Deoxyglucose phosphotransferase activity was detected in all of the laboratory strains, but many clinical strains, especially those from hereditary-fructose-intolerant patients, contained very low or almost undetectable 2-deoxyglucose phosphotransferase activity. In one strain, the activity was restored after repeated culturing in Trypticase-yeast extract medium supplemented with glucose. Glucokinase and lactate dehydrogenase activities were detected in all of the strains tested. No marked differences were observed for these two enzymes between the fresh isolates and the laboratory strains except for three clinical strains which possessed low levels of glucokinase. The growth of all of the strains in a broth containing 4 mM glucose and 4 mM lactose was studied. Various patterns were observed: diauxie, glucose utilized before lactose but without diauxie, both sugars consumed concurrently, and lactose consumed more rapidly than glucose.

[Duodenal microflora in malnourished infants with acute diarrhea, carbohydrate intolerance and cow's milk protein intolerance]

Duodenal microflora was studied in three groups of malnourished infants: I) 10 cases with acute diarrhea; II) six carbohydrate intolerant infants; III) eight cases with cow's milk protein intolerance. In all of them it was observed linear increases of overgrowing flora, with a greater incidence of Gram negative microorganisms. The greatest number of bacterial counts, with mixed flora was found in group III. In group II, "Escherichia coli" was present in all the cultured aspirates, suggesting that it was not a random fact, and could be the agent responsible of diarrhea.

[Duodenal microflora in well-nourished infants with acute diarrhea and with carbohydrate intolerance]

Duodenal microflora was studied in two groups of infants in their first month of life with normal nutritional status: I) 11 infants with acute diarrhea; II) 3 infants with carbohydrate intolerance. No modifications of microflora were found in group I. Meanwhile in group II bacterial counts were always present from 10(3) to indefinite col/ml, being frequent the presence of Gram negative bacteria, with almost half of occasions positive to "Escherichia coli". Duodenal microflora alterations were independent of diarrheal duration and the same than those described in other ages of life.