Risk factors of adult isoniazid-resistant and rifampicin-susceptible tuberculosis in Nanjing, 2019-2021.

INTRODUCTION: This study aimed to analyze the risk factors associated with isoniazid-resistant and rifampicin-susceptible tuberculosis (Hr-TB) in adults. METHOD: The clinical data of 1,844 adult inpatients diagnosed with culture-positive pulmonary tuberculosis (PTB) in Nanjing Second Hospital from January 2019 and December 2021 were collected. All culture positive strain from the patient specimens underwent drug susceptibility testing (DST). Among them, 166 patients with Hr-TB were categorized as the Hr-TB group, while the remaining 1,678 patients were classified as having drug-susceptible tuberculosis (DS-TB). Hierarchical logistic regression was employed for multivariate analysis to identify variables associated with Hr-TB. RESULTS: Multivariate logistic regression analysis revealed that individuals with diabetes mellitus (DM) (OR 1.472, 95% CI 1.037-2.088, p = 0.030) and a history of previous tuberculosis treatment (OR 2.913, 95% CI 1.971-4.306, p = 0.000) were at higher risk of developing adult Hr-TB, with this risk being more pronounced in male patients. Within the cohort, 1,640 patients were newly treated, and among them, DM (OR 1.662, 95% CI 1.123-2.461, p = 0.011) was identified as risk factors for Hr-TB. CONCLUSIONS: Diabetes mellitus is a risk factor for Hr-TB in adults, and the contribution of diabetes as a risk factor was more pronounced in the newly treatment or male subgroup. And previous TB treatment history is also a risk factor for Hr-TB in adults.

Diabetes and Infectious Diseases with a Focus on Melioidosis.

Diabetes mellitus (DM) leads to impaired innate and adaptive immune responses. This renders individuals with DM highly susceptible to microbial infections such as COVID-19, tuberculosis and melioidosis. Melioidosis is a tropical disease caused by the bacterial pathogen Burkholderia pseudomallei, where diabetes is consistently reported as the most significant risk factor associated with the disease. Type-2 diabetes is observed in 39% of melioidosis patients where the risk of infection is 13-fold higher than non-diabetic individuals. B. pseudomallei is found in the environment and is an opportunistic pathogen in humans, often exhibiting severe clinical manifestations in immunocompromised patients. The pathophysiology of diabetes significantly affects the host immune responses that play a critical role in fighting the infection, such as leukocyte and neutrophil impairment, macrophage and monocyte inhibition and natural killer cell dysfunction. These defects result in delayed recruitment as well as activation of immune cells to target the invading B. pseudomallei. This provides an advantage for the pathogen to survive and adapt within the immunocompromised diabetic patients. Nevertheless, knowledge gaps on diabetes-infectious disease comorbidity, in particular, melioidosis-diabetes comorbidity, need to be filled to fully understand the dysfunctional host immune responses and adaptation of the pathogen under diabetic conditions to guide therapeutic options.

Candida albicans skin infection in diabetic patients: An updated review of pathogenesis and management.

Candida species, commensal residents of human skin, are recognized as the cause of cutaneous candidiasis across various body surfaces. Individuals with weakened immune systems, particularly those with immunosuppressive conditions, are significantly more susceptible to this infection. Diabetes mellitus, a major metabolic disorder, has emerged as a critical factor inducing immunosuppression, thereby facilitating Candida colonization and subsequent skin infections. This comprehensive review examines the prevalence of different types of Candida albicans-induced cutaneous candidiasis in diabetic patients. It explores the underlying mechanisms of pathogenicity and offers insights into recommended preventive measures and treatment strategies. Diabetes notably increases vulnerability to oral and oesophageal candidiasis. Additionally, it can precipitate vulvovaginal candidiasis in females, Candida balanitis in males, and diaper candidiasis in young children with diabetes. Diabetic individuals may also experience candidal infections on their nails, hands and feet. Notably, diabetes appears to be a risk factor for intertrigo syndrome in obese individuals and periodontal disorders in denture wearers. In conclusion, the intricate relationship between diabetes and cutaneous candidiasis necessitates a comprehensive understanding to strategize effective management planning. Further investigation and interdisciplinary collaborative efforts are crucial to address this multifaceted challenge and uncover novel approaches for the treatment, management and prevention of both health conditions, including the development of safer and more effective antifungal agents.

Comparison of clinical and microbiological characteristics of community-acquired hypervirulent Klebsiella pneumoniae liver abscess in diabetic and non-diabetic patients.

Invasive infection caused by hypervirulent Klebsiella pneumoniae (HvKP) has been reported worldwide. Most of the patients are community population, related to diabetes mellitus (DM), chronic liver disease and other basic diseases, which prone to systemic migratory infection. In this study, we collected 377 patients with community acquired Klebsiella pneumoniae liver abscess in our hospital from January 2013 to December 2018, 65.8% of whom were male, and 49.6% had DM. Patients with DM are prone to eye and central nervous system (CNS) infection, which need continuous local abscess drainage during treatment. Among them, patients with poor blood glucose control have a higher rate of blood stream infections (BSI). 219 strains of HvKP were obtained, with K1/K2 Serotype accounted for 81.7%. The incidence of BSI in K2 patients was higher than that in K1 patients. The PCR results indicate that the carrying rate of virulence genes (rmpA、areo、kfu、allS、iroN、magA、uge、wcaG) in K1/K2 type strains is significantly higher than that in non K1/K2 type strains. ST23 and ST65 are the most common multilocus sequence typing (MLST), which belong to K1 and K2 Serotype respectively. All of HvKP strains showed high sensitivity to commonly used clinical antibiotics other than ampicillin, with 54.3% of the strains exhibiting high viscosity characteristics. Meanwhile, 35 classic Klebsiella pneumoniae (cKP) strains were collected, and their serum typing is mainly non K1/K2. The carrying rate of virulence genes and viscosity degree in HvKP are significantly higher than those in cKP. Primary liver abscess caused by HvKP is prone to multiple tissue and organ infections, but it shows higher sensitivity to most commonly used antibiotics in clinical practice except for ampicillin. After effective treatment, the overall prognosis of patients is better. This study analyzes the pathogenic characteristics of HvKP and elaborates on the clinical characteristics of patients, which can provide reference for clinical and scientific research work.

Advances in fecal microbiota transplantation for the treatment of diabetes mellitus.

Diabetes mellitus (DM) refers to a group of chronic diseases with global prevalence, characterized by persistent hyperglycemia resulting from various etiologies. DM can harm various organ systems and lead to acute or chronic complications, which severely endanger human well-being. Traditional treatment mainly involves controlling blood sugar levels through replacement therapy with drugs and insulin; however, some patients still find a satisfactory curative effect difficult to achieve. Extensive research has demonstrated a close correlation between enteric dysbacteriosis and the pathogenesis of various types of DM, paving the way for novel therapeutic approaches targeting the gut microbiota to manage DM. Fecal microbiota transplantation (FMT), a method for re-establishing the intestinal microbiome balance, offers new possibilities for treating diabetes. This article provides a comprehensive review of the correlation between DM and the gut microbiota, as well as the current advancements in FMT treatment for DM, using FMT as an illustrative example. This study aims to offer novel perspectives and establish a theoretical foundation for the clinical diagnosis and management of DM.

A comparison of oral bacteriome isolated from periodontal pockets of participants with or without diabetes mellitus in Uganda: a case control study.

OBJECTIVE: Diabetes mellitus predisposes patients to increased incidence and severe forms of periodontal disease. Currently, information on the bacterial diversity of patients with diabetes mellitus and periodontitis in Uganda is scanty. This study set out to describe the bacteria associated with periodontitis in patients with diabetes mellitus in Uganda, as part of a larger study describing the association between periodontal disease and diabetes mellitus. RESULTS: This was a case control involving 45 samples of gingival crevicular fluid collected from participants with periodontitis, the cases being 26 participants with diabetes mellitus and controls 19 participants without diabetes mellitus. Sequencing using the 16s Oxford nanopore long read protocol was followed by a bioinformatics analysis pipeline for alpha and beta diversity indices in the two groups. Multivariate tests were done to determine the differences in the bacterial composition in the two groups. Of the 739 Operational Taxonomic Units and 500 phyla identified, 37.9% (280/739) were from participants with diabetes mellitus. Analysis of beta diversity revealed a dissimilarity between the two study groups (CAP score = 0) with a significant association noted between periodontitis and the subgingival bacteria (P = 0.001). Diabetes mellitus reduced the quantity and altered the composition of the subgingival microbiome in the study participants.

Insights into the Mechanisms of Action of Akkermansia muciniphila in the Treatment of Non-Communicable Diseases.

This comprehensive review delineates the extensive roles of Akkermansia muciniphila in various health domains, spanning from metabolic and inflammatory diseases to neurodegenerative disorders. A. muciniphila, known for its ability to reside in the mucous layer of the intestine, plays a pivotal role in maintaining gut integrity and interacting with host metabolic processes. Its influence extends to modulating immune responses and potentially easing symptoms across several non-communicable diseases, including obesity, diabetes, inflammatory bowel disease, and cancer. Recent studies highlight its capacity to interact with the gut-brain axis, suggesting a possible impact on neuropsychiatric conditions. Despite the promising therapeutic potential of A. muciniphila highlighted in animal and preliminary human studies, challenges remain in its practical application due to stability and cultivation issues. However, the development of pasteurized forms and synthetic mediums offers new avenues for its use in clinical settings, as recognized by regulatory bodies like the European Food Safety Authority. This narrative review serves as a crucial resource for understanding the broad implications of A. muciniphila across different health conditions and its potential integration into therapeutic strategies.

Candida species oral detection and infection in patients with diabetes mellitus: a meta-analysis

Introduction: Diabetes mellitus is a chronic metabolic disorder that induces elevated plasma glucose levels. Diabetic patients are more susceptible to infections, especially fungal infections. There is a direct relationship between increased blood glucose levels and the number of Candida hyphae in the oral mucosa. This study aimed to evaluate oral candidiasis and the different Candida species found in patients with and without diabetes mellitus. Methods: A search for studies on oral candidiasis and diabetes mellitus was carried out in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) and Google Scholar. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (OR) using the Mantel-Haenszel (M-H) method with 95% confidence intervals. Results: 25 studies were included in this meta-analysis. Diabetes Mellitus patients tripled the probability of being infected by Candida species (OR:3.16, p<0.001). Likewise, Candida species infections were more likely in patients with poor glycemic control (OR:2.94, p<0.001) and with dentures (OR:2.22, p<0.001). In contrast, neither gender nor diabetes mellitus type of diabetes conditioned fungal infections (p>0.05). The most prevalent Candida species in both diabetics and controls were C. albicans and C. tropicalis. Diabetics had significantly fewer C. non-albicans species oral infections than non-diabetics (p=0.04). Conclusions: Diabetics are more prone to oral candidiasis, especially C. albicans infections (AU)

Type-2 Diabetes Mellitus Individuals Carry Different Periodontal Bacteria

ABSTRACT Objective: To identify etiologic microbiota associated periodontal diseases among diabetes patients and the factors related to the most commonly identified bacteria species. Material and Methods: Periodontal plaque samples from 11 diabetic participants and 13 non-diabetic controls were collected to assess their aerobic and anaerobic bacterial growth. Different distinct colonies were identified by microscopic and 16srDNA sequencing. Pearson's chi-square tests were conducted to examine any association between categorical variables. Results: The diabetic subjects revealed a more intense plaque formation with a mean plaque index of 2.4 compared to 1.8 in non-diabetics. A total of 86 bacteria were isolated from 24 plaque samples, 44 were aerobic, and 42 were anaerobic. Only aerobic isolates, 22 from diabetic patients and 22 from non-diabetic patients, were evaluated in these analyses. Bacillus spp. (B. cereus mainly) and Klebsiella spp. (K. pneumoniae, K. aerogenes, K. oxytoca) were detected markedly higher in non-diabetic individuals than in diabetic subjects (p=0.026 and p=0.021, respectively). Some bacteria were only identified in the dental plaque of diabetic individuals, namely, Bacillus mojavensis, Enterobacter cloacae, Proteus mirabilis, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus pasteuri, Streptococcus mutans, and Streptococcus pasteurianus. The presence of acid reflux and jaundice were significantly associated with the most common bacterial isolate, namely Bacillus spp., with the p-values of 0.007 and 0.001, respectively. Conclusion: Type-2 diabetes mellitus is associated with a higher amount of dental plaques. Periodontal plaque samples from diabetic and non-diabetic subjects possess differential microbial communities. Diabetic plaques contain more versatile microbes predominated by gram-positive streptococci and staphylococci.

ERG11 gene polymorphisms and susceptibility to fluconazole in candida isolates from diabetic and kidney transplant patients

Abstract INTRODUCTION: Candidiasis is the most frequent opportunistic mycosis in humans and can cause mortality, particularly in immunodeficient patients. One major concern is the increasing number of infections caused by drug-resistant Candidas trains, as these cannot be efficiently treated with standard therapeutics. The most common mechanism of fluconazole resistance in Candida is mutation of ERG11, a gene involved in the biosynthesis of ergosterol, a compound essential for cell integrity and membrane function. METHODS: Based on this knowledge, we investigated polymorphisms in the ERG11 gene of 3 Candida species isolated from immunocompromised and immunocompetent patients. In addition, we correlated the genetic data with the fluconazole susceptibility profile of the Candida isolates. RESULTS: A total of 80 Candida albicans, 8 Candida tropicalis and 6 Candida glabrata isolates were obtained from the saliva of diabetic, kidney transplant and immunocompetent patients. Isolates were considered susceptible to fluconazole if the minimum inhibitory concentration was lower than 8 μg/mL. The amino acid mutations F105L, D116E, K119N, S137L, and K128T were observed in C. albicans isolates, and T224C and G263A were found in C. tropicalis isolates. CONCLUSIONS: Despite the high number of polymorphisms observed, the mutations occurred in regions that are not predicted to interfere with ergosterol synthesis, and therefore are not related to fluconazole resistance.

Mucormicosis rino-órbito-cerebral de origen dental / Rhino-orbito-cerebral mucormycosis from dental origin: Case report

Resumen La mucormicosis es una infección aguda causada por hongos oportunistas pertenecientes al orden de los mucorales, que afecta principalmente a pacientes diabéticos e inmunosuprimidos. Se reporta el caso de un hombre diabético de 63 años de edad, que se extrajo una pieza dental por sus propios medios y, posteriormente, desarrolló una mucormicosis rino-órbito-cerebral con afección cutánea y palatina. La especie aislada mediante cultivos micológicos fue Rhizopus sp.

Abstract Rhino-orbito-cerebral mucormycosis from dental origin is an acute infection caused by opportunistic fungi belonging to the order of Mucorales, which affects mainly diabetic and immunocompromised patients. We report the case of a 63-year old diabetic man who performed a dental extraction on himself by his own means and subsequently developed a rhino-orbito-cerebral mucormycosis with cutaneous and palatal affection. The species isolated in the mycological culture was Rhizopus sp.

In vitro antifungal susceptibility of Candida speciesisolated from diabetic patients

Abstract INTRODUCTION This study aims to evaluate the antifungal susceptibility of different species of Candida isolated from diabetic patients against eight antifungal agents. METHODS Susceptibility testing of 111 clinical isolates of Candida species was performed against 8 antifungals using the M27-A3 protocol of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Voriconazole, lanoconazole, and caspofungin showed the highest in vitro activity against all the isolates of C. albicans. Resistance against the tested antifungals was only observed in the C. albicans isolates. CONCLUSIONS Our finding revealed that resistance against amphotericin B, itraconazole, ketoconazole, posaconazole, and fluconazole can be observed in C. albicans.

New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study

BACKGROUND The link between Candida albicans and diabetes mellitus is well-acknowledged, but incompletely elucidated. OBJECTIVES The purpose of this study is to assess the growth rate of C. albicans (CA) in the presence of different concentrations of glucose and fructose, two of the main pathophysiologic and nutritionally relevant sugars in diabetic patients, in order to obtain a better understanding of the nutrient acquisition strategy and its possible relation to the hyperglycemic status of diabetic patients. METHODS The effects of different concentrations of glucose and fructose (1000 mg%, 500 mg%, 250 mg% and 100 mg% w/v) on the growth rate of CA have been studied by flow-cytometry. FINDINGS We found that glucose concentration is directly related to CA growth, which may be linked to the frequent yeast infections that occur in non-controlled diabetic patients; we also show that fructose inhibits CA growth rate. MAIN CONCLUSIONS As a consequence of our hypothesis, the study demonstrates that fructose-containing food may prevent the development of candidiasis, at least in oral sites.

Avaliação in vitro da formação de biofilme por cepas de Candida spp. provenientes de indivíduos diabéticos e não diabéticos em ambiente sem e com suplementação de glicose / In vitro evaluation of biofilm formation by Candida spp. strains from diabetic and non-diabetic individuals in environment without and with glucose supplementation

É notório o papel do diabetes mellitus como fator de risco para o desenvolvimento de doenças bucais, como a candidíase bucal, cárie e a periodontite. Assim, este estudo tem como objetivo avaliar a formação de biofilme por cepas de Candida spp. provenientes de diabéticos e não diabéticos em ambiente sem e com suplementação de glicose. Trata-se de um estudo experimental laboratorial in vitro, em três etapas. Etapas um e dois, de obtenção e identificação de 48 cepas de Candida spp., sendo que 32 de C. albicans e 16 de C. glabrata, com auxílio da técnica de PCR. Ainda, a etapa três, de processamento microbiológico, com a avaliação da capacidade de formação de biofilme por três ensaios distintos: I) determinação do número de unidades formadoras de colônia (UFC/mL); II) matéria seca dos biofilmes; III) taxa de crescimento de biofilme em fundo de placa de poliestireno. Inicialmente, objetivando simular as características observadas in vivo, o fundo das placas de cultivo recebeu 400 µL de saliva humana para formação da película adquirida. Decorrida a incubação a 37 °C por 24 h, a saliva foi descartada e cada poço de cultura recebeu suspensão padronizada das leveduras (106 UFC/mL) em Saubouraud Dextrose Broth sem suplementação e com suplementação de glicose a 2 e 10 mg/mL, e as placas foram incubadas a 37 °C por 48 h. Para avaliação do número de UFC/mL, o biofilme aderido foi coletado, diluído seriamente e cultivado em placas de Petri com Sabouraud Dextrose Agar. Após incubação os resultados foram expressos em log UFC/mL. Para a avaliação da matéria seca, a solução remanescente foi liofilizada e mensurada em balança de precisão. A taxa de crescimento de biofilme foi avaliada por microscopia Operetta CLS High Content e o FilmTracer(TM) LIVE/DEAD Biofilm Viability kit, conforme o protocolo do fabricante. Posteriormente, 10 imagens por poço foram obtidas e digitalizadas com ampliação de 40 ×. A área recoberta por biofilme (µm2) das imagens foi avaliada com auxílio do software Harmony High Content Imaging. Os dados apresentaram distribuição não normal, e a comparação entre as cepas de diabéticos e não diabéticos foi realizada pelo teste U Mann-Whitney. O teste de Kruskal-Wallis one way foi utilizado para verificar diferenças entre as condições de suplementação de glicose. O nível de significância estatística adotado foi de α = 5%. Os valores de UFC/mL mostraram um maior crescimento das cepas de C. albicans dos pacientes diabéticos em relação aos não diabéticos nas três suplementações (p < 0,001). Por outro lado, acerca da matéria seca em 10 mg/mL e da taxa de crescimento de biofilme sem suplementação de glicose e a 2 mg/mL, os resultados indicaram uma formação de biofilme maior para cepas de C. albicans dos não diabéticos (p < 0,001). Em conclusão, cepas de C. albicans e C. glabrata provenientes de diabéticos e não diabéticos em ambiente sem e com suplementação de glicose apresentaram resultados distintos quanto à formação de biofilme, por diferentes técnicas

The role of diabetes mellitus is notorious as a risk factor for development of oral diseases, such as oral candidiasis, dental caries, and periodontitis. Thus, this study aimed to evaluate biofilm formation by Candida spp. strains from diabetic and non-diabetic individuals in environment without and with glucose supplementation. This is an in vitro experimental laboratory study, in three stages. Stages one and two of obtainment and identification of 48 Candida spp. strains, with 32 of C. albicans and 16 of C. glabrata, with the help of PCR technique. Also, stage three, of microbiological processing, with evaluation of biofilm formation capacity by three different assays: I) determination of the number of colony forming units (CFU/mL); II) biofilm dry matter; III) biofilm growth rate on the bottom of polystyrene plates. Initially, aiming to simulate the characteristics observed in vivo, the bottom of the cultivation plates received 400 µL of human saliva for formation of acquired pellicle. After the incubation at 37 °C for 24 h, the saliva was discarded and each culture well received standardized suspension of yeast (106 CFU/mL) in Saubouraud Dextrose Broth without supplementation and with glucose supplementation at 2 and 10 mg/mL, and the plates were incubated at 37 °C for 48 h. To assess the number of CFU/mL, the adhered biofilm was collected, seriously diluted, and cultivated in Petri dishes with Sabouraud Dextrose Agar. After the incubation, the results were expressed in log CFU/mL. To assess the dry matter, the remaining solution was lyophilized and measured on a precision scale. The biofilm growth rate was evaluated by Operetta CLS High Content microscopy and FilmTracer(TM) LIVE/DEAD Biofilm Viability kit, according to manufacturer's protocol. Later, 10 images per well were obtained and digitalized with 40 × magnification. The area covered by biofilm (µm2) of the images was assessed with the help of Harmony High Content Imaging software. Data showed non-normal distribution, and the comparison among the diabetic and non-diabetic strains was performed by Mann-Whitney U test. Kruskal-Wallis one-way test was used to verify differences between conditions of glucose supplementation. The level of statistical significance adopted was α = 5%. The values of CFU/mL showed greater growth of the diabetic patient's strains in relation to the non-diabetic ones (p < 0.001). On the other hand, regarding dry matter at 10 mg/mL and the growth rate of biofilm without glucose supplementation and at 2 mg/mL, the results indicated a higher biofilm formation for strains of C. albicans from non-diabetic individuals (p <0.001). In conclusion, C. albicans and C. glabrata strains from diabetic and non-diabetic individuals in environment without and with glucose supplementation showed different results concerning the biofilm formation, using different techniques

Analysis of the genetic diversity of Candida isolates obtained from diabetic patients and kidney transplant recipients

Yeasts of the genus Candida have high genetic variability and are the most common opportunistic pathogenic fungi in humans. In this study, we evaluated the genetic diversity among 120 isolates of Candida spp. obtained from diabetic patients, kidney transplant recipients and patients without any immune deficiencies from Paraná state, Brazil. The analysis was performed using the ITS1-5.8S-ITS2 region and a partial sequence of 28S rDNA. In the phylogenetic analysis, we observed a consistent separation of the species C. albicans, C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. metapsilosis and C. orthopsilosis, however with low intraspecific variability. In the analysis of the C. albicans species, two clades were formed. Clade A included the largest number of isolates (91.2%) and the majority of isolates from GenBank (71.4%). The phylogenetic analysis showed low intraspecific genetic diversity, and the genetic polymorphisms between C. albicans isolates were similar to genetic divergence found in other studies performed with isolates from Brazil. This low genetic diversity of isolates can be explained by the geographic proximity of the patients evaluated. It was observed that yeast colonisation was highest in renal transplant recipients and diabetic patients and that C. albicans was the species most frequently isolated.

Aerobic bacterial microbiota of the conjunctiva in diabetic patients with normal and altered glycated hemoglobin levels in two regions in Brazil / Microbiota bacteriana aeróbica conjuntival em pacientes diabéticos com hemoglobina glicada normal e alterada em duas regiões brasileiras

Purpose: To study the aerobic bacterial microbiota of the conjunctiva in diabetic patients with regard to the management of diabetes, assessed using glycated hemoglobin levels. Methods: A cross-sectional study was conducted using conjunctival smears of diabetic patients from both sexes and with different ages, residing in two different Brazilian cities (Sorocaba and Rio Branco). A control group of non-diabetic patients was also included. The diabetic patients were considered to have controlled diabetes when their glycated hemoglobin level was ≤7% and blood glucose level was ≤126 mg/dL. Patients with non-controlled diabetes were those with glycated hemoglobin levels >7% and blood glucose levels >126 mg/dL. The samples obtained were inoculated in Brain-Heart Infusion broth and in culture media for aerobic bacteria (blood and chocolate agars); bacterial growth was evaluated in a microbiology laboratory. Results: A total of 120 eyes of 120 patients were included in the present study. The percentage of cultures in which bacterial growth was observed was greater in diabetic patients, although the difference was not statistically significant (p=0.103). There was a greater trend toward bacterial growth in the conjunctiva of diabetic patients with altered fasting blood glucose. There was no difference in the frequency of bacterial growth on the conjunctiva between diabetic patients with normal or altered glycated hemoglobin levels. In Sorocaba, conjunctival bacterial growth was similar to that observed in Rio Branco. The microorganism most frequently detected in the present study was Staphylococcus epidermidis, followed by Staphylococcus aureus, Proteus mirabilis, and Escherichia coli. Conclusion: There was no difference between diabetic patients with normal or altered glycated hemoglobin levels. The microorganisms found were similar to those found in studies investigating the conjunctival bacterial flora of diabetic and non-diabetic ...

Objetivo: Estudar a microbiota conjuntival bacteriana aeróbica dos pacientes diabéticos em relação ao controle glicêmico, verificado através da hemoglobina glicada, em duas cidades distintas. Métodos: Foi realizado um estudo transversal utilizando raspados de conjuntiva de indivíduos diabéticos de ambos os sexos e idades variáveis de duas cidades: Sorocaba e Rio Branco. O grupo controle foi constituído de pacientes não diabéticos. A amostra foi constituída de pacientes diabéticos que foram considerados controlados com hemoglobina glicada ≤7% e glicemia de jejum ≤126 mg/dl e não controlados com hemoglobina glicada >7% e glicemia de jejum >126 mg/dl. O material obtido foi semeado em meio líquido Brain Heart Infusion (BHI) e em meios de cultivo para bactérias aeróbicas (ágar sangue e ágar chocolate). O crescimento bacteriano foi avaliado em laboratório de microbiologia. Resultados: Foram incluídos 120 olhos de 120 pacientes. A porcentagem de culturas nas quais houve crescimento bacteriano foi maior em pacientes diabéticos, sendo a diferença não estatisticamente significante (p=0,103). Não houve diferença entre o crescimento bacteriano em pacientes com hemoglobina glicada normal e alterada. Houve uma tendência maior de crescimento bacteriano em conjuntivas de pacientes diabéticos com glicemias de jejum elevada. Em Sorocaba houve crescimento bacteriano conjuntival semelhante a Rio Branco. O microrganismo mais frequente encontrado neste estudo foi Staphylococcus epidermidis, seguido de Staphylococcus aureus, Proteus mirabilis e Escherichia coli. Conclusões: Não ocorreu diferença entre pacientes diabéticos com hemoglobina glicada normal e alterada. Os microrganismos encontrados foram semelhantes aos estudos da flora bacteriana de conjuntivas normais e de diabéticos. .

Freqüência e atividade enzimática de Candida spp. na cavidade oral de pacientes diabéticos do serviço de endocrinologia de um hospital de Fortaleza-CE / Frequency and enzymatic activity of Candida spp. oral cavity of diabetic patients of the service of endocrinology of a hospital of Fortaleza-CE

O diabetes mellitus (DM), uma doença endócrino-metabólica de alta e crescente prevalência, é citada como responsável pela ocorrência das candidíases orais. A candidíase constitui um espectro de infecções causadas por fungos do gênero Candida, sendo o seu agente mais comum a Candida albicans, embora outras espécies tenham sido identificadas (Candida tropicalis, Candida guillermondii, Candida glabrata, Candida krusei). O objetivo deste trabalho foi avaliar a freqüência e a atividade enzimática de Candida spp. na cavidade oral de pacientes diabéticos atendidos no Serviço de Endocrinologia do Hospital Universitário Walter Cantídio da Universidade Federal do Ceará (HUWC/UFC). Foram coletadas amostras de 48 pacientes diabéticos, de ambos os sexos, com situações variáveis de controle glicêmico. Os materiais clínicos foram colhidos com ajuda de swabs e semeados em placas de Petri contendo ágar-Sabouraud dextrose com cloranfenicol e incubado a 37ºC. Os crescimentos foram identificados pelas provas clássicas usadas em micologia. Depois, essas cepas de Candida foram submetidas a provas de detecção de enzimas fosfolipase e proteinase. Destas, 15 amostras (31,25 por cento) apresentaram cultura positiva para o gênero Candida. A espécie mais freqüente foi a C. albicans, com 80 por cento, seguida de C. tropicalis (13,3 por cento) e C. guillermondii (6,7 por cento). Quanto à pesquisa da atividade enzimática de Candida spp., foi observado que 86,6 por cento delas apresentaram atividade de proteinase e 80 por cento, de fosfolipase. Conclui-se com tais resultados que a C. albicans é a mais freqüente e que as espécies de Candida isoladas possuem fortes atividades enzimáticas.

Diabetes mellitus, a endocrine-metabolic disease, of high and increasing prevalence, is cited as responsible by the occurrence of oral candidiasis. Candidiasis constitutes a specter of infections caused by fungi of genera Candida; the most common agent is Candida albicans, but other species have also been identified (Candida tropicalis, Candida guillermondii, Candida glabrata, Candida krusei). The objective of this work was to evaluate frequency and enzymatic activity of Candida spp. in the oral cavity of diabetic patients taken care in the service of endocrinology of the University Hospital Walter Cantídio of the Federal University of the Ceará. Samples had been collected of 48 diabetic patients, men and women, with various situations of glicemic control. Clinical materials had been collected with aid of swab and harvested in plates of Petri contend Sabouraud agar dextrose with cloranfenicol and incubated to 37ºC. The grown were identified by the used classic tests in mycology. In the following, these Candida strains were submitted to tests to detect phospholipase and proteinase enzymes. Of these, 15 samples (31,35 percent) presented positive culture for the genera Candida. The species more frequent was C. albicans with 80 percent, followed by C. tropicalis (13.3 percent) and C. guilliermondii (6.7 percent). Asfor the research on the enzymatic activity of Candida sp. it was observed that 86.6 percent presented activity of proteinase and 80 percent of phospholipase. It was concluded with these results that C. albicans is more frequent and that Candida spp. isolated species have strong enzymatic activity.

Infecciones en el pie diabético: importancia de las resistencias bacterianas / Diabetic foot infections: the importance of bacterial resistance

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