Species distribution and influence of glycemic control on fungal infections in pregnant women with diabetes

J Infect. 2004 May;48(4):339-46. doi: 10.1016/j.jinf.2004.01.017.

Abstract

Objectives: (1) To find the distribution of species among fungal strains isolated from pregnant women with diabetes mellitus (DM), gestational diabetes (GDM) and healthy controls (CON); (2) to analyse the influence of glycemia on the prevalence of fungi in different body sites.

Methods: Mycological examinations were performed in 251 pregnant women: 119 diabetic (47 DM, and 72 GDM) and 132 controls. Samples were collected from vagina, rectum and oral cavity of all women and cultured on Sabouraud media.

Results: A total of 212 fungal strains were isolated, 12 fungal species were identified: 89.6% of the strains belonged to Candida gender, 10.4% to Saccharomyces, Geotrichum, Rhodotorula and Trichosporon genera. The prevalence of fungi, respectively, in vagina and rectum, was significantly higher in diabetics with poor glycemic control when stratified (<100 mg/dl, 100-120 mg/dl and >120 mg/dl) both the mean week glucose levels (MWGL) levels (p = 0.03, p = 0.03) and glycemia 90 min after breakfast (p = 0.04, 0.03). No difference was found in the prevalence of fungi and glycolised hemoglobin (HbA1).

Conclusions: MWGL showed an association between glycemia and prevalence of fungi. However, no relation was found between HbA1 and fungal infections in well controlled diabetic pregnancies.

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / microbiology*
  • Diabetes, Gestational / metabolism
  • Diabetes, Gestational / microbiology*
  • Female
  • Fungi / isolation & purification
  • Glycated Hemoglobin / metabolism
  • Humans
  • Mouth / microbiology
  • Mycoses / metabolism*
  • Mycoses / microbiology
  • Pregnancy
  • Pregnancy Complications, Infectious / metabolism
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy in Diabetics / metabolism
  • Pregnancy in Diabetics / microbiology*
  • Rectum / microbiology
  • Vagina / microbiology

Substances

  • Blood Glucose
  • Glycated Hemoglobin A