Candida balanitis: risk factors

Abstract

Background: The amount of available information on the prevalence and incidence of candida balanitis is still surprisingly scarce.

Objectives: To determine the prevalence of candida colonization and candida balanitis in men attending a Sexually Transmitted Diseases (STD) clinic. To identify risk factors associated with candida balanitis.

Methods: During a 36-month period, a cross-sectional study was carried out on consecutive men attendees of the STD clinic in Hospital S. João, Porto. Clinical and epidemiological data were recorded. Specimen collection from the glans penis and the coronal sulcus followed two procedures: a cotton tipped swab and the direct impression on the surface of CHROMagar Candida medium. Risk factors were considered singly and in combination through logistic regression models.

Results: Among 478 men enrolled, the prevalence of candida colonization was 26.2% and the prevalence of candida balanitis was 18%. Candida colonization was strongly associated with an age above 60 years (OR = 3.375; 95% CI: 1.547-7.362) and with the presence of other cause of balanitis apart from Candida organisms (OR: 2.466; 95% CI: 1.491-4.078). An age above 40 years (OR: 2.27; 95% CI: 1.005-4.500), diabetes mellitus (OR: 19.390; 95% CI: 7.789-48.273) and more than ten candida colonies recovered by culture (OR: 9.586; 95% CI: 2.682-34.263) were risk factors for candida balanitis.

Conclusions: This study highlights the impact of factors other than sexual behaviours upon the epidemiology of this infection. For both candida colonization and infection, age was an important risk factor. Diabetes mellitus was an independent risk factor for candida balanitis. More than ten colonies recovered from culture are associated with clinical signs and symptoms.