Candida spp. and Clostridium difficile toxin-negative antibiotic-associated diarrhoea

Unexplained Diarrhoea, Candida in the Faeces

“…Several authors conclude that their findings support an association between intestinal Candida overgrowth and diarrhoea [29,30,38], especially after treatment with antifungal medication [5,49]. In a prospective case-controlled study on hospitalacquired diarrhoea in adults, Zaidi et al [50] performed a multivariate logistic regression analysis and even found an odds ratio of 18.09 for the presence of faecal Candida-overgrowth and/or mycelia forms in his patient-population.…”

“…The diagnosis of Candida as a cause of unexplained diarrhoea requires the exclusion of other etiological factors [20]. Furthermore, faecal Candida counts should exceed 10 5 ± 10 6 cfu/gram faeces [3,5,8,13,30,38] and especially the presence of mycelial forms is thought to be associated with clinical symptoms [23, 30, 39 ± 41].…”

Candida and antibiotic-associated diarrhoea

“…In one study, five of seven patients with Candida overgrowth and AAD were treated successfully with nystatin [1]. In another study, two of nine patients with AAD and Candida overgrowth received nystatin, and their stools solidified within 6 days [4]. Among a further ten patients with diarrhoea and Candida in their stools, all responded to nystatin treatment [3].…”

“…Reported cases of AAD associated with Candida that responded to antifungal treatment, and the presence of high faecal counts of Candida ( ‡ 10 5 CFU ⁄ mL stool) in patients with AAD, supported this association. However, the publication of a few anecdotal case reports of suspected Candida-associated AAD failed to establish convincingly that Candida may be a causative agent of AAD [1][2][3][4], and several recent studies have attempted to elucidate the relationship between Candida spp. and AAD in more detail.…”

Methods for detection of an intestinal secretory immunoglobulin A response to Candida spp. and their preliminary application in human immunodeficiency virus-infected patients with chronic diarrhea

“…Despite reports suggesting a role for Candida spp. in cases of diarrhea in normal individuals, malnourished children, debilitated hospitalized patients, and elderly patients on antibiotics (3,4,7,10), much of the evidence still remains debatable (2). Recently, Candida spp.…”