Candida albicans colonisation, continence status and incontinence‐associated dermatitis in the acute care setting: a pilot study

Abstract

Candida albicans is the most prevalent human fungal commensal organism and is reported to be the most frequent aetiological organism responsible for infection associated with incontinence-associated dermatitis. However, it remains unclear whether incontinence predisposes a patient to increased Candida colonisation or whether incontinence acts as a trigger for Candida infection in those already colonised. The purpose of this observational cross-sectional study was to estimate colonisation rates of C. albicans in continent, compared to incontinent patients, and patients with incontinence-associated dermatitis. Data were collected on 81 inpatients of a major Australian hospital and included a pelvic skin inspection and microbiological specimens to detect C. Albicans at hospital admission. The mean age of the sample was 76 years (SD = 12.22) with 53% being male. Incontinent participants (n = 53) had a non-significant trend towards greater Candida colonisation rates at the perianal site (43% versus 28%) χ (1, N = 81) = 4·453, p = ·638 and the inguinal site (24% versus 14%) χ (1, N = 81) = 6·868, p = ·258 compared to continent patients (n = 28). The incontinent subgroup with incontinence-associated dermatitis (n = 22) showed no difference in colonisation rates compared to those without incontinence-associated dermatitis. Understanding the epidemiology of colonisation may have implications for the prevention of Candida infection in these patients.

Towards an international language for incontinence-associated dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries

“…The assessment of clinical signs of infection was considered important and clinically relevant by the experts when categorizing IAD, as this affects the choice of intervention. This is in line with the high prevalence of cutaneous infections (between 19% and 63%) . Finally, because the purpose of the tool did not include risk assessment, category 0 was deleted.…”

“…Therefore, the skin is more permeable to irritants and pathogens . The most common microorganisms associated with IAD are Candida albicans, Escherichia coli and Clostridium difficile from the gastrointestinal tract, Pseudomonas aeruginosa and Staphylococcus aureus from the perineal skin …”

Anti‐fungal bandages containing cinnamon extract

“…Candida albicans is found in abundance in the human gut flora of around 50% of all healthy adults and is an opportunistic pathogenic yeast . C. albicans is known to cause human infections such as candidiasis, which occurs as a result of its overgrowth and is a contributing factor in tooth decay .…”

Design and psychometric testing of the attitude towards the prevention of incontinence‐associated dermatitis instrument (APrIAD)

“…The main symptoms of IAD are erythema and oedema, sometimes accompanied by bullae with serous exudates, erosion, or secondary cutaneous infection . Recent prevalence figures of IAD on hospital wards vary between 4.3% and 32.0% and in nursing homes between 5.2% and 5.5% …”

“…hospital wards vary between 4.3% and 32.0% [14][15][16][17] and in nursing homes between 5.2% and 5.5%. 18,19 The prevention of IAD focuses on maintaining or enhancing continence and reducing exposure of the skin to urine and faeces.…”