Role of Candida in Antibiotic‐Associated Diarrhea

Abstract

To quantitatively assess the role of Candida species in antibiotic-associated diarrhea (AAD), stool samples from a total of 395 patients and control subjects were cultured in differential isolation medium: 98 patients had AAD, 93 patients were taking antibiotics but did not have diarrhea (A(+)D(-)), 97 patients were not taking antibiotics but had diarrhea (A(-)D(+)), and 107 patients were control subjects (A(-)D(-)). In addition, secreted aspartyl proteinase (Sap) production was tested. In AAD patients, Candida positivity (77/98) and Candida overgrowth (62/98) were not different from that among A(+)D(-) patients (75/93 [P= .860] and 52/93 [P= .375], respectively). Candida overgrowth among A(-)D(+) patients (40/97, P= .003) was less frequent than among AAD patients, but Candida positivity was not different (80/97, P= .612). In control subjects, Candida positivity and overgrowth were less common than in all other groups. Production of Sap did not differ between patients with AAD and control subjects (P= .568 and P= .590, respectively). Data indicate that elevated Candida counts are a result of antibiotic treatment or diarrhea rather than a cause of AAD.

Pathogenetische Bedeutung der intestinalen Candidabesiedelung

“…gegenüber der bakteriellen Darmflora, zu einer Überwuche-rung des Darmes mit Hefen kommen, so dass die Candidazahlen über 10 5 KBE/g Stuhl ansteigen; außerdem setzt vermehrte Mycelbildung ein [84,101,106,107,110,111,112,113,114,115,116,117]. Zur Bedeutung der bakteriellen Flora s. Levy [105].…”

Antidiarrheal Activity of Three Medicinal Plants in Swiss Albino Mice

“…[3,4] Diarrhea is a gastrointestinal tract (GIT) dysfunction, which is considered as a common symptom of infection and one of the causes of intestinal motility disorder. [5] It causes loss of water and important nutrients from GIT in addition to increasing intestinal motility.…”

Antibiotic-associated diarrhea

“…durch die Antibiotikatherapie bzw. durch den Durchfall selbst begünstigt werden und nicht umgekehrt (4). Es wurde gezeigt, dass Candida in Stuhlflüssig-keit von AAD-Patienten besser wächst als in der Stuhlflüssigkeit von gesunden Patienten (6).…”