The pathogenetic significance of intestinal Candida colonization – A systematic review from an interdisciplinary and environmental medical point of view

Lacour, Michael; Zunder, Thomas; Huber, Roman; Sander, Anna; Daschner, Franz; Frank, Uwe

doi:10.1078/1438-4639-00159

Cited by 40 publications

(20 citation statements)

References 77 publications

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“…However, more recent clinical studies examining fecal loads have demonstrated increased Candida levels with antibotic treatment (101). Overgrowth may facilitate localized mucosal infection and/or generalized GI tract disturbances, but the validity of GI candidiasis via overgrowth as a clinical entity is controversial (102,103). This has been difficult to verify due to the lack of specific symptoms (belching, bloating, indigestion, nausea, diarrhea, and gas) and lack of diagnostic tests.…”

Section: Non-cd4mentioning

confidence: 99%

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

et al. 2016

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f Historically, the nature and extent of host damage by a microbe were considered highly dependent on virulence attributes of the microbe. However, it has become clear that disease is a complex outcome which can arise because of pathogen-mediated damage, host-mediated damage, or both, with active participation from the host microbiota. This awareness led to the formulation of the damage response framework (DRF), a revolutionary concept that defined microbial virulence as a function of host immunity. The DRF outlines six classifications of host damage outcomes based on the microbe and the strength of the immune response. In this review, we revisit this concept from the perspective of Candida albicans, a microbial pathogen uniquely adapted to its human host. This fungus commonly colonizes various anatomical sites without causing notable damage. However, depending on environmental conditions, a diverse array of diseases may occur, ranging from mucosal to invasive systemic infections resulting in microbe-mediated and/or host-mediated damage. Remarkably, C. albicans infections can fit into all six DRF classifications, depending on the anatomical site and associated host immune response. Here, we highlight some of these diverse and site-specific diseases and how they fit the DRF classifications, and we describe the animal models available to uncover pathogenic mechanisms and related host immune responses.

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Section: Non-cd4mentioning

confidence: 99%

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

et al. 2016

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“…Most importantly, fungal colonization occurred very rarely. Indeed, Candida albicans, which has been implicated in the pathogenesis of antibiotic-associated diarrhea [82,83], was isolated from the fecal samples of only 2 out of 10 patients given 1,200 mg of rifaximin daily [81] and in none of the volunteers taking 800 mg daily [82].…”

Section: In Vivo Activitymentioning

confidence: 99%

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

2005

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Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo- [5,4-c]-rifamycin SV) is a synthetic antibiotic designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a nonsystemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually nonabsorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimal inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents, therefore, the primary therapeutic target and GI infections the main indication. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease. Potential indications include the irritable bowel syndrome and chronic constipation, Clostridium difficile infection and bowel preparation before colorectal surgery. Because of its antibacterial activity against the microorganism and the lack of strains with primary resistance, some preliminary studies have explored the rifaximin potential for Helicobacter pylori eradication. Oral administration of this drug, by getting rid of enteric bacteria, could also be employed to achieve selective bowel decontamination in acute pancreatitis, liver cirrhosis (thus preventing spontaneous bacterial peritonitis) and nonsteroidal anti-inflammatory drug (NSAID) use (lessening in that way NSAID enteropathy). This antibiotic has, therefore, little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. Although rifaximin has stood the test of time, it still attracts the attention of both basic scientists and clinicians. As a matter of fact, with the advancement of the knowledge on microbial-gut interactions in health and disease novel indications and new drug regimens are being explored. Besides widening the clinical use, the research on rifaximin is also focused on the synthesis of new derivatives and on the development of original formulations designed to expand the spectrum of its clinical use.

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“…Most importantly, fungal colonization occurred very rarely. Indeed, Candida albicans, which has been implicated in the pathogenesis of antibiotic-associated diarrhea [64], was isolated from the fecal samples of only 2 out of 10 patients given 1,200 mg of rifaximin daily [63] and in none of the volunteers taking 800 mg daily [65]. …”

Section: Antimicrobial Activitymentioning

confidence: 99%

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

Scarpignato

Pelosini²

2006

Digestion

101

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Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo [5,4-c]rifamycin SV) is a product of synthesis experiments designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a non-systemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually non-absorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimum inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents therefore the primary therapeutic target and GI infections the main indication. This antibiotic has therefore little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease.

show abstract

The pathogenetic significance of intestinal Candida colonization – A systematic review from an interdisciplinary and environmental medical point of view

Cited by 40 publications

References 77 publications

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

Experimental and Clinical Pharmacology of Rifaximin, a Gastrointestinal Selective Antibiotic

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