Role of Candida in antibiotic-associated diarrhea.
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.
Krause
R
R
Department of Internal Medicine, Karl-Franzens University, A-8036 Graz, Austria. robert.krause@kfunigraz.ac.at
Schwab
E
E
Bachhiesl
D
D
Daxböck
F
F
Wenisch
C
C
Krejs
G J
GJ
Reisinger
E C
EC
D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002175:Candida / Q000145:classification / Q000254:growth & development / Q000302:isolation & purification*; D003967:Diarrhea / Q000139:chemically induced* / Q000188:drug therapy*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D012016:Reference Values
D000900:Anti-Bacterial Agents