title: 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%) χ2(1, N = 81) = 4·453, p = ·638 and the inguinal site (24% versus 14%) χ2(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.
authors.affiliation: Skin Integrity Service, Royal Brisbane and Women's Hospital, Metro North Hospital Health Service, Herston, Queensland,, Australia.|School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland,, Australia.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Campbell
authors.affiliation: School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland,, Australia.|Joint Appointment Intensive Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland,, Australia.|University of Huddersfield, UK.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Coyer
authors.affiliation: Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Metro North Hospital Health Service, Herston, Queensland,, Australia.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Mudge
authors.affiliation: Department of Dermatology, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Herston, Queensland,, Australia.
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Robertson
authors.affiliation: School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland,, Australia.|Australian Centre for Health Services Innovation (AusHSI), School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland,, Australia.|Visiting Research Fellow, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland,, Australia.
authors.forename: Sonya R
authors.initials: SR
authors.lastname: Osborne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D001315:Australia; D002176:Candida albicans / Q000187:drug effects* / Q000472:pathogenicity*; D064648:Critical Care Nursing; D003430:Cross-Sectional Studies; D003872:Dermatitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014549:Urinary Incontinence / Q000150:complications* / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents
keywords: Candida albicans; colonisation; cross-sectional study; incontinence; incontinence-associated dermatitis