Yeast Infection - Pathology
Antibiotics
updated: 13 March 2009
Speciation of fecal Candida isolates in antibiotic-associated diarrhea in non-HIV patients
Jpn J Infect Dis. 2008 Jan;61(1):1-4
Vaishnavi C, Kaur S, Prakash S.
Candida is the most frequently encountered fungal infection of the gastrointestinal tract after antibiotic exposure. The pathogenesis of Candida probably varies with each species. The speciation of fecal Candida after antibiotic use is not well investigated. One hundred and eleven fecal samples negative for Clostridium difficile toxin and for other enteric pathogens formed the basis of our investigation. The diarrheic samples came from patients receiving antibiotics in a hospital setting. In addition, samples from 30 age-matched healthy participants who did not receive antibiotics and did not have diarrhea were also studied. Initially, a Gram stain identification for yeasts was performed for each fecal sample, then each sample was cultured on Sabouraud's dextrose agar. Candida was isolated as pure growth (>10(5) cfu/ml) from the stools of 32 (28.8%) patients. The identification of the yeast was done based upon a combination of morphological, physiological and biochemical criteria. The predominant isolates were C. tropicalis (n=16), C. albicans (n=14) and C. krusei (n=2). Candida isolated from healthy participants (n=4) was sparse and therefore not speciated. Different Candida spp. may play an important role in precipitating antibiotic-associated diarrhea
Publication Types:
Online - Article
Fungal esophagitis
Orv Hetil. 2002 Jul 21;143(29):1731-6
Péter Z, Telegdy L.
The gastrointestinal mucosa is one of the principal portal of entry in systemic fungal infections. Esophagitis is the most frequent among the fungal infections of the gastrointestinal tract. The etiologic factors of fungal infections are various Candida species, most frequently Candida albicans. Due to the large number of asymptomatic patients, great attention should be paid to the predisposing factors (AIDS, cancer, antibiotic or steroid therapy). The diagnosis is based on the endoscopic picture, microscopic examination and culture of the mucosal brushings, and histological examination of the esophageal mucosa. The treatment is based on azol derivates, mainly fluconazole. In fluconazole resistant cases amphotericin B is the drug of choice. The rare complications are perforation, bleeding and stricture.
Publication Types:
Online - Abstract
Antibiotic-associated diarrhea: candidate organisms other than Clostridium difficile
Korean J Intern Med. 2008 Mar;23(1):9-15
Song HJ, Shim KN, Jung SA, Choi HJ, Lee MA, Ryu KH, Kim SE, Yoo K.
BACKGROUND/AIMS: The direct toxic effects of antibiotics on the intestine can alter digestive functions and cause pathogenic bacterial overgrowth leading to antibiotic-associated diarrhea (AAD). Clostridium difficile (C. difficile) is widely known to be responsible for 10 approximately 20% of AAD cases. However, Klebsiella oxytoca, Clostridium perfringens, Staphylococcus aureus, and Candida species might also contribute to AAD. METHODS: We prospectively analyzed the organisms in stool and colon tissue cultures with a C. difficile toxin A assay in patients with AAD between May and December 2005. In addition, we performed the C. difficile toxin A assays using an enzyme-linked fluorescent assay technique. Patients were enrolled who had diarrhea with more than three stools per day for at least 2 days after the initiation of antibiotic treatment for up to 6 approximately 8 weeks after antibiotic discontinuation. RESULTS: Among 38 patients (mean age 59 +/- 18 years, M:F =18:20), the organism isolation rates were 28.9% (11/38) for stool culture, 18.4% (7/38) for colon tissue cultures and 13.2% (5/38) for the C. difficile toxin A assay. The overall rate of identification of organisms was 50.0% (19/38). Of the five patients that had a positive result by the C. difficile toxin A assay, two had no organism isolated by the stool or colon tissue culture. The organisms isolated from the stool cultures were C difficile (4), Klebsiella pneumoniae (K. pneumoniae) (3), Candida species (3), and Staphylococcus aureus (1). C. difficile (4) and K. pneumoniae (3) were isolated from the colon tissue culture. CONCLUSIONS: For C. difficile negative AAD patients, K. pneumoniae, Candida species and Staphylococcus aureus were found to be potential causative organisms.
Publication Types:
Online - Abstract
Antibiotic associated diarrhoea: Infectious causes
Indian J Med Microbiol. 2003 Jan-Mar;21(1):6-11
Ayyagari A, Agarwal J, Garg A.
Nearly 25% of antibiotic associated diarrhoeas (AAD) is caused by Clostridium difficile, making it the commonest identified and treatable pathogen. Other pathogens implicated infrequently include Clostridium perfringens, Staphylococcus aureus, Klebsiella oxytoca, Candida spp. and Salmonella spp. Most mild cases of AAD are due to non-infectious causes which include reduced break down of primary bile acids and decrease metabolism of carbohydrates, allergic or toxic effects of antibiotic on intestinal mucosa and pharmacological effect on gut motility. The antibiotics most frequently associated with C. difficile associated diarrhoea are clindamycin, cephalosporin, ampicillin and amoxicillin. Clinical presentation may vary from mild diarrhoea to severe colitis and pseudomembranous colitis associated with high morbidity and mortality. The most sensitive and specific diagnostic test for C. difficile infection is tissue culture assay for cytotoxicity of toxin B. Commercial ELISA kits are available. Though less sensitive, they are easy to perform and are rapid. Withdrawal of precipitating antibiotic is all that is needed for control of mild to moderate cases. For severe cases of AAD, oral metronidazole is the first line of treatment, and oral vancomycin is the second choice. Probiotics have been used for recurrent cases.
Publication Types:
Online - Article
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