Role of Candida in Antibiotic-Associated Diarrhea.
Krause, Robert 1; Schwab, Egon 1; Bachhiesl, Daniela 1; Daxbock, Florian 1; Wenisch, Christoph 1; Krejs, Gunter J. 1; Reisinger, Emil C. 2
[Article] Journal of Infectious Diseases. 184(8):1065-1069, October 15, 2001.

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: 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.

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