Impact of antibiotic use on fungus colonization in patients hospitalized due to fever

Min-Yi Huang, Jen-Hsien Wang
Section of Infectious Diseases, Department of Internal Medicine, China Medical College Hospital, Taichung, Taiwan, ROC

Invasive candidiasis is an opportunistic infection that occurs in medical and surgical patients and carries a high mortality rate. Because its process always follows from colonization to amplification and to invasion, understand the colonization status is important to understand the likelihood of invasion. Screening for fungal colonization was performed with specimens from urine, throat, anus, and skin in 314 patients admitted for fever both before and after antibiotics treatment was administered. Throat (45%) and anus (43%) had the highest colonization rates. Only 7% of patient had fungal colonization on the skin. Candida albicans was the most frequently colonized species in throat (79%) and anus (70%). Colonized fungal species on skin were diverse, including Candida parapsilosis (33%), C. albicans (29%), and molds (24%). Sex (M:F ratio, 49.7:50.3) was not a factor in fungal colonization, but aging was associated with increased colonization rate. Forty-five patients received antibiotics treatment for more than 2 weeks and second surveillance cultures were taken at the end of the second week. Antibiotics treatment was associated with increased frequency of colonization (p=0.02), but the fungal species distribution pattern remained unchanged after antibiotic treatment.

J Microbiol Immunol Infect 2003;36:123-128.