[Prevention of mycoses caused by yeasts]

The wide-spread ubiquitous occurrence of molds and great masses of aerial spores (conidia, arthrospores etc.) as well as of yeast species with facultative pathogenicity, renders prophylaxis of respective human infections caused by such opportunists, rather difficult. Suppression of such fungi and continuous surveillance of endangered patients require considerable efforts and costs. Adequate control is particularly cumbersome in Candida infections, since the causative yeasts may be considered as "normal" commensals of the mucous membranes in many individuals. Overt secondary infections are frequently of endogenous origin, hence the name "endomycoses" as introduced by Gemeinhardt (1976). Under particular conditions such as care for patients with extended burns, or patients after bone-marrow transplantation or irradiation of the whole body, or patients after joint surgery, the complete elimination of yeasts is just as essential as the antibacterial decontamination over a limited period of time. In other groups of individuals similar drastic measures of control against Candida albicans are not deemed necessary. Reduction of local Candida cell counts to amounts below the individual level of tolerance may be deemed sufficient. Since the level of tolerance is, however, extremely low in infants and in many patients of the intensive care wards, especially in cases of malignant immunocytomas and leukemias of various nature, prophylaxis by proper hygienic measures and eventual preventive antimycotic treatment is an integral part of proper control.