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[Candida infections and their evolution in patients receiving parenteral feeding]
Abstract:
Parenteral nutrition has completely modified the prognosis in a variety of illnesses of digestive tract. The method is not devoid of complications, and septicemias, particularly those originated by fungii of the Candida species, have been informed to occur with an alarming frequency of up to 23%. The patient on parenteral nutrition is an ideal prey for this kind of infection, but if the technic and the metabolic control are brought down considerably. In 30 patients of the Department of Gastroenterology at the Hospital General, Centro Médico Nacional, Instituto Mexicano del Seguro Social, we have studied the frequency and evolution of Candida infections, detected before or during the treatment with parenteral nutrition to know the influence of the method on this type of host-parasite relationship. In the initial cultures 60% of the patients develop Candida in one or several regions; percentage increased to 63.3% at the end of 15 days and decreased spontaneously to 33% at the end of the treatment on the 30 patients we did not observe a septicemia due to Candida. We conclude that parenteral nutrition, while correcting the nutritional state of the patient, with a good technic, favors the spontaneous withdrawal of the fungii, without the necessary specific treatment.
Insights
Parenteral nutrition can lead to Candida infections. However, good technique and metabolic control during parenteral nutrition may help patients clear Candida naturally without specific antifungal treatment.
Area of Science:
- Medical Mycology
- Gastroenterology
- Infectious Diseases
Context:
- Parenteral nutrition (PN) is crucial for managing digestive tract illnesses but carries risks, including a significant incidence of Candida species septicemia (up to 23%).
- Patients receiving PN are susceptible to fungal infections, especially with suboptimal technique or metabolic control.
- The study investigated Candida infections in patients undergoing PN at a major medical center.
Purpose:
- To determine the frequency and evolution of Candida infections in patients receiving parenteral nutrition.
- To understand the influence of PN on the host-parasite relationship with Candida species.
- To assess the impact of PN technique and metabolic control on Candida colonization and infection.
Summary:
- Initial cultures showed Candida in 60% of patients. This increased to 63.3% by day 15 but decreased to 33% by day 30.
- No cases of Candida septicemia were observed in the 30 patients studied.
- Candida colonization decreased spontaneously by the end of the PN treatment period.
Impact:
- Parenteral nutrition, when administered with proper technique and metabolic control, may promote the spontaneous clearance of Candida infections.
- This suggests that optimizing PN protocols could potentially reduce the need for specific antifungal treatments in certain patient populations.
- Further research is warranted to confirm these findings and elucidate the mechanisms behind spontaneous Candida withdrawal during PN.