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Infantile diarrhoea and malnutrition associated with Candida in a developing community
L Klingspor1, G Stitzing, K Johansen
1Department of Paediatrics, Danderyd's Hospital, Stockholm, Sweden.
Insights
Candida species, particularly Candida tropicalis, were frequently found in infants with diarrhoea in Pakistan. Microscopic detection of Candida forms in stool was crucial, especially in malnourished infants under 8 months.
Area of Science:
- Pediatrics
- Mycology
- Infectious Diseases
Background:
- Infantile diarrhea is a significant health issue in developing communities.
- Malnutrition is prevalent in Lahore, Pakistan, potentially influencing gut microflora.
- The role of Candida species in infantile diarrhea requires further investigation.
Purpose of the Study:
- To investigate the association between infantile diarrhea and Candida species in Pakistani children.
- To identify the predominant Candida species and their morphological forms in fecal samples.
- To correlate Candida infections with clinical findings like malnutrition and age.
Main Methods:
- Stool samples were collected from 119 infants with diarrhea and 46 healthy controls.
- Samples were analyzed for yeasts, bacteria, viruses, and parasites.
- Microscopy and culture techniques were used to identify Candida species and their forms (pseudohyphae, blastospores).
Main Results:
- Candida was the most frequent microorganism in diarrhea cases (32%), with Candida tropicalis being dominant.
- Microscopic examination revealed Candida in 19% of cases where cultures were negative.
- Malnutrition (69%), young age (<8 months, 90%), and pseudohyphae (71%) were characteristic in Candida-only infections.
Conclusions:
- Candida species are significant in infantile diarrhea in this population.
- Microscopic detection of Candida forms is vital, especially when cultures are negative.
- Malnutrition and young age are key risk factors for Candida-associated infantile diarrhea.
Abstract:
The association of infantile diarrhoea with the occurrence of Candida species and their different morphological cell forms (pseudohyphae and/or blastospores) in faeces was studied in children of 0-15 months in a developing community (Lahore, Pakistan) where malnutrition is prevalent. Stool samples from 119 patients admitted to the Diarrhoea Treatment Unit, Department of Pediatrics, King Edward Medical College, and 46 healthy children were investigated for yeasts, bacteria, viruses and parasites. Salmonella and enteropathogenic Escherichia coli were seen in 13 (11%) each of the cases while Candida was the most frequent micro-organism, grown in cultures from 38 (32%) of the diarrhoea cases. C. tropicalis dominated (19%) over C. albicans (6%) and C. parapsilosis (3%). However, in a great number of cases (23, equals 19%), Candida did not grow in cultures but blastospores and/or pseudohyphae were seen on microscopical examination. Other Candida species and yeasts were relatively more common in the control group. Candida albicans, C. tropicalis and C. parapsilosis were the only identified agents in 23 of the cases (19%). The characteristic clinical findings in children with Candida as the only identified pathogen were malnutrition (69%), age less than 8 months (90%), and microscopically identified pseudohyphae in faecal smears (71%).