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[Characteristics of fungus carriers as a source of infection]
1Sektion Mykologie, Universität Freiburg.
Abstract:
1. The great majority of Central Europeans is colonized by a commensal yeast flora, mostly Candida species. These colonized humans permanently liberate yeasts mainly via the faeces. 2. The commensal yeast flora in an individual is qualitatively and quantitatively stable for long periods. 3. The commensal yeast flora is not dangerous for the immunocompetent human and should not be drug-treated without indication. An eradication of the commensal yeast flora by non-resorbable polyene antimycotics is not possible. 4. Infectious complications of the intestinal tract are etiologically rarely caused by fungi. The diagnosis of an intestinal mycosis requires the exclusion of other more frequent etiological factors. The rate of Candida excretion in a human with Candida enteritis or Candida enterocolitis is higher than in healthy carriers. 5. The immunocompromised neutropenic risk patient is highly dangered by candidosis originating from the commensal yeast reservoir of the patient's own gastrointestinal tract or from the environment. 6. The faecal and, to a minor extent, the aerogenic excretion of commensal yeasts may cause anal-oral or oral-oral infections. Due to a relatively minor environmental resistance of the yeasts these infection chains are not stable and limited relating to space and time. Immunocompromised risk patients, however, being present in the vicinity of carriers are dangered. Prominent examples are the colonization of the gastrointestinal tract of newborns as well as the colonization of catheters in the intensive care wards. A preventive monitoring to interrupt infection chains may be necessary in this domain.